Missouri health care providers will now track patient’s prescriptions

Ted BojorquezJuly 5, 2023

Abortion medicine pills drugs pharmacy pharmaceutical medication allergies store over the counter prescription prescribed — (AP Photo/Charlie Riedel, File)

JEFFERSON CITY, Mo. – Within the coming weeks, Missouri health care providers will be able to track a patient’s prescriptions with the goal of preventing overdoses and opioid abuse.

Missouri is the last state in the nation to create a statewide prescription drug monitoring program. Roughly 75 counties already have a database in place, but following a law passed in 2021, all providers will be required to submit patient information or be penalized.

“Ultimately, it is to provide the best care for the patient and decrease loss of life in the state of Missouri,” Dean Linneman, executive director of the program, said.

Overseen by a taskforce of licensed healthcare professionals, Missouri’s new prescription drug monitoring program (PDMP) will allow physicians and pharmacists to track a patient’s prescriptions.

“It will alert the providers saying, we had morphine equivalents earlier, if it gets into a certain range, this will be something that is red flagged, hey physician, hey dentist, hey prescriber, this is something you need to be aware of, so you can rethink this, have this conversation with this patient,” Linneman said.

Linneman, the former director of the Department of Health and Senior Services (DHSS) Division of Regulation and Licensure, which oversees licensing components for hospitals, long-term care facilities, nursing homes, and childcare facilities, said the state is currently in the implementation phase. About 85% of the state’s population uses a database from St. Louis County.

“We’re working through some processes with St. Louis County to get that information transferred over,” Linneman said. “So, there is additional 30 to 40 counties that we’re going to need that full training to get their systems set up where they can submit the data to the program.”

Back in January, Linneman said the state awarded the contract to Kentucky-based Bamboo Health, which already oversees the St. Louis County program.

The program will not track all prescriptions. The drugs are based off of the ability to become addictive or probability of abuse and include Schedule II, III, and IV controlled substances.

Schedule II drugs are considered a high potential for abuse and lead to severe psychological or physical dependence and are considered dangerous. Those substances include:

Morphine
Vicodin
Oxycontin
Methadone
Hydromorphone (Dilaudid)
Fentanyl
Methamphetamine

Schedule III drugs may lead to moderate or low physical dependence or high psychological dependence and include:

Tylenol with codeine
Ketamine
Anabolic steroids
Testosterone

Schedule IV drugs are substances or chemicals with a low potential for abuse and low risk of dependence and include:

Xanax
Soma
Darvocet
Valium
Ativan
Ambien

The data collected in the program will include things like the type of prescription, the amount, whether it was a new prescription or a refill, the and the provider who prescribed it. The information would only be kept for three years and cannot be used to obtain a search warrant or arrest.

Linneman told the Substance Abuse Prevention and Treatment Task Force last month, the state is still working on an exact go-live date for the program since the state needs agreement from the counties who already are using St. Louis County’s PDMP to transfer over data.

“Once that’s able to be determined, about four, five, or six weeks prior to that go-live date, we’ll start our communication campaign, which is already kind of on-hold,” Linneman said.

The program is supposed to reduce doctor-shopping by patients who are seeking multiple prescriptions for painkillers. In 2021, 2,163 Missourians died from an overdose, that’s nearly 300 more deaths from 2020 when 1,879 people died.

The big picture is to save lives,” Linneman said. “We want to make sure the providers, the dispensers have the ability to look at what they are prescribing, what they are dispensing, with the history of the patient they are providing the prescription too.”

According to the Centers for Disease Control and Prevention (CDC), in 2016 Missouri averaged 80.4 opioid prescriptions per 100 people. Four years later in 2020, the rate was down to 54.4.

Under the law, once the state’s PDMP is up and running, which Linneman expects to happen this fall, St. Louis County’s program will dissolve. When signing the budget into law last week, the governor approved to spend roughly $2 million for the database.

If a provider does not upload a patient’s information to the database, he or she could be fined up to $1,000.

Linneman has previously said the state, law enforcement or licensing boards will not have access to the information. Sen. Holly Thompson Rehder, R-Sikeston, tried for nearly a decade to get the legislation across the finish line. Governor Mike Parson signed the bill into law in June 2021. The bipartisan legislation received pushback for years, with some concerned it would affect their ability to own a firearm and the privacy concerns when it comes to companies collecting medical information.

The Joint Oversight Task Force for Prescription Drug Monitoring is made up of six members: two from the Missouri Board of Registration for the Healing Arts, two from the Missouri Pharmacy Board, the state’s dental board, and one from the Missouri Board of Nursing.

Ted BojorquezJuly 5, 2023