Visit a California emergency room and it’s likely a doctor will check a patient’s medical record on the computer terminal in the room. But there could be critical information missing that the state tracks — the person’s prescription opioid use.
That information is included in a database run by the California Department of Justice and is available to physicians through a secure website. A bill moving through the Legislature would directly link the confidential database to hospitals and doctors’ offices — a capability medical advocates say would especially help emergency room doctors, who are some of its biggest users.
“Unfortunately we see folks coming into the emergency department who are complaining of pain, not necessarily identifying to a specific injury, but they are really drug seekers,” Tim Madden, a lobbyist with the American College of Emergency Physicians, told lawmakers Monday at a hearing before the Senate Business, Professions and Economic Development Committee.
For those patients, doctors must often leave a patient’s room to manually log into what is known as the Controlled Substances Utilization and Review Evaluation System (CURES) database. Physicians must then manually add the patient's information into their own health IT system.
Allowing health-care providers to link directly into the database would eliminate that step and give doctors the information upfront. “Once we have the information, we’re better prepared for any issues that come up, providing more efficient care,” Madden said.
The database contains records of more than 100 million prescriptions, with more than 8,000 doctors and pharmacists who have signed up to use it since 2009, according to a committee analysis of the bill.
The committee approved the bill, AB 40 by Assemblyman Miguel Santiago, D-Los Angeles, after accepting amendments that would ensure the Department of Justice doesn’t pick just a few health IT system vendors to access the system. That was a concern raised by the California Medical Association, who feared some of the members might be left out.
“I don’t think the intent is to choose winners and losers,” Santiago said. “It’s to create a framework. That’s the direction we’re going in.”
Specifically the amended bill would allow doctors and associations to figure out which technology they are going to use to access the database, he added.
The committee approved the bill on a 6-0 vote, which now goes to the Senate Judiciary Committee for consideration. AB 40 includes an urgency clause, meaning it must garner a two-thirds vote in the Senate to pass. The Assembly approved the bill earlier this year.