# Presentation: 449464

## OTHER

**OTHER**

- Paul Wormeli
- IJIS Institute
- paul.wormeli@ijis.org

- June 8-9, 2005

## Industries embracing XML

- Retail—data standards and models
- Health care—XL-7 Revision to XML
- Pharmaceuticals—data standards
- Automobile dealers
- Mercedes Benz Fleet Management
- Patient Records in Switzerland
- Belgium Employment Services

## XML Closer to Home

- DOD, Navy, EPA, IRS, GSA, NIST, etc.
- DOJ/DHS/DOT
- Intelligence Community
- FBI—NDEx
- Victim Notification Services (SAVIN)
- Prescription Drug Monitoring Exchange

## Prescription Drug Monitoring Program Information Exchange

## Presentation Topics

- The Problem Domain
- The Challenges
- The Project
- Anticipated Solution
- Project Status
- Future Activities

## The Problem Domain

- Prescription Drug Abuse/Misuse is now the fastest growing drug crime

## The Problem Domain (cont.)

- Prescription Monitoring Programs (PMPs)
- Used by Law Enforcement and Health and Human Service agencies to detect ‘controlled substance’ (prescription drug) abuse or fraud
- PMPs require state legislation to be established
- Approximately 20 states have PMP programs in place
- A variety of electronic and paper systems are in use
- Some standards do exist for managing prescription dispensing information

## The Challenges

- Agencies managing PMPs are generally small, not well funded, and have little IT support
- Electronic PMP systems are dissimilar in technology, age and functionality
- Sharing Expectations
- Degree of Use, Reliability, Timeliness factors
- Sharing Exchange Mechanisms
- Method of communications, Data model, Security
- Managing Cost
- Start-up, Ongoing maintenance, Enhancements

## The Project

- BJA/IJIS PMP Information Exchange Project Goal
- Create a model standard for the exchange of PMP information among states
- Objectives
- Develop a Concept of Operations document to support the existing model standards and describe the exchange of PMP information between states
- Develop system architecture for states to implement in support of such information exchanges.
- Create a set of ‘reference documents’ that describe a model standard for the exchange, based on the GJXDM
- Produce a final report that includes recommendations for updates to the GJXDM to support PMP information sharing
- Create a demonstration of PMP information sharing involving two or more states

## The Project – Solutions Considered

- Central Repository (No)
- States object to building a massive prescription database and wish to maintain control of own data
- Brokered Services (No)
- No desire to host a central broker server
- Peer-to-Peer (Maybe)
- Must be secure
- Federation of Web Services (Likely)
- Can be used even within legacy applications
*States envision *_*regional*_* sharing agreements vs. a nationwide sharing network*

## Anticipated Solution – Components 

- Types of Inter-state Information Sharing Requests
- Patient Profile
- A history of prescription drugs dispensed to a person (patient)
- Detect “doctor shopping”
- Practitioner Profile
- A history of dispensed drugs authorized by a practitioner (generally a doctor)
- Detect over-prescribing
- Pharmacy Profile
- A history of drugs dispensed by a pharmacy
- Detect fraudulent pharmacies/pharmacists

## Anticipated Solution – Components 

- Security Model
- Requests for profile information will be funneled through local state PMP program
- Requesting user will be authenticated and authorized by requesting PMP Administrator
- Disclosing state decides what to share but will likely make decisions based on agreement with requesting state

## Anticipated Solution – Components 

- Auditing Requirements
- Capture each sharing request processed, processed with modification or denied
- Capture response data provided...need “official” record of what was shared (HIPAA)
- Provide reporting on all statistics

## Anticipated Solution

- Technology
- GJXDM for modeling sharing interactions
- Extend the GJXDM model with PMP-specific data types (body surface area, body temperature...)
- Web services will be used as exchange interface technology

## Project Status

- Committee Composition
- Industry expertise from state PMP operations: *large and small states*; *states with law enforcement focus and prevention/ health intervention focus*
- System vendor (IJIS) representation
- Federal support from DEA and BJA
- Committee Accomplishments
- Determined main functional requirements for PMP information sharing
- Reviewed results of DEA survey on data collected at each state
- Developed a draft for a *Concept of Operations* document as basis for sharing effort
- Drafted GJXDM reference documents that describe the main PMP exchanges
- Interviewed select states PMP to determine potential software architecture for pilot

## Project Status (cont.)

- Under Investigation
- Security/access requirements to ensure prescription data requestors receive only the data they are allowed to see
- Potential cost models for states to support an electronic PMP information exchange

## Future Activities

- Remaining Activities
- Refine and finalize the PMP information exchange *Concept of Operations* document
- Finalize PMP exchange GJXDM reference documents
- Develop viable system architecture for PMP exchange
- Produce final report and committee recommendations
- Develop PMIX demonstration/prototype between at least two states
- Decide on a cool acronym for “PMP Information Exchange”

## Questions?