Orange County Medical Society
Seminole County Medical Society
Guidance on the appropriate use of reports from E-FORSCE, the Prescription Drug Monitoring Program, is one of the most frequent questions we receive from physicians and their staff members. Now that physicians are mandated to consult the PDMP prior to writing a prescription for any controlled substance, physicians need to pay specific attention to how they are handling these sensitive reports. Access to PDMP records is considerably more restrictive than HIPAA and carries significant penalties for unlawful disclosure.
During a meeting on Wednesday with Rebecca Poston, BPharm, MHL, Program Manager for E-FORSCE, Florida's Prescription Drug Monitoring Program, she referenced the rule that dictates appropriate use of these records.
Rule 64K-1.005(7), Florida Administrative Code, provides that "to prevent inadvertent release or disclosure of the confidential and exempt information in the database, pharmacists, prescribers and dispensers should avoid downloading and printing information from the database."
Scanning the report into the chart is not prohibited, however it may not be released to a patient, or pursuant to any other record release request or subpoena, therefore it should be maintained in a manner preventing such disclosure.
During our conversation we had the opportunity for additional role play on scenarios that are common in medical practices.
First, you are not allowed to provide your patient with a copy of their PDMP report, even if they request. There is a mechanism in the statutes that dictates how patients have to request access to their record from E-FORSCE.
Second, if you are going to copy or download the report into your Medical Record, you can do so, but you have to make sure only the prescriber, or the official designee registered to the prescriber on E-FORSCE, has access to the actual report. Additional office staff who are not registered as a designee are prohibited from accessing this report.
Finally, when responding to a records request of any kind, you have to make sure that all PDMP records are redacted from the medical record, even when responding to subpoenas.
Because of the potential likelihood of unlawful disclosure of the PDMP record, it is recommended that physicians do not download the reports and place them in the medical
record. It is sufficient to simply document in the chart that you consulted the PDMP and dictate what you saw, if anything, that relates to your treatment. It is the report that is protected, not your dictation of what you saw. Physician queries on the database are saved in the PDMP for 4 years. This query history will provide documentation of the date and time of your query and what you actually viewed in the PDMP. This query history therefore will supplement what you dictate in the chart.
One final thought. If you are planning to integrate your Electronic Medical Record with the PDMP, you need to ask questions on whether the actual PDMP report will become part of the medical record. If so, you will need a plan to limit access to that report and a method to redact the report as necessary.
Physicians are encouraged to reference the Florida Department of Health website for more information. This is the definitive source for regulation of this legislation: http://www.flhealthsource.gov/FloridaTakeControl/
On July 13th the OCMS & SCMS are hosting a Legal Symposium that will include the 2-hour state mandated controlled substance prescribing course. Click here to get more information and to register. Space is limited.