PDMP on Life Support

Attached a link to an article published in today’s Miami Herald titled “Statewide pain-clinic database may be abolished” focusing on efforts to shut down the Prescription Drug Monitoring Program (PDMP)in Florida. On Monday, the Florida Department of Health will hold a workshop in Tallahassee to discuss further limiting access to records of who writes and fills prescriptions for the most addictive drugs. The meeting comes in response to allegations last month that medical data for 3,300 Floridians had been “leaked.” The American Civil Liberties Union of Florida demanded a federal investigation, and critics pointed to the incident as evidence that the system was fundamentally flawed and had allowed an inevitable breach of privacy. It also proved a rare point of agreement between the ACLU and conservative lawmakers who have opposed the database for years, even as Florida gained a reputation as ground zero of a deadly prescription drug abuse epidemic. “I think this leak by the PDMP proves it is a risk for patients,” said state Rep. Rob Schenck, R-Spring Hill. “We should do away with the whole database.” But the leak is not due to a design flaw of the PDMP but the inappropriate use and misuse of data downloaded from the database. In this case a DEA agent queried the program for names of the doctors’ patients and got about 3,300 in return. That request led to six arrests, seven people whose identities had been stolen and 63 fake names used to get fraudulent prescriptions. The names of all those patients, including those not under investigation, were provided on computer discs to prosecutors and to the defense attorneys of those charged. They included clear warnings that the records were confidential. But one of those defense attorneys recognized a name on the disc — fellow lawyer Michael Lambert — and gave him a copy of all the names, despite the confidentiality warning. Lambert filed a lawsuit, alleging that law enforcement should never have received information about innocent patients. He demanded an injunction and asked the court to determine if the program is “an unconstitutional infringement upon the fundamental rights of the plaintiff and other Florida citizens.” In a subsequent complaint to the U.S. Department of Health and Human Services, the ACLU of Florida echoed Lambert’s objections. But no one asked an obvious question: was the “leak” made by the agent who included the names on the disc, or by the attorney who gave the disc to Lambert? As a result of this data leak Florida legislators and the ACLU are calling for the dismantling of the PDMP. Would Florida lawmakers also call for the dismantling of the electronic banking system because bank employees have access to financial data and some may even abuse this privilege? Lets not forget that the program is already on life support receiving a measly $500,000 annual funding out of a $74 billion budget, which was only granted in the final night of the 2013 session. In my professional experience the PDMP provides for accountability and transparency in the prescribing process for controlled substances. In my medical practice I identified at least a dozen patients who received controlled substances from several physicians and NONE of those colleagues were aware of it. Several of those prescriptions, if not identified, could have triggered accidental overdose and death. Instead of dismantling the system we should expand the program, fund an awareness campaign to educate physicians on how to use the program and to increase security measures to ascertain patient privacy. Now is not the time for rash decisions but rational thought and measured decision making. Lets not throw out the baby with the bath water. The PDMP save lives! Yours Bernd