Who are the true stakeholders?

[serich]

In reviewing our committed membership in the PDMP initiative, I noticed that the Charter only lists "EHR vendors" and "HIEs" as the project stakeholders  It seems odd that the State PDMPs, Pharmacy interests, broader healthcare organizations, narcotics enforcement agencies, Federal interests, pharmaceutical manufacturers, and perhaps others were excluded. Does the Charter accurately reflect the only intended stakeholders or is this section just out-of-date?  Thanks.

[Vickie]

I second that Scott.  I feel that the scope of this project has been limited to prescribers and their EHR process which is not the same as the pharmacy process.  I feel there should be a second initiative to review specifically what is best for pharmacy workflow, especially since all pharmacies will not have an EHR like prescribers will.  Let's not forget that pharmacies are the ones reporting the data today (in ASAP).  They are the ones that ultimately dispense the medication to the patient.  They are a very important stakeholder.   

 

I was on the original work group that defined the fields for display back to the prescribers AND pharmacies.  We didn't segment one area from the other.  Why are we doing so here if the initiative is to satisfy both.  EHR was not our immediate stakeholder then so why it is now?

[Chad Garner]

I think this is a question that needs to be considered seriously. Looking at the members of this group, I only recognize a couple of us as representing a Prescription Monitoring Program. We're currently voting on which data format to transmit data with, but if the decision is largely decided by EHR vendors and HIEs, I'm not sure what has really been accomplished. If we were talking about exchanges of information between EHRs and HIEs, then it would be great. But, in this case, it is the PMPs that you are looking to get data from. If they don't support this data standard, then what have we accomplished? Currently, PMPs are supporting 2 data standards - one of which is viable for Request/Response. As a whole, we don't use either of the standards being considered. What is the PMPs' incentive for supporting a new standard, which duplicates work that is already in place?

[John Poikonen]

<<< What is the PMPs' incentive for supporting a new standard, which duplicates work that is already in place? >>>

How about relevancy?  Unless the data from PMP's is transacted, there is little value for them, IMHO. 
May not want you want to hear, but the EHR world is beating to the NCPDP and CDA drum. Let's not let the good get in the way of the perfect.

P.S. I have little skin in this game other than the practice and progress of pharmacy and medical care.

[Chad Garner]

That would make sense, if PMPs were private sector businesses. Asking for additional taxpayer dollars in order to "stay relevant" is a good way to become immediately irrelevant.

[Prescription Drug Monitoring Program]

Scott – the section was out-of-date, and we have corrected that on the charter – thanks for pointing it out.  I added the State PDMPs, which better reflects participants on the meetings.  The update also reflects the use case we've focused on - automating the interface between PDMPs and EHRs/HIEs.

[Prescription Drug Monitoring Program]

Vickie – the initial focus of our working group for the S&I initiative has been on the gap between the PDMP and the EHR/HIE system and proposing a data standard to best tackle automating that connection.  We will capture your suggestion that a follow-on initiative address the pharmacy workflow.

[James Dyche (Pennsylvania)]

There are some very good points being brought up here.  Since we are deviating a little from the stakeholder question a little bit.  Its seems to me that there may be a good business model for someone/some business to perform transformation between government and industry (assuming the Government stakeholders don’t belong).  Like it or not the Federal Government and many states are moving to the beat of the NIEM drum…. Many states have already started mandating business and industry partners to conform to their standards and keep them from implementing every different nuance of “standards” implementations.  Many of the current CDA standards really don’t interoperate due to their specific implementations.  It’s expensive for government to address non interoperable standards implementations ….and who pays for that ….you and I as tax payers… Alright enough of that….

 

Regarding the original stakeholder question.  If we agree these stakeholders should not weight in per this group….Should a new group be formed with the stakeholders mentioned by Dr. Serich to address the other half of the drug monitoring/enforcements standards problem?