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Health-records software pushed opioids to doctors in secret deal with drugmaker

bloomberg.com

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Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#4

Post by pimmen »

I think this creates an interesting discussion on the part of the designers and programmers. Did they understand that what they were building was going to increase opioid dependence? Did they ask about it?

And, the most interesting question of all: If they found out that was the case did they try to justify building it to themselves in some way?

Full disclaimer: I have built software that I had ethical reservations about myself. I am in no way a saint, I don't claim to know what I would've done in the same situation but I think it's for the benefit of software development to acknowledge that we do make ethical decisions when we build things and that the solution to something as complicated and diverse as ethics is not to just ignore it.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#5

Post by codeulike »

[when opening a patients records] a pop-up would appear, asking about a patient’s level of pain. Then, a drop-down menu would list treatments ranging from a referral to a pain specialist to a prescription for an opioid painkiller.

Click a button, and the program would create a treatment plan. From 2016 to spring 2019, the alert went off about 230 million times.

The tool existed thanks to a secret deal. Its maker, a software company called Practice Fusion, was paid by a major opioid manufacturer to design it in an effort to boost prescriptions for addictive pain pills ...

Its existence was revealed this week thanks to a government investigation.

Holy shit

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#6

Post by nkrisc »

pimmen wrote: post #4

I think this creates an interesting discussion on the part of the designers and programmers. Did they understand that what they were building was going to increase opioid dependence? Did they ask about it? And, the most interesting question of all: If they found out that was the case did they try to justify building it to themselves in some way? Full disclaimer: I have built software that I had ethical reservations a…

To be fair to the developers and designers: how exactly would they know that the inclusion of "opioid prescription" as an item in that list would help fuel a an opioid epidemic? Hindsight is 20/20, but would you expect them at the time to think, "If we include this as an option in this list, it will contribute to a nationwide epidemic of opioid abuse and countless deaths"? Honestly, I think it's a stretch, especially if they weren't aware of a deal with opioid manufacturers being the reason for it in the first place.

It would be one thing of some product manager came to them and said, "since a large opioid manufacturer has paid us a lot of money, we're going to implement this feature in order to increase unnecessary opioid prescriptions" but I would be surprised if that happened. "We're going to implement this feature to help doctors pick the right treatment for a patient's pain."

Someone here is evil and deserves what's coming, but I don't know that it necessarily would have been readily obvious to those implementing it. In fact, it would likely have been preferable to conceal the true nature of it lest any of them have any moral qualms or objections.

I'm not trying to negate your question, either. I think it's a good question to ask and consider.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#9

Post by r_singh »

In retrospect doesn't seem like a very big surprise that they would resort to something like this as Practice Fusion was initially launched as free for a long time, and costed only $99 per month later.

One should be increasingly wary of using free software for crucial applications and sensitive data. Being HIPAA compliant isn't enough.

There's a regulatory body called POC3 (https://www.poc3.org) for communication device (and software) providers who make money from pharmaceutical ads to lay down ethical guidelines. Hopefully a body like this should be formed for partnerships between pharmaceutical companies and EHR (& similar) software products too.

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