Florida Flights Opioid Epidemic with Narxcare Tracking
In response to the opiate epidemic and the pill mill phenomenon, the state of Florida instituted a prescription tracking system under Rick Scott. The system is called NarxCare. It tracks the pharmacy, the physician, and the patient when they fill a prescription for a controlled substance in the following states: Alabama, Connecticut, Florida, Georgia, Louisiana, Maine, Michigan, Minnesota, Mississippi, North Carolina, Ohio, Rhode Island and South Carolina. More states will be added in the future. This system is run by artificial intelligence and features a scoring system whereby each patient receives a numerical score on a scale between 0 and 1000. The higher the score, the more risk the patient is for an overdose or other adverse outcome. The artificial intelligence system compiles data on the patient based on the number of pharmacies they go to, the number of outpatient clinics they go to, and the number of drugs they are on. More addictive and more dangerous drugs with overdose potential such as those in the benzodiazepine, opiate and amphetamine classes cause the patient to accumulate more points and score higher.
This whole system was set up to prevent people from doctor shopping and being overprescribed controlled drugs. The system has been effective in realizing this goal. Each time a patient sees a physician and requests a prescription for a controlled drug, the physician will download the patient’s prescription history from the NarxCare system. If the physician sees that the patient has been prescribed a similar drug or multiple controlled drugs from other physicians, they will most likely not prescribe them, therefore avoiding duplicate prescriptions and preventing overprescribing. That is the greatest positive result of this system.
But there is a downside, a negative aspect of the system. By its very nature, the system basically places a label on patients with high scores. That high score translates to high risk, and for that reason alone, nobody wants to treat or prescribe medicine to them. Because they are also evaluated by the system, the physicians, hospitals, clinics and pharmacies do not want to treat these high scoring patients because they are a huge liability. The NarxCare system has created a group of medical undesirables. The criteria used to create these undesirables is not always fair. In many cases, these patients actually need good medical care more than those with lower scores and lower risk, but they may be hard pressed to find someone to treat them. They are turned away by the health care system. This can be a very dangerous thing. Patients in desperate need of medicines may not be able to get them because of the label. People who go to the hospital emergency rooms and urgent care centers can be treated very badly because of their high scores and sent away with no treatment. This NarxCare system is new territory, and physicians must learn to navigate through it while providing good medical care to their community. Perhaps they should not make decisions based solely on a score generated by an electronic algorithm; they should also exercise common sense and good judgement in considering treatment for all those who go to them seeking medical help.