The number of doctors and health care providers who have access to patient records is growing as the state implements a venture to integrate computer systems in Indiana.
While the state-funded merger of patient records is seen as a critical point in attacking the opioid epidemic, there is some concern as to what entities will have access to the records.
Currently, health care providers can read a patient’s electronic records in medical offices. They also can log in to a separate system to track prescriptions for controlled substances through the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) program.
But currently, accessing the two systems simultaneously for some offices takes patience.
“Without that integration it takes five minutes to fire up INSPECT and to get the integration you need,” said Dr. Richard Feldman, a family doctor and a member of a legislative committee on public health. “And a lot of primary care providers have 10 minutes to see a patient.”
The committee is exploring ways to improve INSPECT, which allows a physician to check patient records on controlled substances such as opiates.
Currently, 43 percent of the physicians who are registered to issue controlled substances are using INSPECT. As of August, that was 32,290 physicians, according to the Indiana Professional Licensing Agency.
INSPECT, which has been in use since 2007, relies on Indiana’s 6,117 pharmacists updating a patient’s prescription records.
Those updates typically take 24 hours. That could mean a patient could “doctor shop” in one day’s time to get as many opioid prescriptions as possible.
“Under the current system, in theory, a person could — and they do — go to multiple doctors and get several prescriptions, go to different pharmacies, and as long as they do that within a 24-hour period, they can get their hands on several different opiates,” Sen. Erin Houchin, R-Salem, told the committee.
Last session, she authored Senate Bill 408 that created the committee.
“INSPECT is a valuable tool in curbing the over-prescribing of opiates,” said Houchin.
In some rural areas, slow internet access frustrates physicians from logging into the two separate systems.
“It’s not as simple and as clean as it might sound,” said state Rep. Dennis Zent, R-Angola, a member of the interim committee.
“If I have to sit at that desk and it only takes 5 to 8 seconds but it took me 5 minutes to put that information in and my computer’s still spinning after 10 minutes I get a little frustrated,” Zent said.
He added: “So now you’re got the additional problemwhere you’re probably going to delegate that to some trusted staff, and now we’ve heard about all the hacking that’s going on, even with the credit unions, and you’re starting to wonder just how safe all of this is.
“I’ve got a lot of patients who come to see me that don’t even want to give me pertinent information because they think everybody else is going to get it. ... I appreciate the work you’ve done, but the reason why it hasn’t been wholesale accepted is because there’s obstacles,” he told INSPECT officials.
Zent is a retired endodontist, or post-graduate dentist specializing in root canals.
Anyone who can legally prescribe or dispense controlled substances, along with law enforcement, can use INSPECT’s web-based system.
In August, Indiana Gov. Eric Holcomb announced a $1.3 million contract with Appriss Health to launch a statewide platform for merging INSPECT with a patient’s electronic records.
The Professional Licensing Agency is urging 100 percent participation by health care providers. Funds for the integration come from controlled substance registration fees and grants for the first of a three-year contract.
The next meeting of the Interim Study Committee on Public Health, Behavioral Health and Human Services is set for Oct. 26.