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Published Online: 18 July 2008

Calif. Online Database Will Reduce 'Doctor Shopping'

California is the latest to join a roster of states that are establishing a quick online resource to allow physicians and pharmacies to check whether a patient is “doctor shopping” for addictive medications.
The state announced plans in June to launch a $3 million online database of controlled-medication prescriptions by next year. The system is an upgrade of the existing phone- and fax-based system that contains 86 million records of schedule II, III, and IV prescriptions dispensed in California.
“If California puts this information online, with real-time access, it will give authorized doctors and pharmacies the technology they need to fight prescription drug abuse, which is burdening our health care system,” said California Attorney General Edmund “Jerry” Brown Jr. at a June 4 news conference announcing his support for the system.
Prescription drug fraud is costly, with insurers losing $72 billion a year nationally, according to a 2007 study by the Coalition Against Insurance Fraud.
The upgrade is expected to speed up the current California system that requires doctors and pharmacists to submit requests for information on patients they suspect of doctor shopping to the attorney general's office by fax or telephone. It can take several days for that office to respond to such requests, however, which causes some physicians and pharmacies not to bother submitting the information, Brown said.
California has monitored controlled drugs since 1940. Narcotics prescribers are required to mail or fax weekly patient reports to the state's Department of Justice.
Although the database has raised patient-privacy concerns, advocates of the online tool said it will provide critical instant access to medical records. Once the online system begins operation, it will be the nation's largest such database and join the Web-based monitoring systems in Illinois, kentucky, Maine, Ohio, North Carolina, Tennessee, Virginia, and West Virginia.
Supporters said the online system would not only cut down on doctor shopping but also raise prescriber accountability and help save lives by helping to avoid accidental overdoses.
State medical boards have strongly supported the development of such online prescribing databases, according to the Federation of State Medical Boards, since they speed up medical boards' investigations of prescribing irregularities.
An additional 14 states have proposed or are considering the use of online databases, according to the University of Wisconsin Pain and Policy Studies Group.
Groups concerned with chronic-pain treatment, such as the Pain Relief Network, have criticized the databases for allowing law-enforcement agencies to have even limited access. Details about law-enforcement access to California's system have yet to be worked out, but other states often require case-by-case subpoenas before police can see such files.
More information on California's prescription-monitoring program is posted at<http://ag.ca.gov/bne/trips.php>.

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Published online: 18 July 2008
Published in print: July 18, 2008

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California's database for prescriptions of controlled medications is likely to be the largest of a growing number of online state drug-tracking registries.

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