As the founder and CEO of Invistics, a drug supply tracking software company for healthcare facilities, Tom Knight is well aware of another opioid crisis: the theft and abuse of drugs by healthcare providers.
While the problem usually gains headlines after isolated incidents—such as after an outbreak of hepatitis C virus infection in Washington state last month that was likely caused by unsafe injection practices used during drug diversion by an emergency room nurse—Knight has found the problem to be far more pervasive.
"I don't think most people realize how big the problem is," said Knight, who is also chairman of the Healthcare Diversion Network. Published research has estimated between 8% and 12% of providers will divert drugs from patients at some point in their careers. But it is hard to accurately track the problem, he said.
So earlier this month, Knight started HealthcareDiversion.org, part of a nonprofit he created specifically to catalog reports of diversion from state and federal regulators into a central database. "We're going to work with a bunch of stakeholders that already have pieces of the answer and hopefully they put together the complete picture across the whole country," Knight told FierceHealthcare. "The goal is to shine a light on how big the problem is and equip healthcare systems and healthcare executives with what they need to reduce the problem in their facilities."
The effort comes as scrutiny from the Drug Enforcement Agency (DEA), the Food and Drug Administration and other regulators has grown in recent years amid the opioid crisis, and a collection of tech-enabled solutions have gained increasing importance in addressing the simultaneous problem of diversion by providers.
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"The healthcare executives we talk to are really feeling the heat because they know there's diversion happening in their facilities," Knight said. They might not know who is diverting, but they fear the reputational harm if reports of diversion make the news. "More than anything, it's that need that's driving companies like Invistics to try to solve the problem," he said. "There is a role for the technology providers to play to help those executives solve the problem and detect the diversion, hopefully, before it causes injuries to their patients or harm to their communities."
That has been the experience for Kevin MacDonald, CEO and co-founder of Kit Check, which sells automated medication tray management solutions and uses artificial intelligence to help track and audit controlled substances.
When Kit Check unveiled its first product, the company's main focus was helping hospitals improve the safe, efficient use of their drugs and curb waste. It didn't take long for the company to widen its focus. "The way we got into diversion, quite frankly, is because one of the big areas where it's really hard to catch diversion is in the operating room environment," MacDonald said. "We were already providing a level of visibility and traceability to these drugs that no one else had. It was a natural move for us."
The company has been able to flag about 3.6% of providers showing unusual or risky behavior at hospitals that use its solution. "What we've been seeing very consistently is that as folks come on to the product, a lot of times during go-live, they are identifying nurses and anesthesia providers that are presenting unnecessary risk and unusual behavior."
Knight said he's hoping the database will be a catalyst for change among administrators to tighten up their reporting. Or at the very least, it will bring awareness that could spark policy change.
"There's very little awareness right now either at the federal or state level of how big the problem is. And so by putting this all together on a map in front of governors, in front of federal regulators, we're hoping that policy will change and we'll do a better job as a country reducing drug diversion," Knight said. "Through this nonprofit, we want to change that behavior and show people in these leadership positions that healthcare organizations that it is in their best interest to report appropriately."