We’ve made great strides in addressing the opioid epidemic at a national level. Just two months ago, Congress passed a comprehensive bipartisan package (PDF) taking aim at substance abuse disorders by combining ideas from 58 opioid bills.
But one area that still eludes our industry is the drug diversion happening within healthcare systems by as many as 10% of all healthcare providers.
As a 2017 Porter Research survey (PDF) on this topic noted, 96% of healthcare industry respondents acknowledged that while drug diversion is occurring in healthcare, most diversion goes undetected.
In 2011, Piedmont Athens Regional Medical Center began building a drug diversion program, which was practically unheard of at the time. Through trial and error, the program has grown from an ancillary agenda into a full-time effort.
We started off with manual investigations and reporting, eventually growing the program to include dispensing cabinet analytics—which is typical of large health systems today.
However, looking at patterns of medication waste and tracking inventory through automated dispensing cabinets offers only a small portion of information.
It usually takes at least a week to establish a pattern that flags our compliance team. With opioid users, a lot can happen during a week. And the broad nature of data can lead to a lot of false positives. We found ourselves wishing that we could generate reports and follow up on red flag incidents more quickly and accurately.
Serendipitously, in 2017, the National Institutes of Health (NIH) awarded a grant that ultimately set the stage for a new phase in our program. Piedmont partnered with Invistics, a provider of healthcare analytics software, to utilize machine learning to gain insights into medication discrepancies.
With this new technology, we were able to gain real-time visibility across the entire supply chain and multiple systems to extrapolate meaningful information, such as high-risk patterns within medication management, from various sources of raw data. We’ve also established markers within the software that alert us based on the risk of incident or behavior.
Another pivotal moment for us came in 2017, when Piedmont leadership saw an opportunity to create a task force that brought together leaders from clinical, operations, marketing, government affairs and pharmaceutical teams.
Our entire health system is now sharing knowledge on how to prevent and address the opioid crisis from every aspect of our health system.
And as of 2017, the state of Georgia requires all physicians to undergo mandatory, three-hour opioid prescription training before they can renew their medical licenses. We saw this as another opportunity to further educate clinicians on diversion and the consequences of addiction.
Setting the bar
Every healthcare facility administering medication to patients is at risk of diversion. The question is not if diversion will occur in a facility, but when it will occur.
As a result of our engaged leadership and new technology, we’re able to spot and investigate potential red flags and minor issues before they become major ones.
These days, we’re contacted at least once a week by outside hospital system leaders to discuss our drug diversion program and share insights. As we strive to find new ways to prevent drug diversion, we hope open communication about our experiences will benefit hospitals across the nation.
Lily Henson, M.D., is the chief medical officer of Piedmont Henry Hospital. Russ Nix has over 20 years of investigations experience with I5 years of experience in criminal narcotics investigations. Nix serves as a drug diversion specialist at Piedmont Athens Regional Medical Center.