Updates from the Prescription Review Program

Expanded focus on the national drug strategy

The harms associated with controlled psychoactive prescription drugs such as opioid analgesics, sedative-hypnotics and stimulants represent a significant public health concern. A recent study from Ontario published in the journal Addiction found that opioid deaths, for example, increased 242% in the 10 years from 1991 to 2010.

In response to this growing problem, the federal government has committed $44.9 million over the next five years to expand the focus of the national anti-drug strategy to include activities to address prescription drug abuse. This includes working closely with regulatory authorities such as the various provincial colleges of physicians and surgeons.

In British Columbia, the College has in place a number of mechanisms to support practitioners’ prescribing practices for controlled substances. For example, the Prescription Review Program—one of the College’s quality assurance activities—assists physicians with the challenging task of prescribing potentially addictive medications with appropriate caution. The work of the program is informed by the PharmaNet database.

In addition, the College offers an annual Prescribers Course, where participants learn techniques for talking to patients in realistic terms about the risks and benefits that attend the use of opioids, benzodiazepines and other potentially habituating medications—situations that challenge even the most seasoned practitioners. Participants in this intensive course learn new approaches, primarily though interview simulations in small groups, supported by sympathetic, experienced and clinical teachers.

Given growing demand for the Prescribers Course, the College will offer for the first time two sessions on November 27 and 28, 2014. Registrants interested in attending should contact the Prescription Review Program at 604-733-7758 extension 2629.

Protecting patients from unauthorized access to PharmaNet and other electronic systems

The Vancouver Sun recently reported a breach of prescription records in the PharmaNet system that affected 1,600 people. By accessing a physician’s PharmaNet account without consent, an unauthorized individual was able to see personal patient information including names, dates of birth, addresses, telephone numbers, and medication histories. Although the breach did not result in fraudulent prescriptions, enough information was accessed to be used for identify theft.

For physicians using electronic health information systems—including electronic medical records and PharmaNet—ensuring the privacy and security of data is both a professional and legal obligation. The College expects registrants to be aware of and comply with their obligations, and to ensure that patient information under the custody and control of physicians’ private practice offices is handled in a secure manner from the time the patient records are created to the time patient information is disposed. 

Physicians’ private practice offices are subject to the Personal Information Protection Act, SBC 2003, c.63, which requires physicians to make reasonable security arrangements to protect personal information, including patient medical records, from unauthorized access, use, disclosure and disposal, and sets out consequences for non-compliance.

Registrants have at their disposal a number of resources to assist them in meeting their professional and legal obligations in this area:

  1. The Canadian Medical Association describes the ethical obligations of physicians regarding privacy and confidentiality in its Code of Ethics.
  2. The College, the Doctors of BC (formerly the British Columbia Medical Association) and the Office of the Information and Privacy Commissioner of British Columbia (OIPC) have jointly issued two documents. The first document entitled Physicians & Security of Personal Information discusses safeguards for protecting patient records, and the second, BC Physician Privacy Toolkit, includes a section outlining key steps for physicians when responding to a privacy breach.
  3. The College has a number of professional standards and guidelines related to medical records. All are available on the College’s website under For Physicians > Standards and Guidelines.

Registrants who have specific inquiries about patient confidentiality and privacy are encouraged to seek the guidance of legal counsel or the Canadian Medical Protective Association (CMPA) or may contact the College's registrar staff to discuss expectations.

The Prescription Review Program (PRP) is a practice quality assurance activity established to assist physicians in the challenging task of utilizing opioids, benzodiazepines, and other potentially addictive medications with appropriate caution for the benefit of their patients. The work of the PRP is informed by the PharmaNet database.