In partnership with IntelliGuard Intelligent Inventory Solutions
The first time I ever even began to understand the process of diversion was sometime during medical school. The next time was in residency when we had a guest speaker, not too different from myself, discuss their methods of capitalizing on wasted medication in the operating room. Then, years later when I started abusing controlled substances myself, I thought about it every day.
I was sitting in a large lecture hall at 19 years old, looking forward to the rest of my career, when a physician talked to an auditorium full of prospective doctors about the pressures that being a doctor entailed. While the main takeaway was regarding how those pressures could often lead to the temptation to use the substances intended to help patients relieve their pain, all I could think about was how that temptation would never find me.
And now, as you all know too well, I couldn't have been more wrong. But, if you've read the previous blogs in this series, you are familiar with my story as an addict, and how I was able to return to my practice as an anesthesiologist. So, with the final blog in this series, I'd like to end my thoughts and plant a seed of hope - prevention is possible.
However, it is paramount to understand that the possibility of prevention becomes a reality only when every system, department, and facility within the healthcare system works toward the same goal. Protocols, people, technology, reporting, and oversight will limit our risk and ensure that we distribute medication safely. A holistic approach from prescribing, ordering, procurement, storage, and wasting is safest when automated and supported by technology. High-risk processes, especially, should be treated with even more sensitivity. Not only does this require more staff, but a complete chain of custody - all of which can be managed by advanced technological systems like RFID.
The healthcare industry is notoriously known for creating disjointed workflows and time-consuming steps for caregivers at all levels, including anesthesiology providers. Because systems from different departments fail to communicate with each other, providers are oftentimes forced to shift most of their focus from patient care to administrative work.
There are so many gaps in the medication management and workflow that can lead to diversion. The opportunities, especially when it comes to medication waste and inventory management, can often be endless. Mechanisms and processes are the next way to track medications and prevent diversion. Understanding and having a way to close the diversion gap during the waste process will lead to better patient care.
Part of my healing journey is identifying what else I can do to support my colleagues and help prevent others from falling into the diversion/addiction cycle. Partnering with industry - and specifically cutting-edge technology - which helps prevent diversion events before they start. IntelliGuard is committed to developing the systems that are needed to fill in these gaps. If we as pharmacists, physicians, and patients are the soldiers, IntelliGuard's technology is the weaponry and armor that protects us as we move forward into battle.
The company developed the first and only anesthesia solution that combines secure medication storage and access with RFID-enabled automated data collection. Medication inventory automatically updates in real-time each time a drawer is closed – with no manual input – eliminating delays and interruptions in the operating room.
The benefit of this technology is twofold:
- Pharmacy teams get real-time visibility to accurate medication inventory data in every operating room or procedural area, every minute of every day.
- Anesthesia providers (like myself) enjoy quick, simple access and confidence that the right medications will be available when and where I need them for every specific case.
More importantly, the system securely stores and manages controlled substances. With hundreds of controlled substances scanned simultaneously within seconds, pharmacy staff is alerted of any sign of diversion in real-time and can track the chain of custody from the pharmacy to the point of care. It’s another level of checks and balances that could ultimately save a life.
They also offer a waste witness software module that integrates with the electronic health record (EHR.) It automates dispense, administration, and waste events creating data-rich analytics to which can be used to detect controlled substance anomalies. This is another example of how the company is committed to preventing diversion, an area that is ripe for improvement and modernization.
Furthermore, the recent webinar Healthcare Professionals: The Road from Diversion and Addiction to Prevention served as a safe space, an army base - if you will, that allowed several soldiers, including myself, to gather and debrief on the future of diversion prevention. During this time, the Director of Pharmacy Services at Emory University Hospital, Tony Scott, made several profound declarations.
"We are the centralized department that handles the medication-use process. So, as we control the point-to-point use of medications and controlled substances, I think we (pharmacists, academics, and administrators) play a central role not only in managing diversion but preventing it as well," Scott said.
Tony continued to explain how to achieve this by stabilizing all touchpoints within the distribution of the medication-use process, "I think that our role in prevention as pharmacists positions us to lead the charge to help not just be reactive but also be proactive in terms of identifying solutions and opportunities to reinforce diversion prevention."
It has become more and more clear: in order to properly prevent diversion, healthcare organizations need to implement technology and diligent surveillance to more effectively review process compliance and effectiveness, strengthen controls, and proactively prevent diversion.
This implementation, it starts with you. This is no cross for me to bare alone. Sharing my story has felt like a sounding bell, an outcry for others to do the same. Will you be the one to sit at your next committee meeting and talk about the hard things? Will you be the one to recognize the elephant in the room that sits there, heavy, when it becomes known that a doctor or nurse is struggling? Will you join our army?