A Tech Solution to Drug Diversion: What to Do When a Supplier Steals a Patient’s Medication

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Imagine that you are injured in a car accident and you go to the hospital. While you’re there, you’re given doctor-prescribed painkillers…unless you don’t.

Unfortunately, too many patients go without prescribed drugs because medical professionals – a distinct but sizeable minority – “divert” drugs for other purposes, often misusing the drugs themselves. An estimated 10% of healthcare workers abuse drugs, according to the US Substance Abuse and Mental Health Services Administration and the American Nurses Association.

The diversion of drugs on this scale represents a great deal of pain for the patients concerned, who may be illicitly receiving other drugs to mask the act. However, the damage goes well beyond a single patient. Any patient can find themselves at the mercy of a deficient clinician. There is also a risk to third party recipients of stolen drugs, some of which can be fatal.

Diversion of provider-prescribed medications can cost hospital systems millions in fines for flawed medication management processes. And there’s the reputational damage if the public finds out that doctors or nurses are stealing patients’ medicines.

Hospitals, health systems, pharmacies, clinics, nursing homes and emergency centers are at risk. Each has several drug lifecycle processes that are vulnerable to diversion, including supply and delivery to wholesalers, central pharmacy inventory management, pharmacy distribution, distribution to doctors and nurses and , finally, administration to the patient.

The problem of drug diversion has been around since Hippocrates, but it’s especially serious now. Overdose deaths in the United States hit an all-time high in 2020 and are still on the rise, and the Covid-19 pandemic has strained an already stretched healthcare workforce. Crowded intensive care units couldn’t be more demanding environments, making it easier than ever to divert medications.

Health administrators need support

Hospitals and health systems have worked hard to address the problem, creating busy oversight committees and laborious processes. On paper and in rudimentary computer systems, they attempted to track every prescription from the pharmacy to the patient (and – if there is excess medication to dispose of – back to the pharmacy).

The work is so complex and the offenders so elusive that detection is more than humans alone can handle. Countering drug diversion is a job best suited to advanced analytics and machine learning, which many healthcare systems are embracing. Well-designed systems are equipped to understand the normal flow of drugs in a sprawling organization and detect anomalies while minimizing false positives.

Of course, the technological challenge is important. Abnormalities in prescription drug flow are only significant when compared to a valid picture of normal use. If a hospital only has three years of historical drug data and two of those years were significantly impacted by a pandemic, what is the true baseline? The answer is that no one knows.

Ever-changing pharmaceutical information systems, automated dispensing systems, and electronic health record systems add to the difficulty of synthesizing useful data. The same goes for the different labels that different technology vendors use for different data, such as brand name drugs and their generic equivalents.

Another challenge is that machine learning systems require regular human attention to do their job: someone has to tell the system whether its latest alert is accurate – that the identified employee is actually diverting prescription drugs – or a fake. positive. This is one way machine learning gets smarter; skip this step and you’re wasting your time and money.

Finally, there is the challenge of keeping the data up to date. Few drug diversion detection systems feed real, instantaneous drug flow data back into the system in near real time. But that’s what it takes to refine the baseline.

Done well, advanced computing-based drug diversion prevention can save lives, improve patient care, reduce healthcare costs, and eliminate wasted effort.

It’s important work, and it’s satisfying. For me, the reward is not shaming people with substance abuse disorders. This is about protecting patients, healthcare workers, hospital systems and public health – and making life easier for everyone involved.

Photo: cagkansayin, Getty Images


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