We recently reported on the rising incidence of prescription drug abuse in the United States, which has led to an increase in overdose-related hospitalizations. Patients can choose from any number of tactics to illegally obtain medications: They may steal drugs, purchase them online, forge a prescription, edit an existing prescription, or call in a phony prescription and give their own phone number.
Another type of prescription drug fraud is known as “doctor shopping,” in which patients hop from one physician to another, collecting multiple prescriptions for the same drug. Former child actor Corey Haim, who died in March, managed to accumulate prescriptions for up to 553 drugs in the last year of his life. Investigators say Haim visited several emergency rooms or urgent care clinics complaining of injury or depression. The official cause of death has not been announced; toxicology reports are still pending.
Although doctor shopping makes up a small percentage of prescription fraud incidents, CNN reports that government officials and healthcare providers are concerned. More than 30 states now have prescription monitoring programs that allow doctors to find out which drugs a patient has purchased in the past six months to a year (although some patients try to cheat the system by using fake identities or buying drugs in different states). A database in the state of Ohio indicated that almost 19,000 people obtained prescriptions from 10 or more doctors in 2009, although the number of doctors visited isn’t enough evidence to brand someone an addict. One provider of prescription monitoring software is BioScriptRx. The company’s software relies upon fingerprinting technology instead of identifiable patient information.
Pharmacies and physicians can also keep track of prescriptions through the use of electronic prescribing (e-prescribing) software. In addition to verifying a patient’s medication history, physicians can use e-prescribing software to directly issue prescriptions and request refills. experts believe that e-prescribing software has the potential to reduce incidences of prescription fraud as well as decrease the risk of medication error due to illegible handwritten prescriptions, alert healthcare providers to drug interactions and allergies on a patient’s record, improve compliance by eliminating the need for patients to physically drop off prescriptions at the pharmacy, and improve efficiency by automating the refill process. Kryptiq and AllScripts are two companies working in this space. Another company, SureScripts, operates a nationwide e-prescribing network that connects pharmacists, payers and healthcare providers. Among its members are a number of major insurance companies and retail pharmacies.
Some barriers are preventing the widespread adoption of e-prescribing software, Federal Computer Week reported in January. Industry experts cited reliability issues related to network outages and outdated medication information on patient profiles. Another obstacle to e-prescribing was removed in March aby the Drug Enforcement Administration, when the federal agency issued an interim rule allowing the electronic prescribing of controlled substances such as Oxycontin. Previous federal regulations had prohibited doctors from issuing electronic controlled substance prescriptions, forcing many healthcare practitioners to maintain two separate prescribing systems: one digital, one paper.
An estimated 191 million e-prescriptions were issued in 2009, nearly three times as many as were issued the previous year. The new interim rule regarding controlled substances is expected to increase the adoption of e-prescribing software among healthcare providers, according to the Wall Street Journal. In turn, the move toward e-prescribing software may lead to the wider use of electronic medical records. The Center for Medicaid Services has shown its support for paperless prescriptions by giving bonuses to doctors who use e-prescribing software. In 2012, the agency will start penalizing doctors who haven’t made the switch.
We’d like to hear your opinion on e-prescribing software. Will it help cut down on prescription fraud? What other measures or tactics are effective at preventing the practice of doctor shopping?