Identifying drug diversion at Piedmont Athens: from weeks to 24 hours
Georgia’s Piedmont Athens Regional Medical Center, the east hub of the 11-hospital Piedmont Healthcare system, created a strong, proactive drug diversion prevention program in response to the growing opioid crisis.
The hospital embraced the culture of responsibility in healthcare, realizing the risk of drug diversion within healthcare facilities. Piedmont Athens Regional’s program identified high-risk areas and created plans to mitigate these risks, seeking to establish a high standard for the industry in pursuit of best practices.
The greatest risk identified was the window of time between when an incident of drug diversion occurs and when the incident is actually discovered. This window of time creates higher risk for patient safety.
Piedmont Athens Regional is working with cloud-based inventory visibility and analytics vendor Invistics to track and identify drug diversion across nursing and pharmacy departments.
“Invistics’ advanced healthcare inventory visibility and analytics software helps Piedmont Athens Regional get a transparent view into its drug inventory and uses advanced analytics to detect instances of drug diversion in almost real time,” said Russ Nix, drug diversion specialist at Piedmont Athens Regional Medical Center. “Before working with Invistics, it could take weeks for Piedmont Athens to identify instances of drug diversion – now it takes less than 24 hours.”
Additionally, since starting the program with Invistics, Piedmont Athens has been able to accurately identify cases of drug diversion 100 percent of the time, Nix said. That is substantial because in situations like this there are often false positives, he added.
“A possible solution for this risk was presented by Invistics,” he said. “Flowlytics provides alerts for high-risk incidents in almost real time. This technology communicates across other information systems within the facility, reconciling data automatically and providing alerts within 24 hours. This ability reduces the window of discovery from an average of two to four weeks to one to three days.”
There are a variety of inventory visibility technology vendors with products on the market. These include Cardinal Health, Clear Spider, Cognizant, IntelliGuard and Omnicell.
MEETING THE CHALLENGE
As the drug diversion specialist, Nix conducts the monitoring and investigations regarding drug diversion and medication management. This position determines what incidents warrant further investigation based on a number of factors, including type of medication, patterns of medication management, trends in diversion and behavior. He then conducts investigations starting with an initial follow-up and ending with a resolution.
“The Flowlytics technology integrates with the automated medication dispensing cabinets from Omnicell, the medication administration records/chart from Epic, time clocks from Kronos, and other systems to capture all of the pertinent information in one location for analysis,” Nix explained.
Alerts are provided in near real time, which significantly reduces the window between incident and discovery of incident. These alerts have also been accurate, as all of the alerts thus far have either been indicative of diversion or medication management issues, Nix said.
The technology has also been used to identify areas in the facility where procedures needed adjustments and staff required training, while also providing information that warranted full investigation, he added.
Piedmont Athens Regional’s drug diversion program primarily focuses on two distinctly different but related areas: drug diversion and medication management. While attempting to mitigate drug diversion and the risks associated with diversion, the program also seeks ways to address medication management issues such as disordered practice, policy violations and training issues.
Addressing these simultaneously enables Piedmont Athens Regional to ensure patient safety at the highest level, which is the ultimate goal, Nix said.
“Utilizing Invistics’ technology has enabled Piedmont Athens Regional’s drug diversion program to identify both of these issues without false positives, creating a much more effective and efficient program,” he said. “As a result, more focus can be given to resolving the issues that exist, while also expanding the education and awareness within the organization.”
It helped elevate a program that was already establishing the standard for drug diversion prevention to even higher levels, Nix contended.
ADVICE FOR OTHERS
“The most important point that I can make regarding other healthcare providers or organizations is to act,” Nix advised. “In an industry that thrives on progress and pursuit of best practices, healthcare is behind when it comes to addressing the opioid crisis and drug diversion.”
There is no longer time to consider reactive measures and processes for dealing with drug diversion, he said. Technology is available and has the capability to help minimize the risk of harm created by diversion, he said.
“Healthcare has a responsibility in this epidemic, to our patients, visitors, staff and community,” he said. “Creating a truly proactive drug diversion program is necessary, and technology must play a role in that program for it to be successful.”