Drug track­ing sys­tem has tech snag

Some providers won’t be able to ac­cess state data­base meant to de­ter over­doses and over­pre­scrib­ing.

Los Angeles Times - - CALIFORNIA - By Me­lanie Ma­son

SACRA­MENTO — As the state pre­pares to un­veil an en­hanced pre­scrip­tion drug data­base next week, some health providers say it will be in­com­pat­i­ble with their com­puter sys­tems, hob­bling their ac­cess to a tool meant to com­bat drug abuse.

The data­base, called the Con­trolled Sub­stances Uti­liza­tion Re­view and Eval­u­a­tion Sys­tem, or CURES, tracks pre­scrip­tions for cer­tain nar­cotics. Af­ter a Times in­ves­ti­ga­tion found that it was un­der­used and un­der­funded, leg­is­la­tors in­creased fund­ing for the sys­tem in 2013.

The $ 3- mil­lion up­grade is set to roll out July 1, but a com­pat­i­bil­ity prob­lem with cer­tain Web browsers may make it im­pos­si­ble for some doc­tors to use it. The Cal­i­for­nia Med­i­cal Assn. sent a memo to its mem­bers last week warn­ing that thou­sands of physi­cians could lose ac­cess to the sys­tem.

The new ver­sion of CURES will not work with

older ver­sions of In­ter­net Ex­plorer.

Some health sys­tems say newer browsers will not work with their elec­tronic records.

That’s the case for Kaiser Per­ma­nente, said Amy Thoma, a spokes­woman for the com­pany, which em­ploys more than 12,000 doc­tors statewide and op­er­ates 35 hos­pi­tals.

David Bel­tran, a spokesman for the state Depart­ment of Jus­tice, which ad­min­is­ters CURES, said doc­tors and hos­pi­tals had am­ple no­tice about the po­ten­tial prob­lem and plenty of time to up­date their sys­tems.

The depart­ment “no­tif ied physi­cians months ago that ac­cess­ing CURES 2.0 would re­quire an up- to- date browser, which is crit­i­cal to en­sur­ing the high­est pro­tec­tion of pa­tient in­for­ma­tion,” Bel­tran said.

Other net­works af­fected in­clude Dig­nity Health, which op­er­ates 39 hos­pi­tals and eight phar­ma­cies, and Sut­ter Health, which has 24 hos­pi­tals and 5,000 af­fil­i­ated doc­tors.

Bill Glee­son, vice pres­i­dent of com­mu­ni­ca­tions for Sut­ter, said the com­pany will use Google’s Chrome browser with CURES in the short term, “as we make the nec­es­sary longer- term up­grades to In­ter­net Ex­plorer.”

State of­fi­cials plan to launch the up­graded data­base as planned but will also con­tinue to op­er­ate the older ver­sion for doc­tors who can­not ac­cess the new one.

Back­ers of drug data­bases like CURES say they are ef­fec­tive in clamp­ing down on pa­tients who seek nar­cotics pre­scrip­tions from mul­ti­ple doc­tors and in iden­ti­fy­ing physi­cians who over­pre­scribe such med­i­ca­tion.

But a 2012 Times in­ves­ti­ga­tion found that less than 10% of physi­cians, pharma- cists and other pro­fes­sion­als el­i­gi­ble for online ac­cess had signed up to use the data­base. The Times re­ports, which ex­am­ined the epi­demic of pre­scrip­tion drug over­doses, prompted new state ef­forts to com­bat the abuse of painkillers.

A 2013 law re­quired health prac­ti­tion­ers who pre­scribe or dis­pense cer­tain nar­cotics to ap­ply for online ac­cess to the data­base by the end of this year. That leg­is­la­tion also in­creased CURES’ fund­ing with a $ 6 an­nual fee levied on doc­tors.

But ef­forts to bol­ster CURES in Cal­i­for­nia re­main po­lit­i­cally fraught.

Although the Cal­i­for­nia Med­i­cal Assn. backed the 2013 leg­is­la­tion, the group op­poses ef­forts to make use of the data­base manda­tory, ar­gu­ing that the sys­tem has so far not been func­tional enough to im­pose such a re­quire­ment on doc­tors.

Manda­tory use of CURES was one com­po­nent of a bal­lot ini­tia­tive that vot­ers re­jected last year, a pro­posal to in­crease lim­its on med­i­cal mal­prac­tice awards and in­sti­tute drug test­ing of physi­cians. In one provoca­tive ad against the mea­sure, op­po­nents al­leged that the data­base could be vul­ner­a­ble to hack­ers and thus jeop­ar­dize pa­tient pri­vacy.

A bill in the Leg­is­la­ture that would re­quire doc­tors to check CURES be­fore pre­scrib­ing cer­tain drugs has been de­layed un­til next year.

Bob Pack, an In­ter­net ex­ec­u­tive who has cham­pi­oned the up­grade, said the con­cerns about tech­nol­ogy are “overblown.”

“I see it as a way for the CMA to con­tin­u­ally blast the CURES pro­gram,” said Pack, who took up the cause af­ter his two chil­dren were killed by an im­paired driver who had ob­tained mul­ti­ple pre­scrip­tions for painkillers.

Molly Weedn, a spokes­woman for the as­so­ci­a­tion, said that “CMA and our physi­cians have long sup­ported the CURES pro­gram.”

She said the de­ci­sion to run both the old and new data­bases con­cur­rently was a “step in the right di­rec­tion,” but added, “We’re go­ing to push back un­til the pro­gram is fully func­tion­ing and works for ev­ery­body.”

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