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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

#41

Post by bpaddock »

idiot900 wrote: post #14
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…

I'm a doctor. During medical school and residency, I was taught in good faith that "only as much as necessary" opioid was OK to give and wouldn't create dependence - it was only an "excess" of opioid that would cause a problem. So under the banner of reducing the suffering of our patients, and a mandate to reduce patient-reported pain scores, opioids flowed relatively freely. Now we know that was a terrible idea with…

The problem is things have gone to far the other way now. Those with Chronic Pain are now committing suicide (as did my wife) when they are let to suffer.

The CDC itself stated in April of 2019:

"CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain Some policies, practices attributed to the Guideline are inconsistent with its recommendations"

Sadly the medical community is not getting that message due to this mater now becoming political.

https://www.cdc.gov/media/releases/2019/s0424-advises-misapp...

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

#42

Post by to11mtm »

conanbatt wrote: post #38
dirktheman wrote: post #23

If I would know that my MD is using a free, cloud based, ad-supported platform to keep my health records I'd be rather ticked off...

You could ask your provider to use Epic, which is none of those and can cost upwards of 10k a year per doctor. Practice fusion is an industry leader precisely because it makes delivering care compliant and cheap for doctors. In any case, the user of EMR's are providers, not patients.

Also, I've never heard a good thing about Epic...

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

#43

Post by conanbatt »

bpaddock wrote: post #35
marriedWpt wrote: post #12

Remember when physicians said they should be the only ones to give out antibiotics for our safety? Can we totally kill that excuse for their monopoly? We trusted the physician cartel for decades and they have made healthcare worse.

Fluoroquinolone antibiotics such as Levaquin (no longer manufactured, only generics now [you can not sue the makers of generics in most states]), Cipro etc. should be removed from the market due to their devastating side effects. My late wife's Journal was part of the 2015 FDA hearing about getting these restricted from doctors giving them out like candy. Alas all we got was yet more "Black Box" warnings that you and…

I thank you for sharing your story and I can't even imagine the pain your wife and you went through.

I do think that even though there are dangerous drugs, there are costs to making the use more expensive or harder to get. All drugs have side effects and some are truly devastating and the best way to handle that risk/reward tolerance is talking to a provider and managing it. The same way some drugs create dependence, the lack of them also cause enormous pain, and their increased price also create inaccessibility.

There is definitely a rampant culture of consuming pharmacological products in the US: maybe there are things that are causing the US society to be so dependent on drugs that can be addressed.

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

#44

Post by conanbatt »

to11mtm wrote: post #42
conanbatt wrote: post #38

Earlier quoted context omitted.

You could ask your provider to use Epic, which is none of those and can cost upwards of 10k a year per doctor. Practice fusion is an industry leader precisely because it makes delivering care compliant and cheap for doctors. In any case, the user of EMR's are providers, not patients.

Also, I've never heard a good thing about Epic...

It's made in Visual Basic, and it literally cannot interact with its own versions. Hospitals have different versions of the same system in the same building and cant exchange information.

All EMR's suck though. (note: I made one)

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

#46

Post by conanbatt »

bpaddock wrote: post #41
idiot900 wrote: post #14

Earlier quoted context omitted.

I'm a doctor. During medical school and residency, I was taught in good faith that "only as much as necessary" opioid was OK to give and wouldn't create dependence - it was only an "excess" of opioid that would cause a problem. So under the banner of reducing the suffering of our patients, and a mandate to reduce patient-reported pain scores, opioids flowed relatively freely. Now we know that was a terrible idea with…

The problem is things have gone to far the other way now. Those with Chronic Pain are now committing suicide (as did my wife) when they are let to suffer. The CDC itself stated in April of 2019: "CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain Some policies, practices attributed to the Guideline are inconsistent with its recommendations" Sadly the medical community is not…

Incredible that this is another comment of yours that manifests the answer I gave you in this topic.

Providers are under the microscope for opioids now, so why risk it, it's not their pain. Medicine is a rough field.

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

#48

Post by bpaddock »

bpaddock wrote: post #41
idiot900 wrote: post #14

Earlier quoted context omitted.

I'm a doctor. During medical school and residency, I was taught in good faith that "only as much as necessary" opioid was OK to give and wouldn't create dependence - it was only an "excess" of opioid that would cause a problem. So under the banner of reducing the suffering of our patients, and a mandate to reduce patient-reported pain scores, opioids flowed relatively freely. Now we know that was a terrible idea with…

The problem is things have gone to far the other way now. Those with Chronic Pain are now committing suicide (as did my wife) when they are let to suffer. The CDC itself stated in April of 2019: "CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain Some policies, practices attributed to the Guideline are inconsistent with its recommendations" Sadly the medical community is not…

Pain Warriors documentary about Chronic Pain and medical establishment teaser is on my YouTube channel. Read the reviews of those that have seen the full movie previews.

https://www.youtube.com/watch?v=TN3T7lfab7Y

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

#49

Post by bpaddock »

conanbatt wrote: post #43
bpaddock wrote: post #35

Earlier quoted context omitted.

Fluoroquinolone antibiotics such as Levaquin (no longer manufactured, only generics now [you can not sue the makers of generics in most states]), Cipro etc. should be removed from the market due to their devastating side effects. My late wife's Journal was part of the 2015 FDA hearing about getting these restricted from doctors giving them out like candy. Alas all we got was yet more "Black Box" warnings that you and…

I thank you for sharing your story and I can't even imagine the pain your wife and you went through. I do think that even though there are dangerous drugs, there are costs to making the use more expensive or harder to get. All drugs have side effects and some are truly devastating and the best way to handle that risk/reward tolerance is talking to a provider and managing it. The same way some drugs create dependence,…

I've gathered all of the FDA warnings and some of the EU warnings (they say don't use them) at the link below.

The FDA itself says these should not be used until all other possibilities have been exhausted. Sadly the doctors are not getting the message and are giving them out like candy.

http://www.kpaddock.com/fq

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

#50

Post by abdullahkhalids »

codeulike wrote: post #5

[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 s…

I see people here who don't seem to get why this is unethical. So let's be crystal clear.

Doctors are simply opening a patient's record, for whatever reason. This patient may not even be sick or need any medication. The doctor has to deal with a pop-up, and if they interact with it, they get presented with various options. Both options mentioned in the news report are likely to increase opioid addiction.

The problem is not in what order the options are presented, or what the default is. It is a problem that the treatment plan it creates was not created by the patient's primary doctor, but this is not the biggest problem. The problem is that a pop-up appears, forcing doctors to choose 230 million times between opioids or no opioids.

The very existence of the pop-up is the problem.

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