KASPER

1
KASPER

• Enhanced Rx Data
• Collection Project

Michael Smithson Office of Information
Technology Cabinet for Health and Family
Services 4th National Conference, State
Prescription Monitoring Programs December 6-7,
2007
2
What is KASPER?

• KASPER is Kentuckys Prescription Monitoring
  Program (PMP). KASPER tracks Schedule II V
  controlled substance prescriptions dispensed
  within the state as reported by pharmacies and
  other dispensers.
• KASPER is a Web accessed database that provides a
  tool to help address one of the largest threats
  to patient safety in the Commonwealth of
  Kentucky the misuse, abuse and diversion of
  controlled pharmaceutical substances.

3
Project Objective

• Address concerns of Kentucky legislators
  regarding real time data collection.
• Data reported every 8 days (per KY statutes),
  resulting in system data 16 to 20 days old.
• Key issue with law enforcement.
• Typically not an issue with healthcare providers.
• Primarily batch based data collection

4
Current Process

• Statute - 8 days to submit data
• 3rd party vendor - 7 days
• Load eKASPER - 3 days
• Data is roughly 2 weeks old

5
Goals of Project

• Primary
• Decrease Rx data collection time to 1 day
• Improve data quality and accuracy
• Switch provides record level validation
• Improve dispenser compliance with KRS 218A.202
• Secondary
• Smooth transition for dispensers
• Add Cardholder ID
• Process reversal rebill records
• Determine source of record

6
ASAP 95 Current

• 222 bytes / record
• KASPER required elements batch (file based)
• If anyone of the percentages fails the whole file
  is sent back

7
Proposed Solution

• Contract with RelayHealth (formerly
  NDCHealth/Per-Se Technologies)
• Largest pharmacy claims switching vendor in the
  country
• High probability dispensers currently use their
  service to submit insurance claims
• Dispensers may also be using their pre and
  post-editing (PPE) services
• Roughly 80 across U.S. use at least one of their
  services
• Primarily switch (record) based data collection

8
ASAP 95 Proposed

• KASPER required elements switch (record based)
• If anyone of the fields is blank only the record
  is returned

9
Project Phases - Planned

• Phase 1. Start-Up / Design / Development Ramp Up
• Phase 2. Development and QA Iterations through
  Evaluation System Readiness
• Phase 3. 30-Day Evaluation System Testing and
  Refinement
• Phase 4. 60-Day Parallel Production System
  Testing and Refinement
• Phase 5. Ongoing Full Production Operations

10
Project Timeline
11
Methods of Transmission

• RelayHealth network switch
• Delivered to KASPER within 24 hours of receipt
• If it meets new record validation criteria
• Batch transmission
• Delivered to KASPER within 24 hours of receipt
• If it meets current file validation criteria
• Manual transmission
• Delivered to KASPER within 3 business days
• If it meets current file validation criteria

12
Customer ID Issue

• Issue some contained null values
• Possible improvement use Bin Code (Positions
  4-9)
• 000000 From Paper submission, Customer ID is
  probably DL or SSN
• 000001 From Batch submission, Customer ID is
  probably DL or SSN
• 000002 From Switch submission, Customer ID is
  probably DL or SSN
• 000003 From Switch submission, Customer ID was
  blank populated with Insurance Cardholder ID

13
Reversal Rebill Issue

• No way to handle reversal and rebill records with
  current process
• Possible improvement use Transaction Code
  (Positions 12-13)
• 00 From Batch or Paper submission, new record,
  not a reversal
• 01 From Switch, new record
• 02 From Switch, reversal record
• Record includes Dispenser DEA , Rx , Date
  Filled, NDC , and Transaction Code
• 03 From Switch, rebill record
• Includes reversal record and new Rx information
• No record received if claim reversal processed
  the same day from switch

14
Files Sent to RelayHealth

• KASPER provides monthly
• Controlled substance listing by NDC Number
• Used to pull CS from switch
• Dispenser listing with DEA , NPI (if known)
  and NCPDP (if known)
• Used to identify dispensers from switch
• Prescriber listing with DEA and NPI (if
  known)
• Used to validate prescribers DEA from switch

15
System Reports

• Provided weekly by RelayHealth
• List of dispensers who have not submitted data
  within the last 7 days
• Provided monthly by RelayHealth
• List of non-validated prescribers to KASPER
• Monthly transmission confirmation report to each
  reporting dispenser detailing CS Rxs by day
• Dispenser DEA s of non-switch submitters who do
  not pass file level validation

16
Project Issues

• Dispensers
• Buy-in
• Completing registration process
• Increase Phase 3 to 60 days and Phase 4 to 90
  days
• Automating load process
• Ultimate percentage of Rxs received within 1 day
• Target 80

17
Results Pilot Study

• Pilot 48 Rx records received loaded within 1
  day of Date Filled vs. 0 with current process
• Reversal and rebill records are now received and
  processed
• Date Written populated from more major pharmacy
  chains
• Ability to identify dispenser method of data
  transmission

18
Questions? Visit the KASPER Web
Site www.chfs.ky.gov/kasper