NARxCHECK - The Next Generation of Controlled Substance Prescription History Reports for the Healthcare Professional - Presented by Appriss

1. The Next Generation of
Controlled Substance Prescription History
Reports for the Healthcare Professional
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2. NARxCHECK: 2nd Generation PMP Reports
Carl Flansbaum, RPh.
– Director of Client Relationships and Government Affairs, Appriss
– Former State PMP Director; 20+ years as a licensed Pharmacist
Dr. James E. “Jim” Huizenga
– Emergency Medical Physician
– Creator of NARxCHECK
Dr. Bruce G. Jones
– Emergency Department Medical Director, Doctors Hospital,
Columbus, OH
– NARxCHECK user

3. PMP Request Report: Process
State PMP Web Portal Through a Healthcare Entity Integration
Log into PMP using username / password N/A
Navigate to PMP Request Report Page N/A
Enter required information (Name, DOB at a
minimum)
Manual or automated “trigger”
Review PMP Report Review PMP Report
PMP Request Report
Patient Controlled Substance
Prescription History

4. PMP Request Report: Default Format
Patient
Patient Record Details (Name, Address, DOB, etc.)
Prescriptions
DRUG QUANTITY DAYS SUPPLY DATE FILLED RX # PRESCRIBER PHARMACY REFILLS PAYMENT TYPE
OXYCODONE 30MG 90 30 3/21/2016 012581 ABC123 PHARM025 0 INSURANCE
ALPRAZOLAM 1MG 60 30 3/15/2016 328623 CDF1578 PHARM324 2 PRIVATE
HYDROCODON-ACETAMINOPHN 10-325 30 10 3/15/2016 328597 CDF1578 PHARM324 0 PRIVATE
OXYCODONE 30MG 90 30 2/28/2016 012001 ABC123 PHARM025 0 INSURANCE
Prescribers
ABC123 Dr. Earl Jones 123 Main Street, Your Town, GA 123456 555-123-8945
CDF1578 Dr. Cathy Simpson 1257 1st Ave, Not Your Town, SC 23547 555-458-8945
Dispensers
PHARM025 Bob’s Drug Store 2548 2ND Street, Your Town, GA 123456 555-123-8978
PHARM324 DRUGS FOR LESS 1600 Evergreen Hwy, Not Your Town, SC 23547 555-459-1325

5. PMP Request Report: NARxCHECK Report

6. NARxCHECK History
• 2010 Landscape
– Focus on prescription drug abuse epidemic increasing
– PMP programs getting better and more numerous across
the country but access is difficult
– NARxCHECK project conceived to address issues
of usability
• Risk scoring
• Enhanced visualization
• Automated access

7. NARx Score
• Developed to create risk awareness
– Not abuse awareness
• Based on the concept of comparative scoring
– Example
• 25,000 MME in 1 year
– A lot or not?
» 96th percentile
• End result is somewhat analogous to a credit score

8. NARx Score
• Ranges from 000-999
– Narcotics, sedatives , and stimulants
• Scores increase as risk factors increase
• Last digit is the number of active prescriptions
• Distribution
– < 200 = 75%
– > 500 = 5%
– > 650 = 1%

9. NARx Score
• Preliminary data using Ohio DOH 2014
unintentional overdose death

10. NARx Report
• Focus is on data visualization
– Patterns of use matter (maybe matter most?)
• Providers
• Overlapping prescriptions
• MME
– Guides provider awareness to the types of risk that
present

11. Examples - patients with similar risk

12. Same data seen through a
NARxCHECK Report

13. NARxCHECK
Report

14. ED Environment
• Opiate use/abuse
• ERs are busy place
• Time
– Old PMP vs NarxCheck

15. Importance
• Knowledge helps improve care
• Valuable information
– High, medium, low
– Suboxone

16. High Numbers
• Recognize addiction (potential)
• Dose up for fractures/etc
• Intervene vs ignore

17. Low Numbers
• Adjust dose/no dose?
• Be more alert for occult critical condition
• More quickly treat (back pain, toothache, etc)

18. QUESTIONS?
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