[Maine-NPs] Fwd: Inquiry concerning prescribing data

[Emil Bukher]

Here is the most comprehensive response I have received to my question
regarding protection of NPs prescriptive data. Hope this has been helpful
for those of you interested in this issue.

Emil

---------- Forwarded message ----------
From: Mary Jo Goolsby <mjgoolsby at aanp.org>
Date: May 10, 2007 8:37 AM
Subject: Inquiry concerning prescribing data
To: emil.bukher at gmail.com
Cc: Judith Dempster <dempster at aanp.org>, Jan Towers < jtowers at aanp.org>,
Charon Pierson <cpierson at aanp.org>


 Emil: I am sorry for the delayed response.  Like the ANCC, the data that
AANP collects as an organization is not what is really relevant to your
issue--at least at this point. We collect a wide range of data on NPs,
starting with the National NP Database we maintain and then further
including data from a number of large-scale  surveys.  But any reports that
are shared are in aggregate form and de-identified. However, I do understand
what you are talking about.  The amusing part is that while physicians have
been tracked for years. NPs really have not been and have frequently
complained in the past. Yet even the physician data is inaccurate. Often,
the name at the top of the prescription is recorded by the pharmacy and,
while this does provide "credit" for the practice having written a number of
scripts, it does not get to the actual provider.  Now there is a shift in a
number of prescribers not wanting this process to identify them.  We are
seeing now that physicians are increasingly questioning the use of their
data and have asked for options to not be included in that process, as you
pointed out.
    It is my understanding that the AMA opt-out program is based on the fact
that the pharmaceutical data is somehow historically matched by various list
companies to data from the AMA Masterfile.  The Masterfile is a large
database of information on individual physicians that is started by the AMA
at the time a physician enters medical school and then updated
periodically.  These data are available at a cost from AMA and/or its
vendors.  It is the contract vendors who have shared physician information
for prescription tracking in the past. Through the opt-out program,
physicians have an opportunity to tell AMA they do not wish to have their
data (from the masterfile) shared/used for this purpose and the request then
must be honored by the list vendors.  At that point, while the prescriptions
can be tracked in a general sense, they cannot be tied to the individual
prescriber.
    AANP has maintained the AANP National NP Database for approximately 20
years (although it has become much more sophisticated and comprehensive over
the years). This is the closest thing the NP community has to the AMA
Masterfile.  We do NOT release information to anyone from this list.  It is
used in a proprietary manner to accurately enumerate NPs and identify
characteristics of NPs, as well as for important communications and
research/education purposes.  I have been told by reps from a couple of list
companies that their current NP-data sources are often the
various regulatory bodies (boards of nursing). But this is limited to those
boards that release information for this purpose.  Other sources include
data collected at exhibits, meetings, through detailing. etc.
    It would be entirely possible for AANP to have a campaign similar to
the AMA's and to keep an additional database of NPs who wish to NOT be
identified in this way.  This would require a further campaign to have the
list companies and pharmaceutical companies obtain/honor information
received directly from AANP on a periodic (quarterly, for instance)
basis.   There is no other NP organization that is in a position to do this
that I no of, as we do maintain the most comprehensive and accurate list of
NPs.  One process could include sharing what names they can use and the
related data for that person and which names they should not use, regardless
of their data source.  However, as mentioned earlier, we do not currently
license this information to other entities--ours is already protected. And
it would be a problem to institute something like this.  As an alternative,
we could serve as a source of NP names or NPIs that the various list and
pharmaceutical companies have to honor, regardless of where they get their
data--without AANP having to be the source of that data. At this point the
details are not important, but trying to explain that anything we institute
would have to be different from the medical community's, since we have never
licensed our list out to others.
    We haven't heard requests to institute anything from our members or
other NPs (until your message), although we have been watching the process
and are interested the outcomes from the medical community (it is awfully
new at this point). We appreciate your question because it does help us to
know that there are NPs who are becoming concerned about this as they
are increasingly being identified by the various companies. And it will
trigger us to start looking more closely at how something could be done to
the benefit of the NP community. Thanks for your question.  Mary Jo

Mary Jo Goolsby, EdD, MSN, NP-C, FAANP
Director of Research and Education
American Academy of Nurse Practitioners
512.276.5903  //  mjgoolsby at aanp.org



-- 
Emil Bukher PMH-NP
PROTEA Behavioral Health Services
Waterville, ME



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