Prescription Monitoring Program (PMP)
The facts about prescription drug abuse are astounding. According to Center for Disease Control data, deaths from drug overdose have been rising steadily over the past two decades and have become the leading cause of injury death in the United States. Every day in the United States, 105 people die as a result of drug overdose, and another 6,748 are treated in emergency departments for the misuse or abuse of drugs.
Prescription drug information sharing strategies are an important part of combatting this growing national problem. Thanks to a national initiative funded by the Bureau of Justice Assistance (BJA) and the Office of National Drug Control Policy (ONDCP), and led by the IJIS Institute, states can share prescription information with one another – and potentially save lives.
The primary goal of the Prescription Drug Monitoring Program (PMP) Information Exchange (PMIX) is to establish a national interoperability architecture, specifications, and a reusable infrastructure for the secure, reliable, and sustainable interstate exchange of state prescription data. PMIX leverages service-oriented architecture (SOA) principles through the Global Reference Architecture (GRA) to minimize custom development and maximize future agility.
Guiding the PMIX initiative is a steering committee comprised of people who have implemented state PMPs, members and alliance partners of the IJIS Institute, and representatives of Federal agencies, including:
- Indian Health Service (IHS)
- Department of Veterans Affairs (VA)
- Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services (HHS)
- Drug Enforcement Administration (DEA)
PMIX Pilot Project
Infrastructure for the PMIX Pilot was tested in a successful pilot exchange of live data between the Kentucky All Schedules Prescription Electronic Reporting system and the Ohio Automated Rx Reporting System. Under the PMIX approach, all protected health information was encrypted at the message level so that private data was not visible to any intermediary servers outside state boundaries. The supporting technologies used for the Pilot follow:
- Data interoperability was enabled through National Information Exchange Model (NIEM) Information Exchange Package Documentation (IEPD).
- Messaging interoperability was through a GRA PMIX Service Specification Package, including reliable secure web services capabilities.
- A software development kit containing a State Routing Service intermediary and a reference implementation was used to reduce cost and accelerate adoption of the required state-side software.
The BJA/IJIS PMP committee is participating in related initiatives, particularly those involving ongoing cooperation with the PMP Center of Excellence and with the Office of the National Coordinator for Health Information Technology (ONC). PMIX is funded by grants from the BJA, through Brandeis University and ONDCP.
PMIX State Assistance Project
The PMIX Pilot Program is just a start. The next step is for the PMIX State Assistance Project to accelerate nationwide PMIX adoption across the U.S. To that end, the PMIX Project is providing technology assistance (TA) to enhance the PMIX interoperability infrastructure. Another series of TAs with various states and the Indian Health Service (IHS) will assist them in reporting IHS prescription dispensing data to state PMPs. PMIX is also working to develop recommendations for the creation of anonymous, multi‐state PMP datasets in which records arising from the same patient can be linked to one another. The PMIX State Assistance Project is funded by the ONDCP.
The RxCheck hub is the baseline implementation of the PMIX architecture. The hub was developed, with BJA support, to create an operational data sharing hub to implement the PMIX specifications and to deliver a functional, interstate, data-sharing hub. The RxCheck hub was designed with the involvement of the state PDMP practitioner community, private industry, and the Federal government, and began as the PMIX hub during a prototype development phase with data exchanges between Ohio and Kentucky. The hub was subsequently renamed the RxCheck hub to avoid confusion between the architecture and the hub.
For the past few years, the IJIS Institute has operated a provisional RxCheck hub under the auspices of the RxCheck Governance Group. The IJIS Institute and RxCheck Governance group have come to an agreement that allows the IJIS Institute to host the RxCheck hub on a permanent basis. The Governance group (comprised of states connected to, or with plans to connect to, the RxCheck hub) continues to own the hub and provides the guidance, stewardship, and leadership for the RxCheck hub. The IJIS Institute manages the RxCheck hub and operates as an agent of the RxCheck Governance group in its maintenance and operation.
- Prescription Drug Monitoring Programs (July 10, 2012)
- PDMP Training and Technical Assistance Center, Brandeis University
- RxCheck Connection Guide (June 2014)