Oklahoma PMP

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Real-Time Definition. Defined as reporting a scheduled prescription to the Oklahoma PMP within. 5 minutes of delivering the prescription to a customer. Placing the scheduled prescription into a bin for pickup is not considered a “ delivery” under this definition.
Oklahoma PMP R E A L - TIME R E PO R T I NG I N P R ACT I CE

Real-Time Definition

Defined as reporting a scheduled prescription to the Oklahoma PMP within 5 minutes of delivering the prescription to a customer. Placing the scheduled prescription into a bin for pickup is not considered a “delivery” under this definition.

Impact of Real-Time Reporting PR E SCR IB ER S U S I NG T HE P MP Prescribers

Percentage Using

Top 10

100%

Top 50

96%

Top 100

93%

Top 250

93%

Top 500

91%

Historically, each time Oklahoma has shortened the reporting period, there has been a significant increase in utilization

NU MB ER O F R E P O R T R E QU E S T

REPORT GROWTH 2011

2012

1,257,418

786,829

QUERIES

Flow of Data Overview

• Within 5 Minutes of Sale • Web Service, SFTP or Manual

Received and Processed • Format Verified • Error/Success Returned • Delivered for Parsing or Rejected

Prescription Reported

• Data Parsed • ASAP Data Elements Verified • Errors Identified and Stored • Prescription Stored in Database and Ready for Retrieval

Step 3 Validation and Insertion

Submission Types • Manual Entry • SFTP (Secure File Transfer Protocol) • Web Services over SSL (Secure Socket Layer)

Manual Entry Mainly used by Veterinarians and Dispensing Physicians 5 minute reporting requirement enforced

SFTP (Secure File Transfer Protocol) The use of a secure ftp service (portal.obn.ok.gov) to transmit controlled substance prescription information. An Internet connection which provides 128 bit encryption Secure Socket Layer (SSL), must be used to transmit all controlled substance prescription information. OBN’s SFTP server is located at portal.obn.ok.gov or 98.173.249.171 using Port 22 and SSH1 or SSH2 for security. The system can support additional security, including a Public Key exchange. PMP users who need an SFTP connection must fill out and submit an application for access at http://www.ok.gov/obndd/Prescription_Monitoring_Program/Request_FTP_Access.html File naming convention shall be the following for all batch data transfers: NCPDP_YYYYMMDDMS.DAT (Year, Month, Day, Minutes, Seconds) The PMP System process SFTP uploads every 60 Seconds. Large file sizes are not expected

Web Services (XML Over SSL) • SSL 128 Bit or SSL 256 Bit Connection • Web Services 1.1 • Commercial Certificate • Can Handle Single or Multiple Transactions • ASAP Block Contains the ASAP Format in One Block • A Full XML Non-NIEM Version of ASAP 4.2 Exists but Not Used by Oklahoma • Error Messages are Returned

XML Request and Response

Expected Response Time of 3 Seconds or Less Re-Transmissions Allowed Recommended 60 Second Time-Out Set on Sender’s Side

Once File is Verified (Contains Expected Elements) Parsing and Processing are Immediate

Parsing Typical ASAP Data String TH*4.0*8976546780987.DAT*01**20110119*110545*P*\ \IS*8976543*SOME Pharmacy\PHA*890789078*78907890*PHARM*PharmacyName****OK**5555555555\PAT**05*111111111****LASTNAME*FIRSTNA ME****PATIENTSTREET**CITY*OK*12345*5555555555*19430101*F*01\DSP*00*245896*20100805*2*20110401*2*01*57754324554*3 0*30*01*02*2**7425732542542*99\PRE**AA123456***LASTNAME*FIRSTNAME\TP*8\TT*89677834547478.DAT*11\

Parsing Breaks the String Into Individual Segments For Processing TH*4.0*8976546780987.DAT*01**20110119*110545*P*\ \IS*8976543*SOME Pharmacy \PHA*890789078*78907890*PHARM*PharmacyName****OK**5555555555 \PAT**05*111111111****LASTNAME*FIRSTNAME****PATIENTSTREET**CITY*OK*12345*5555555555*19430101*F*01 \DSP*00*245896*20100805*2*20110401*2*01*57754324554*30*30*01*02*2**7425732542542*99 \PRE**AA123456***LASTNAME*FIRSTNAME \TP*8\TT*89677834547478.DAT*11\

Parsed Segments Are Inserted Into Database Tables for Validation Checking TH – IS – PHA – PAT – DSP – PRE - TP

Errors Are Placed Into a Separate Table for Online Correction by the Pharmacy

Network Design SAN’s are generally expensive, especially those using fiber channel configurations Load Balancers allow you to scale as traffic increase Storage redundancy and back-up devices are critical to continuous operations

Database and SAN • Microsoft SQL Enterprise Offers Significant Performance and Recovery Features over the Standard Version

• Databases Need Large Amounts of RAM for Caching and Processing • Data Should Be Stored on a SAN

• Database Processes Should be Ran From the Database Server • Virtualizing the Database is Possible but Not Recommended

Database

SAN

SQL 2008r2 Enterprise

Raid 5

192 Gig Ram

iSCSI vs. Fibre Channel

Supports More Than 4 CPU’s

56 Terabytes of Storage

Supports Snapshots

Multiple Volumes

Views Can Be Indexed

High Availability

Data Encryption

Uses Standard Copper

Things to Consider • Bandwidth and Networks • QOS, Network Segments, Virtualized Environments, Hosted vs. Self-Hosted, DR, COOP

• Network Card Drivers (Up to Date and Optimized) • Drivers can and do effect system performance

• System Update Planning • Patch Tuesday • Using Test Systems

• Security • DMZ, Firewalls, DOS, Penetration Testing and SQL Injection

• Costs

Issues Related to Real-Time Data Collection • Identifying Non-Compliance • Baselines, Database Jobs and Triggers

• Error Correction • Duplication, Revised and Voided Scripts Sent Before the Original Script

• System Failures • Collecting Back Data, Notifying Pharmacies, Maintaining Compliance, Database Quirks

• Report Creation and System Response Under Load • Caching, HTML vs. PDF, XML, File Locks, Queue Indicators

• Overtaxing Human Resources

Thank You For Attending The Oklahoma PMP Real-Time Webinar

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