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A ubiquitous problem in workers’ compensation patient care, as well as in the general clinical healthcare setting, is an individual patient’s use, and potential abuse, of controlled prescription narcotics.  The Prescription Drug Monitoring Program (PDMP) is the State of Colorado’s secure, central electronic informational data base that records and tracks each pharmacist’s dispensement of controlled narcotics. In an effort to curb narcotic prescription abuse, as well as to improve overall clinical care, the state of Colorado recently revised its PDMP guidelines with the goal of promoting more accessibility to the PDMP’s recording and research functions.

Currently, medical professionals use the PDMP to track a particular patient’s use, prescription quantity, frequency of prescriptions, and procurement of controlled substances. The PDMP is frequently used in the workers compensation system to reference whether an injured worker is obtaining narcotics prescriptions from more than one physician, or whether an injured worker has a history of narcotic dependency. The PDMP is considered a medical record, and protections of HIPPA apply to PDMP information. This information can be used to evaluate a specific course of treatment unique to the injured workers’ clinical history; however, a long-standing issue has been the quality and quantity of the information available to physicians.

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Prior to October, 2014, PDMP users were only permitted to upload data twice every month. As of October 15, 2014, the revised PDMP regulations, administered by the Division of Professions and Occupations, require that all in-state and non-resident pharmacies registered by the state’s Pharmacy Board submit controlled substance dispensing data to the PDMP on a daily basis. Most of these changes are contained in House Bill 14-1283. Any pharmacist or physician possessing a Drug Enforcement Agency registered narcotics prescriber permit is required to register with PDMP and follow rules and regulations of the State Board Pharmacy. The new regulations also contain tools to help ease the burden of having to enter massive amounts of patient data in real time. As of January 2015, each prescriber and pharmacist registered as a user with the PDMP may delegate access to the PDMP to three agents by way of creating sub-accounts with the PDMP under the corresponding prescriber or pharmacist’s account.

Granting broader access to the PDMP is an important step for purposes of controlling and containing medical costs in workers’ compensation. Based upon the new revisions to the PDMP guidelines, a workers’ compensation authorized provider may delegate authority to access the PDMP database to three designees acting for the provider. Large and small facilities treating patients will now be able to utilize nurses, or other health care professionals who did not previously have access to the PDMP, as delegated agents authorized to research an injured workers’ narcotic prescription history. The regulatory changes will give busy pharmacists the opportunity to input data on a daily basis. Physicians practicing in workers’ compensation can then obtain real time data about an injured worker’s prescription history by using their staff to obtain and process the clinical information.

Under the applicable rules, physicians performing independent medical examinations may not access the PDMP for information on an injured worker. However, it is recommended that, after obtaining a HIPPA compliant release, the authorized physician be asked to check the PDMP to evaluate an injured worker’s narcotic prescription and compliance history. It is also recommended that insurance representatives adjusting a workers’ compensation claim make repeated requests for PDMP information throughout any claim when narcotic prescription management is an issue.

More information about Colorado’s PDMP can be found at

https://dpo.colorado.gov/PDMP