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Prescription Crosscheck Program Helps Tricare Beneficiaries

By Navy Lt. Jennifer Cragg
Special to American Forces Press Service

WASHINGTON, March 5, 2009 – The Tricare military health plan is ensuring patient safety for its 9.2 million beneficiaries through a revolutionary drug utilization program, a senior Tricare official said last week.

“We cover about 2.2 million prescription medication claims per week -- that’s about 120 million prescriptions per year,” Navy Rear Adm. Thomas J. McGinnis, chief of Tricare’s pharmaceutical operations directorate, told “Dot Mil Docs” listeners Feb. 26 on BlogTalkRadio.com. “That data comes into the Pharmacy Data Transaction System, … and the purpose of PDTS is to provide a safety net via electronic drug utilization reviews.”

McGinnis said the software notes any new medication coming into a patient’s profile and compares it to other medications in that patient’s profile. The software looks for duplications in therapy or possible drug interactions.

“If it notes a serious interaction, PDTS sends a message to the pharmacist, who will call the prescriber to discuss what the patient should do,” McGinnis explained. “Our ultimate goal here at Tricare is to identify safety concerns in our beneficiary population before the number of serious adverse events triggers a concern at [the Food and Drug Administration].”

He added that the Defense and Veterans Affairs departments have made great strides in collecting medical and pharmaceutical data in a way that potentially can identify safety issues quickly. The departments have formed a partnership with FDA in a new initiative called “The Sentinel Network,” an advanced adverse-event surveillance system.

“We also need this capability to assess the negative risk of medications vs. their benefit in the population at large,” McGinnis said. “Any medications you take has risks. Our goal is to assess the risk and notify the providers and patients so that they can make informed decisions about how they should take their medications.”

McGinnis added that the system is able to see clinical data, such as laboratory results, for patients under the care of a military treatment center. “The military treatment centers use an electronic medical record called ‘Altha,’ but not all doctors’ offices in the private sector use an electronic medical record yet,” he added. But the use of electronic medical records will increase in the private sector over the next five years, he said, and this will help Tricare to capture data and to be able to do robust, clinical studies.

“That’s coming soon with a big push now from the government to capture these data in an electronic medical record,” he said. “That data will not only flow to Tricare, but it will flow from Tricare to providers who see our patients so they can see what laboratory or radiology studies were done in the military treatment facilities.

“We also plan to provide patients with this same data in an electronic ‘personal health record’ if they would like to have it,” he continued. “That, too, is coming soon.”

(Navy Lt. Jennifer Cragg serves in the Defense Media Activity’s Emerging Media directorate.)

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