Prescription Database Privacy Case Heads For Legal Showdown
California Supreme Court will decide whether the state's medical board breached patient privacy when it used data from a state prescription database to discipline a physician.
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To combat "doctor shopping," "pill mills," and addiction to medications such as pain and anti-anxiety pills, many states have created databases that track the doctors who prescribe and patients who take these medications. Used by pharmacies and practices to ensure consumers aren't seeing multiple physicians to get controlled substances, these databases also have become a tool for law enforcement -- and at least one medical board's investigative arm.
But could investigators' access to these records, which also include non-controlled medications, jeopardize patient privacy, especially when data segues from deidentified to clearly identified information and patients are called upon to hand over their complete medical records as part of an investigation? How are patients affected? And could the evolving new healthcare model -- which demands more synergies between clinicians and consumers -- be damaged if doctors cannot openly discuss topics such as weight?
At issue: In 2012, Lewis received his second amended accusation in two years based on one patient's complaint about the quality of care she allegedly received from him, in part related to comments the doctor reportedly made about her weight (which he denied).
As part of its investigation into the physician who's known for his "Five Bite Diet," the Medical Board researched Lewis' prescribing history by searching prescription drug monitoring program (PDMP) known as CURES -- the Controlled Substance Utilization Review and Evaluation System -- which electronically captures data on all controlled medications prescribed in the state.
Covered by HIPAA, the database includes more than 100 million entries of controlled substances dispensed in California and the database responds to more than 60,000 requests from practitioners and pharmacists annually, according to the California Department of Justice, which operates and maintains the PDMP. During the search, the Medical Board homed in on a handful of patients and requested further information on their prescription and medical histories via administrative subpoena, The Recorder reported.
"His disciplinary order and the 26-page accusation information is all the we can share at this time," a Medical Board spokeswoman told InformationWeek. "The CURES system is not operated by us, it is operated by the DOJ. We are currently working to get physicians registered into the system so they can use it as a tool."
An administrative law judge found Lewis engaged in unprofessional conduct by failing to keep adequate records with the first plaintiff. The judge determined Lewis had overprescribed controlled substances for two other patients for a short period; the doctor, however, had not repeatedly overprescribed or given dangerous drugs without a prescription, the Recorder wrote. As a result, Lewis was disciplined and placed on probation for two years.
When they receive controlled substances, patients are -- or should be -- aware they could come under government surveillance, the court argued. The database was designed so healthcare officials could search, in real-time, for
Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio
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