A FLAWED SYSTEM

State database on prescription drugs too slow to be effective

A statewide electronic database has been designed to identify possible
abusers of prescription drugs. It is meant to thwart their efforts to fill
identical prescriptions at multiple pharmacies, but it has a major flaw:
It's too slow to be effective.

A state panel including lawmakers, doctors and law enforcement is looking
at ways to streamline the system - while still maintaining federal
requirements for patient privacy. That's no easy task, but the goal is a
worthy one.

Currently, the state maintains a database called Kentucky All Schedule
Prescription Electronic Reporting. The system, called KASPER for short, is
intended as a tool for doctors, pharmacists and law enforcement to monitor
and curb illegal prescription drug abuse. Patient information - including
name, Social Security number and address - is compiled into the database
after prescriptions are filled.

Doctors and pharmacists can use the information in writing and filling
prescriptions. Police agencies with "bona fide" investigations can see how
many times a potential suspect is writing or receiving prescriptions. By
law, police investigators must show they have evidence that an individual
may be abusing prescription medications before they can receive information
on those patients. Police cannot use the system to check the records of
individuals not suspected of misusing drugs.

With law enforcement agencies claiming prescription drug abuse is
Kentucky's most serious drug problem, the database is an excellent idea.
This newspaper strongly supported the 1998 bill that established it, but
the law cannot be effective as long as the database is flawed.

New prescriptions don't get compiled for about 30 days, and people
requesting the reports have to wait anywhere from four hours to a week,
said Dr. Steve Davis, director of the Health Services Cabinet's Division of
Adult and Child Health. That's much too slow.

Doctors should get a patient's prescription history back sooner so they can
get the correct medications, Davis said. Drug investigators also should be
able to access the database information timely enough to catch someone who
may be writing inappropriate prescriptions or a patient who is
"doctor-shopping," he added.

The database is not designed to prevent those who have legitimate medical
reasons for prescription drugs from acquiring them. Neither is it to be a
source of unfocused, wild-goose chases by law enforcement officers.
However, the state has a legitimate interest in preventing patients from
receiving identical prescriptions from multiple doctors and having them
filled at different pharmacies.

The database provides the best hope for doing just that - but only if it
can provide vital information quickly. To date, it doesn't