Prescription Database Privacy Case Heads For Legal Showdown - InformationWeek
Healthcare // Security & Privacy
09:36 AM

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.

Mental Health Tools: From Office To Pocket
Mental Health Tools: From Office To Pocket
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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?

California's Supreme Court is expected to address these questions when it hears the case of Dr. Alwin Carl Lewis v. the Superior Court and Medical Board of California in 2015.

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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.

(Source: Dominique Godbout/Flickr)
(Source: Dominique Godbout/Flickr)

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

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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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User Rank: Apprentice
10/10/2014 | 6:18:35 PM
CURES Database - ONLY Controlled Substances
This article is filled with inaccuracies and hysteria.  Obviously, these people have never signed into the CURES data base to see the information it actually contains or the reports that are generated.  It is ONLY controlled substance prescriptions; NOTHING else.  The CDC issued a newsletter in July about the nationwide epidemic of opioid and controlled substance abuse that is a real problem we need to address as a nation.  Forty nine of our 50 states have these programs because more people are dying everyday of prescription drug overdoses than illegal drug overdoses.  Think about it!  Who is enabling all these controlled substance prescriptions?  This problem can be solved.  Also think about why they call them "controlled substances".  It because they are tracked in order to control misuse and abuse by patients and prescribers.  If you are taking these drugs or prescribing these drugs in a rational manner, you have nothing to be afraid of.  If you are abusing these drugs or prescribing them in an unscrupulous manner, you should be very afraid - you will be found out and dealt with accordingly.  Several states have now mandated that prescribers MUST review their state controlled substance database before writing controlled substance prescriptions in order to identify abusers that need help with substance abuse and not further enable them.  Many states have the ability to to do searches of multiple state databases because drug seeker are known to cross state lines just to get more.
User Rank: Ninja
10/9/2014 | 12:49:59 PM
Re: Prescription Database Privacy Case Heads For Legal Showdown
The prescription database is the best thing that could happen to protect both the physicians and the patients alike. It will put an end to doctor shopping, illicit prescription drug sales, overdoses, physician fraud, etc.
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