Please write 100 words response to each of my peers

1)Although both North Carolina and Florida created a similar legislation I feel that Florida too will unfortunately present a similar result of minimal compliance with the law as well. When it comes to House Bill 21 and auditing of the prescriiption data for compliance remains essential. So, I think that the ability to audit prescriiption data is relevant and very much needed in order to make processes put in place such as House Bill 21 effective. Auditing the electronic medication administration record for random pain exception documentation would also be initiated. In addition, I think it also remains just as important to check and streamline the process improvement which is the legislation. With that being said, the legislation would need to be periodically looked at and addressed for updates as processes become more effective. Taking in considerations for the next step of House Bill 21 as it relates to a concrete pain management strategy for those that are considered on opiates, I think will be of importance because it will involve collaboration amongst the provider, pharmacist, and patient. Creating a sense of inclusion for the patient will be important toward recovery and prevention. In fact, “the continuing evolution of pharmacy services encompasses this renewed emphasis on safety, an increasing focus on patient care outcomes and treatment costs, and a renewed focus on formulary development and drug use policy” (Wolper, 2010). Both North Carolina and Florida legislation along with all of states that are mandated reporters of Scheduled II Controlled Substances should incorporate stiffer penalties for those that are not in compliance. The benefit of auditing will hold providers and pharmacies accountable that are in violation and furthermore will prevent patients from selecting such providers and pharmacies. As of now the US Drug Enforcement Administration Office of Diversion Control has a reporting system that individuals can use to report any abuse such as doctor shopping, drug abuse, and many other issues. By auditing the process, the legislation can be updated to be more effective and create a culture of safety while adapting to the needs of the patient and the pharmacies.

References:

Wolper, L. F. (2010). Health Care Administration: Managing Organized Delivery Systems, 5th Edition (5th ed.). Jones & Bartlett Learning.

2)Prescriiption drug monitoring programs (PDMP) now exist in 49 states. The requirements vary greatly from state to state, from who is required to use them to how much drug a prescriiption can be for to when data must be submitted to the state. Studies have shown these programs to be effective at reducing not only abusive use of opiates but overall crime rates (Dave et al., 2021). Unsurprisingly, Dave et al. found that states with more strict mandatory participation rules saw a greater reduction in prescriiption opiate abuse.

Florida House Bill 21 (HB21) requires consultation of the PDMP and allows for discipline of those licensed professionals who fail to meet this requirement. The law is vague on what penalties should be imposed, leaving it up to the various boards who control the licensure process. However, HB21 does explicitly allows the state Department of Health (DOH) to “initiate an investigation” (HB21, 2018, 2 section) to determine if there is a violation or pattern of abuse. Such an investigation would be an audit of the system and the ways it is used.

The Department of Health should audit the Electronic-Florida Online Reporting of Controlled Substance Evaluation Program (E-FORCSE) to determine its effectiveness at reducing the abuse of controlled substances and to determine the degree of compliance with its rules of use. Specifically, audits should be done to determine how many prescriiptions are processed by every provider and dispenser. Targeted audits should be set up to delve into the EMRs used by selected practitioners to determine if proper documentation concerning pain severity and acute versus chronic pain was entered. Because the system is relatively new, these audits should not be punitive, but should be seen as an opportunity for all parties to learn and develop better solutions. Because HB21 authorizes investigations, I would think the DOH has every right to conduct such audits. Once valid data is obtained, then informed decisions can be made regarding mandatory participation and the penalties for failing to comply.

References

Controlled Substances, CS/CS/HB 21 Chapter 2018-13 (2018). https://www.flsenate.gov/Session/Bill/2018/21/ByCategory

Dave, D., Deza, M., & Horn, B. (2021). P