Pubdate: Thu, 17 Mar 2005
Source: Messenger-Inquirer (KY)
Copyright: 2005 Messenger-Inquirer
Author: Mark R. Chellgren  Associated Press
Bookmark: (Oxycontin/Oxycodone)


FRANKFORT -- Kentucky officials say a new system that allows doctors, 
pharmacists and police to access prescription records over the Internet is 
a faster, more efficient way to stop drug abuse and improve health care.

But some civil libertarians and health experts are concerned about the 
privacy of the system and question whether it will end up discouraging 
doctors from writing some necessary prescriptions.

For more than five years, Kentucky has tracked prescriptions for so-called 
schedule drugs, from the extremely powerful, addictive and often abused 
narcotics like OxyContin to simple cough medicines with codeine.

Under the old system, dubbed Kasper -- Kentucky All Schedule Prescription 
Electronic Reporting, pharmacists and doctors would fax requests for 
information to the Cabinet for Health and Family Services, which often took 
hours to fax back responses.

The new program allows medical personnel and police to search for 
information online so they can get answers at any time.

Cabinet inspector general Robert Benvenuti said drug abuse task force 
personnel and police can track doctor shopping -- when patients see more 
than one physician to get multiple prescriptions -- and doctors who might 
be abusing prescription authority.

Dr. Bob Esterhay of the University of Louisville school of public health, 
said the availability of the information is helpful and a cause for concern.

While medical personnel can get useful data and drug abuse can be 
interrupted, Esterhay wondered whether doctors might be somehow dissuaded 
from writing some prescriptions for needy patients knowing they may be 
scrutinized. And as an individual, Esterhay said he wondered about all that 
personal information available to so many people.

"There are always issues in terms of an individual's privacy," Esterhay said.

Benvenuti said law enforcement personnel must sign documents to reflect an 
ongoing investigation in order to access information. Health care 
professionals are covered by federal privacy rules.

Benvenuti said during the years the Kasper system has been in place, there 
have been no reports of abuse.

"I don't think there's any need for any concern whatsoever," said Benvenuti.

Beth Wilson, director of the American Civil Liberties Union of Kentucky, 
said there should always be concern when people's privacy is at stake.

Esterhay said basing the new system on the Internet also presents an 
opportunity for personal information to leak into the public eye.

Examples of supposedly secure information being posted on public Web sites 
or hackers breaking into secret databases are now routine.

Benvenuti said the computer security levels are similar to those a bank 
might use.

"Any system is hackable," Benvenuti said. "It doesn't negate all the benefit."

Nearly 87 percent of the inquiries during the first years of the system 
came from doctors, officials said. Law enforcement authorities accounted 
for 6 percent of inquiries and pharmacists made up 4 percent. A system 
originally designed to field 2,000 queries a year has recently received an 
average of 2,500 a week.

"It's an interesting dilemma," Esterhay said. "You just hope all the people 
involved do their best to keep the information secure."
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