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Wacky IN PMP Policy
Indiana physicians face yet another specific restriction regarding medical records when accessing the state’s INSPECT controlled substance database, more evidence that HIPAA does not cover everything, regardless of your “covered entity” status, and another gratuitous distraction from patient care.
Prescription monitoring programs (PMP) have helped track controlled substance prescribing in most states. Here in WA, where entries may change, I always make sure to place a copy of the report in the electronic medical record (EMR). But according to Indiana policy “If the INSPECT Patient Rx History Report is stored along with a patient’s other medical records, it must be clearly marked 'Do Not Copy.' It should never be included when sending a patient’s medical records to another health provider.” Furthermore, the statute stipulates “The report, or the contents of the report, should never be faxed, mailed, emailed or otherwise disseminated. Practitioners must also not provide a copy of the INSPECT report to the patient.” This last sentence would appear to violate the patient’s right to see their medical records.
We already have to obtain specific authorization to release records pertaining to STDs, addiction, and psychiatric illness. Federal law tells us not to release “genetic” information (family history) to employers. We must send a special notice along with records pertaining to addiction according to 42CFR.
Where will it end?
The only good news: INSPECT has special functionality for sharing a report with other prescribers. Physicians should have a right to incorporate anything they deem relevant in their medical records, and release it to anyone with authorization from the patient. PMP reports can help document a physicians basis for decisions about treatment. Indiana should not add yet another administrative hurdle for physicians trying to practice medicine.