ONC targets Rx drug abuse with new data initiative

WASHINGTON – The Office of the National Coordinator for Health IT has launched a pilot program to make existing prescription drug use data available to healthcare providers and pharmacists when they treat patients during office visits and in emergency departments.

The test projects in Indiana and Ohio will measure the effectiveness of expanding and improving access to prescription drug monitoring programs (PDMPs) as part of the administration’s efforts to reduce prescription drug abuse.

The monitoring programs are statewide electronic databases, which are designed as a tool for providers to identify and intervene in cases of potential prescription drug abuse. The databases collect, monitor and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners.

The idea is that by improving real-time access to the information it will encourage providers to use the program more than it is now. So far, 49 states have legislation authorizing prescription drug monitoring programs or have active programs.

“The PDMP pilot projects will help hospital staff identify a patient’s controlled substance history at the point of care to enable better targeting of appropriate treatments and reduce the potential of an overdose or even death,” said Farzad Mostashari, MD, national coordinator for health IT. “We are not creating new systems; we are adding value to those that exist,” he added.

In Indiana, emergency department staff will be able to receive a patient’s controlled substance prescription history directly through the Regenstrief Medical Record System (RMRS), a care management system used by Wishard Health Services, a community health system in Indianapolis, and other hospitals.

The project is a collaboration of ONC, Regenstrief, Wishard, the National Association of Boards of Pharmacy, Appriss Inc., and the State of Indiana. In some states, Emergency departments are responsible for almost 25 percent of all controlled substance prescriptions.

The Ohio pilot will test having a drug risk indicator in the electronic health record (EHR) and how that affects clinical decision making. The Ohio project is a collaboration with the Springfield Center for Family Medicine, Eagle Software Corporation’s NARxCHECK, the State of Ohio, and MITRE.

The hope is that the pilots will improve real-time data sharing among providers, increase interoperability of data among states, and expand the number of people using these tools, according to Gil Kerlikowske, director of National Drug Control Policy.

The Enhancing Access to PDMPs Project stems from joint efforts of public sector and private industry experts that participated in the White House Roundtable on Health IT and Prescription Drug Abuse last year and the subsequent action plan (PDF).

The Centers for Disease Control and Prevention has said that the United States is in the midst of an epidemic of prescription drug overdose deaths, which outnumber deaths from heroin and cocaine combined.

Parents can build in 'special time' with kids this summer

The unofficial start of summer may have arrived already, but for many families, what once were the lazy days of summer have become the crazy days.

Parents and kids often find themselves racing to work, camps, swim meets and ballgames, plus answering cellphones, text messages and e-mails 24/7. So how can parents get more out of their time with their family?

They should consider setting aside an hour a week for "special time" with each child, says psychologist David Palmiter, author of Working Parents, Thriving Families and a public education coordinator for the American Psychological Association.

For that hour, each parent should focus totally on the child while doing something enjoyable, such as shooting baskets, playing a video game or drawing, he says.

Parents should keep in mind that the child should choose his activity, and many things he would choose will work, except for watching TV, Palmiter says.

He often spends special time with his own children, ages 11, 15 and 16, when they are going out for breakfast, taking a walk or shooting baskets.

Make kids the priority

Parents should really listen to what the child has to say and enjoy the child's company by living in the now, he says.

During special time, parents should avoid correcting behavior or ideas or directing the conversation, he says. That should be done at another time.

"Just focus on being with your child and enjoying him all that you can," Palmiter says.

And don't jump up to answer your cellphone or check your text messages, he says, "because that suggests to the kids that your iPhone is a higher priority than they are."

Special time with children is different from quality time in which parents divide their attention across fun family activities such as going to sporting events, fishing or riding roller coasters. Those serve a different purpose for enriching family life and building memories, he says.

Psychologist Mary Alvord, who has a private practice in Rockville, Md., and is the author of Resilience Builder Program for Children and Adolescents, says parents and kids can do simple things such as playing board games, bowling, playing miniature golf or cooking.

This hour can even be time in the car. "With teens, it's a nice time to talk with them because they're captive. Just make sure they're not texting."

So often parents and children do parallel activities such as sitting together to watch TV or going to the movies, and they're not conversing with each other, Alvord says.

"When you look at the research, kids' resilience is often based on time they spend with their parents, knowing they are appreciated by the family," she says. "Parents have to really listen to them. If you are always multitasking, it's not the same kind of listening."

Palmiter says that special hour each week can be used for all ages, including adult children, and it's important to have special time each week with your spouse or significant other. Even a dinner or a picnic can provide the opportunity to focus on your spouse, he says.

The process is the point

For many families, the best way to have richer time together is to build on activities family members love, says psychologist Susan Linn, author of The Case for Make Believe. Parents can share the hobbies and activities they especially love with their children. That might be music, art, dance, woodworking, crafts, sewing, knitting, gardening or outdoor activities such as sports, fishing or hiking.

If parents are truly interested in what they're doing, they can pass that enthusiasm on to their children.

What's most important is that children enjoy the experience. So if you're making something with a child, perfectionism needs to go out the window. The process of doing it should be more important than the product, she says.

"One of my husband's most vivid childhood memories was hammering nails into a bench for fun at his father's picture-frame shop. He grew up to be an art restorer, and it all began with sitting hammering nails into the bench until the entire end of the bench was metal."

Parents also can share with their kids the games they played as a child. "I taught my grandchildren Mother May I, and they ask me to play it with them. We make up ridiculous steps.

"Parents have to keep in mind the importance of play for children � and for adults."