The Department of Justice intends to certify the state’s opioid prescription drug database no later than July, triggering a six-month mandate that requires doctors to consult the database before writing a new prescription for a controlled substance.
The July date was announced Tuesday at an Assembly hearing held to examine how the database works and how it might be improved to help the state and local communities stem what is a national opioid epidemic.
“We just completed hiring the resources that will be dedicated to that effort, and we’re currently conducting system and load testing,” said Tina Farales, the program’s manager in the California Attorney General’s Office.
Once testing is complete, Farales added, the department will certify the CURES database, otherwise known as the Controlled Substances Utilization Review and Evaluation System, which contains prescription records for all Schedule II, III and IV drugs dispensed in California.
The certification will trigger a six-month clock for health professionals who prescribe opioids to begin using the system, a mandate that lawmakers imposed two years ago but one that has been delayed as the department upgraded and rolled out an improved, redesigned database known as CURES 2.0. It replaced a system that doctors complained was hard-to-use and often logged them out.
Today, that upgraded database, along with a Web-based registration system, has improved physicians’ access to a patient’s prescription history, and provides “vital data” in the state’s efforts to cut opioid abuse, doctors, public health advocates and state regulators told lawmakers at the Assembly Business and Professions Committee.
“CURES is a pillar of the state's collaborative effort to translate data into actionable information,” said Karen Smith, California's public health officer.
Doctors and pharmacists use the database to check whether a patient might be “doctor shopping” for pain meds before giving a drug to a person. Regulators with the state Medical Board check it to identify doctors who might overprescribe opioids, and law enforcement has uncovered illegal drug diversions.
Queries to the database have skyrocketed, with doctors and other prescribers pulling more than 4 million patient reports in 2017, compared to 645,000 in 2011, according to the Attorney General’s Office. The number of registered users has jumped from 5,550 to more than 128,000 over the same time.
Although users generally credited the department’s revamped database — once described as a failed state IT project — the system still lacks in some areas, several doctors testified. For example, the database can’t be connected with other state prescription drug databases, and the system continues to kick some users off and prevents them from pulling patient reports, said Lee Snook, a Sacramento pain management doctor.
“We continue to have information technology problems,” Snook said. “Our concern about mandating a system that may not be ready for prime time is that it unfairly impacts the practitioner in trying to provide a mandated documentation that we’re unable to provide.”
The DoJ’s Farales declined to answer Techwire’s questions after the hearing about the database’s functionality and its certification. Aides directed a reporter to the department’s press office, which also declined to say whether the issues raised at the hearing would be addressed before the system is certified this summer.
“As testified today, certification is a priority and we are working to get this done as soon as possible,” the spokesperson, who declined to give their name, wrote in an email to Techwire.
In addition to certification, the CURES program is moving forward with a legislative mandate that hospitals and doctors' offices be given direct access — through their own electronic health-care systems — to the confidential database by Oct 1. Farales told lawmakers that the department is “in the early stages of developing the technical and administrative aspects” to comply with AB 40, which lawmakers passed last year.
With the opioid abuse crisis continuing to impact many communities in California — with nearly 2,000 deaths reported in 2016 — lawmakers this year are again pushing a number of bills intended to help health professionals curb the addiction. Among the measures are two bills by Assemblyman Evan Low, chairman of the Business and Professions Committee, that would create a framework so that CURES could connect with other state prescription drug databases and would add Schedule V controlled substances to the database.
