Innovate to make KASPER more Kentucky-friendly

Published 6:15 am Saturday, June 16, 2018

Guest columnist

Secretary Meier: Congratulations on your appointment to lead the Cabinet for Health and Family Services, which, with 8,500 employees, is state government’s largest agency.

The release from the governor’s office announcing your appointment commended your emphasis as former deputy chief of staff “on improving technology and analytical capabilities to better measure policy outcomes.”

Email newsletter signup

Your work has led to important reforms, including securing and beginning to implement Kentucky’s Medicaid waiver granted by the federal government.

You can count this columnist among those who heartily agree that you’re the “ideal choice,” as your boss put it, to lead the cabinet.

Maintaining your commitment to innovation and modernization could leave a lasting legacy through policies that save and better Kentuckians’ lives.  

Take, for instance, the cabinet’s prescription drug-monitoring policy.

Like dial-up was once the pinnacle of telecommunications tools, the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system was previously the gold standard of drug reporting activity, resulting in the commonwealth’s ranking among states with the highest nonmedical use of painkillers dropping from second in 1999 to No. 31 less than 15 years later.

But just as technological advances rendered dial-up obsolete, so the increased appetite to obtain opioids for illegal use revealed the need for databases that help prescribers know, accurately report and monitor patients — especially those at high risk of overdosing who are adept at masking their true condition.

Like the demand for mobility led to the replacement of clunky dial-up devices by wireless and much smaller cell phones, allowing for instant communication and real-time access to worldwide developments, so the need to effectively address the growing prescription drug crisis has resulted in the creation of a new software platform — a new gold standard, if you will.

Ironically, however, even though this new approach was created by Louisville-based Appriss, Kentucky remains one of eight states stuck in prescription drug monitoring dial-up mode.

It’s hardly coincidental that Kentucky both clings to its outdated KASPER like a toddler refusing to let go of her security blanket while also landing in the top-10 states with the highest opioid-related overdose deaths, including 989 – nearly double the national rate – in 2016.

Most other states have invested in and transitioned to new-generation and highly accessible prescription-monitoring platforms like the Appriss Health AWARxE solution, which reduces the time needed to obtain patient reports and score the risk factor for opioid abuse from up to 10 minutes to less than a second.

Using this cloud-based technology allows the integration of patients’ up-to-date information into doctors’ hand-held devices, removing the need for physicians to log in on separate server-based computers.

Kim Gaedeke, deputy director of Michigan’s Department of Licensing and Regulatory Affairs, in a recent email offered important life-saving changes brought about by using Appriss’ platform and its accompanying tools to revamp the Michigan Automated Prescription System (MAPS).

Gaedeke reports the upgrades led to increased use of the system and have made it possible for Michigan to require prescribers to “query the system prior to subscribing or dispensing a controlled substance to a patient in a quantity that exceeds a 3-day supply.”

How many such deadly supplies are now being prescribed that an AWARxE-like revamped KASPER system would allow us to catch and stop here in Kentucky?

We know you’re currently evaluating the most effective approaches to take in updating the cabinet’s policies and which technological tools will position Kentucky to successfully address health issues in the future, including how best to modernize the outdated KASPER system.  

Thank you, in advance, for applying your continuing commitment to “improving technology and analytical capabilities” in developing and improving policies which use the cabinet’s considerable resources to save lives by effectively fighting back against Kentucky’s devastating drug scourge.

Jim Waters is president and CEO of the Bluegrass Institute for Public Policy Solutions, Kentucky’s free-market think tank. He can be reached at and @bipps on Twitter.