Saturday, November 5, 2011

Electronic Health Records (EHR) & Medical Marijuana Dispensaries

I had to think long and hard before publishing this blog. I know the topic is still very controversial in many circles. But after 40 years of keeping silent... 

Introduction

What do the Open Source, Alternative Energy, and Medical Marijuana communities have in common? First, they appear to have a number of common values like freedom, independence, thriftiness, creativity, and innovation. Second, they are challenging major corporations in entrenched industries with traditional business models. Third, they are trying to change long accepted attitudes and behavior. Finally, they are each working to modify or change existing government legislation and outdated policies.

Background

According to a recent Gallup poll taken in 2011, a record-high 50% of Americans now say the use of marijuana should be made legal, up from 46% last year. Forty-six percent of Americans still say marijuana use should remain illegal. When Gallup first began asking the how people felt about legalizing back  in 1969, only 12% approved and 84% opposed the idea.  Approval figures hovered in the mid-twenties from the late 1970s to the mid-1990s before beginning the current dramatic upward climb.

CNBC Report on the Marijuana Industry - Based on various demand-based studies, best estimates put the annual marijuana market at $35-$40 billion. According to a 2009 Standard & Poor's industry report, the tobacco and alcohol industries generated $263 billion combined.

The advocacy group National Organization for the Reform of Marijuana Laws claims that marijuana is the third-most-popular recreational drug in America, behind only alcohol and tobacco. Some states have decriminalized marijuana's use, some have made it legal for medicinal use, and some officials, including former U.S. Surgeon General Joycelyn Elders, have called for legalizing its use.

Police prosecuted 858,408 persons for marijuana violations in 2009, according to the FBI's annual Uniform Crime Report. Of those charged with marijuana violations, approximately 88 percent (758,593 Americans) were charged with possession only.    -  NORML News

According to a 2010 survey, Gallup found that 70% of the population favored making it legal for doctors to prescribe marijuana in order to reduce pain and suffering. Americans have consistently been more likely to favor the use of marijuana for medicinal purposes than to favor its legalization generally. Currently 16 States and the District of Columbia offer legalized medical marijuana.

This leads me to the somewhat odd, but related discussion of practice management (PM) and electronic health record (EHR) systems and their use in medical marijuana clinics and dispensaries.

Medical Marijuana Information Systems

With the passage of medical marijuana legislation allowing for the creation of medical marijuana dispensaries or clinics, the need for practice management (PM) and electronic health record (EHR) systems to help manage their operations - tracking inventory, generating reports for management and the government, register patients, schedule appointments, accept prescriptions, bill customers, and much more. Surprisingly, medical marijuana dispensaries or clinics are moving fairly quickly to embrace the use of these systems. These include both commercial-off-the-shelf (COTS) and free & open source software (FOSS) products.

Selected Examples

Commercial-Off-The-Shelf (COTS)
  • Cougar Mountain -  Cougar Mountain integrated accounting and point of sale software for medical marijuana dispensaries. See http://www.cougarmtn.com/medical-marijuana/
  • IMCL 420 - Innovative Marijuana Caregiver Logistics (IMCL) 420, providing government agencies, dispensaries and caregivers with state-of-the-art tools to successfully manage Medical Marijuana business activities. See http://imcl420.com/default.aspx
  • Kush-Cart – A full featured online software system specifically designed for the legal medical marijuana dispensary and delivery industry.  The software allows you to manage your entire inventory, patient records, make and track orders, and more.  See http://kush-cart.com
  • mmjmenu -  Built from the ground up for medical marijuana dispensaries, co-ops, collectives and wellness centers. The system helps track sales, generate profit loss reports, track and manage your entire inventory, and help you stay compliant with state laws. See http://mmjmenu.com  
  • MJFreeway -  A fully integrated Point of Sale (POS), Inventory Control and Patient Management System designed from the ground up to serve Medical Marijuana Centers (MMC), Caregivers, Collectives, Dispensaries and Patients. See http://www.mjfreeway.com  

Free & Open Source Software
  • GrowAssistant - Free and open source software that assists you in all phases in the growth of marijuana plants. See http://www.growassistant.com
  • Herb.IQFree & open source software that can be used by Medical Marijuana patients and caregivers to track all aspects of your growing environment, e.g. plants, schedules, budget, etc. See http://herbiq.codeplex.com
  • 420 Web Pros -  Providing web development and hosting for the Medical Marijuana industry. They use the Magento open source e-commerce software to manage their sites. See http://420webpros.com/web-solution-services/web-design/ 

* Also, see Google links to free Mobile Cannabis Apps


Conclusions & Recommendations

Here are some basic observation, conclusions, and recommendations for developers working on health IT systems supporting the medical marijuana industry:
  • Legalization must come first.
  • Privacy and security are key to the development of these systems.
  • Medical marijuana data, terminology, and  telecommunications standards will become an issue that will need to be addressed.
  • Consider simply adding a medical marijuana module to existing practice management and EHR systems.
  • Consider building a personal health record (PHR) system and associated web site for your patients or consumers.
  • For organizations with multiple facilities, there will eventually be a need for a Master Patient Index, Master Provider Index, and a Master Facility Index.
  • Start thinking about an interface to the National Health Information Network (NHIN).


Selected Links/References


So, some of the many questions raised here include:
Do you think Medical Marijuana laws should be passed in your State? Do you think Marijuana should be legalized and industry controls put into place to regulate the industry? Will people be more willing to share information about their use of drugs with their doctor? Why are Medical Marijuana clinics adopting EHR systems at a more rapid clip than doctor's offices? Will legalization reduce the number of people prosecuted? The number of people jailed? Reduce the power of drug cartels? Save significant tax dollars currently going to support the legal system, jails, etc.? Should we be discussing this issue in more public forums? Who benefits from not legalizing marijuana?