Subcommittee on Oversight and Investigations Hearing, RE: NASPER (National All Schedules Prescription Electronic Reporting)
WASHINGTON, DC,
Oct 24, 2007 -
Thank you Mr. Chairman, I appreciate very much you holding this hearing today. Back in my home state in Texas, in the city of Dallas, the Dallas Morning News ran a series of several articles in 2003, 2004, and 2005 on a physician who ran a pill mill. It seems that everyone knew about the pill mill. He didn’t make appointments, but he saw a lot of patients. And the patients were seen, I guess you’d call it in kind of a modified wave method of making appointments. The patients would sleep in the parking lot so they would be the first in line to get in the door the next day. In fact, sometimes the clinic had to hire off duty police officers to kind of keep order in the parking lot before the clinic opened. The doctor would see 200 patients a day. They were mostly Medicaid or Medicare beneficiaries. In fact, this office was the source for the largest single source of diazepam prescriptions for Medicaid prescriptions in the state of Texas. Now at least 11 of his patients died. And they died of drug overdoses or drug complications, and after a very long investigation, culminating just a few weeks ago, this doctor received probation. I think had this program, had NASPER been up and running and functioning, I think he certainly could have been contained much earlier and I think some patients and their families could have forgone some needless suffering. And perhaps we could have even avoided loss of life.
Now when NASPER was signed into law on August 11, 2005, it was the only congressionally authorized program to assist state Prescription Drug Monitoring Programs. The previous program, established by the Department of Justice, was created with a lack of adequate congressional oversight and appropriate administration by the Justice Department. Both parties agree that such a program should have strict guidelines and that Health and Human Services is better suited to administer such a program than the Department of Justice. So NASPER must be funded; especially to guard against scenarios such as this that has been well documented in my papers back home. Well, Chairman Stupak I thank you and Ranking Member Whitfield for holding the appropriators’ accountable and I join in asking them to make the Appropriations Committee aware and to fund this program.
And NASPER could allow doctors to find out what medications a patient is currently taking and what he or she has taken in the past. Without a database in place for doctors to track patient history, doctors have no way of knowing who is really in pain and who is looking to abuse the system. And I speak of this with some authority because I was a practicing physician back in Texas for 25 years and I certainly know I got caught in similar situations.
I do have some questions. I have some questions about how this is affected by our current HIPPA laws. And then going further, how is the law that we recently passed, the Genetic Information Non-Discrimination Act, how is that going to affect the sharing of information because that bill was fairly broadly constructed and I think may have more of an effect on this that will curtail the sharing of data.
Now database is extremely powerful. Extremely powerful in helping to manage a patients care, and helping to provide information to caregivers about a patient’s status. We had a situation in Dallas right after Hurricane Katrina landed in New Orleans 2 years ago. A lot of folks were taken from the Superdome in Louisiana and delivered to the parking lot outside of Reunion Arena in Dallas. These people were patients who were on multiple medications. Many of them had been without their medications for several days, and some where just a few steps away from getting into serious trouble with their underlying illness. One of the chain pharmacies set up a mobile unit right outside Reunion Arena, and doctors where able to quickly access the database, get information about the patients. Obviously Cherry Hospital didn’t have electronic medical records up online, but this data was available to the doctors who were receiving those patients and triaging those patients in the parking lot of Reunion Arena. And within a very short period of time were able to accommodate those patients’ needs. And I think out of the many, many thousands of people who were transferred from New Orleans to Dallas only a few required hospitalization because they got timely treatment and timely recognition on the night of their arrival. So it just underscores how powerful a database can be if used appropriately.
Ranking Member Whitfield alluded to how important it is to have inner operability of databases, and I certainly think that is key. If we are going to have two side by side systems clearly they need to be able to communicate with each other in an efficient fashion. But realistically if we could have a single system that worked and was funded, I think that’s the preferable route to go. Mr. Chairman, I give back the balance of my time.
