Parts I through III of this paper will examine several, increasingly comprehensive forms of aggregation, ranging from insurance reimbursement “lock-in” programs to PDMPs to completely unified electronic medical records (EMRs). Each part will advocate for the adoption of these aggregation systems and provide suggestions for effective implementation in the fight against opioid misuse. All PDMPs are not made equal, however, and Part II will, therefore, focus on several elements — mandating prescriber usage, streamlining the user interface, ensuring timely data uploads, creating a national data repository, mitigating privacy concerns, and training doctors on how to respond to perceived doctor-shopping — that can make these systems more effective. In each part, we will also discuss the privacy concerns of aggregating data, ranging from minimal to significant, and highlight the unique role of stigma in motivating these concerns. In Part IV, we will conclude by suggesting remedial steps to offset this loss of privacy and to combat the stigma around SUDs and mental health disorders in general.
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Id. (“In interviews and surveys of prescribers, pharmacists and law enforcement when asked about their experience with HB1 and its implementation stated that although there was initial confusion and disruptions to workflow in their professions those have largely been resolved and, for the most part, have not negatively impacted health care professional practices. It should be noted however, that a minority of prescribers indicated they no longer prescribe CS, or prescribe fewer CS, as a result of the HB1 mandate and its burden on their practices.”).
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42 C.F.R. § 2.31(a) (“A written consent to a disclosure under the regulations in this part may be paper or electronic and must include:...The specific name(s) or general designation(s) of the part 2 program(s), entity(ies), or individual(s) permitted to make the disclosure.”).
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92.
Protecting Jessica Grubb’s Legacy Act, S. 1850, 115th Cong. (2017).
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45 C.F.R. § 164.512(b)(1)(i).
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National Alliance on Mental Illness, NAMI Policy Priorities and Comprehensive Mental Health Reform Legislation (2016), at 7, available at <http://www.namikenosha.org/uploads/4/9/0/6/49066629/nami_policy_priorities_and_comprehensive_mh_reform.pdf> (last visited on February 22, 2018) (“NAMI strongly supports inclusion of language that repeals 42 CFR Part 2, federal regulations restricting the disclosure of individual’s alcohol and drug records. NAMI believes HIPAA provides sufficient patient protections and that this separate regulation creates barriers to integration of care and improved health outcomes for people living with cooccurring mental health and substance use disorders.”).
42 C.F.R. § 2.12 (“These regulations do not apply to information on substance use disorder patients maintained in connection with the Department of Veterans Affairs’ provision of hospital care, nursing home care, domiciliary care, and medical services under Title 38, U.S.C. Those records are governed by 38 U.S.C. 7332 and regulations issued under that authority by the Secretary of Veterans Affairs.”).
100.
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