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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

#61

Post by JMTQp8lwXL »

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.

I can't imagine what kind of reaction you'd get to asking a medical provider to use specific software. As a patient, you're not a doctor, it's not your wheelhouse, it really isn't your place to tell them how to fulfill their job function, even if that software isn't in your best interest -- because the latter point will be quickly lost to the former.

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

#62

Post by jrockway »

JMTQp8lwXL wrote: post #61
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.

I can't imagine what kind of reaction you'd get to asking a medical provider to use specific software. As a patient, you're not a doctor, it's not your wheelhouse, it really isn't your place to tell them how to fulfill their job function, even if that software isn't in your best interest -- because the latter point will be quickly lost to the former.

I trust my doctor to recommend other doctors. It doesn't seem too far afield for a doctor to trust a software engineer on software.

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

#63

Post by logfromblammo »

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...

Worked for Epic after the dot-com crash, as they were finishing up their Verona headquarters. I will tell you one good thing about it: underground parking. That matters in Wisconsin.

All of the good things I could tell you that I remember about Epic have zero relationship with the software they sell. And none of them could stop me from leaving, because the software was the job. It was all essentially gold spray paint on a turd.

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

#64

Post by JMTQp8lwXL »

jrockway wrote: post #62
JMTQp8lwXL wrote: post #61

Earlier quoted context omitted.

I can't imagine what kind of reaction you'd get to asking a medical provider to use specific software. As a patient, you're not a doctor, it's not your wheelhouse, it really isn't your place to tell them how to fulfill their job function, even if that software isn't in your best interest -- because the latter point will be quickly lost to the former.

I trust my doctor to recommend other doctors. It doesn't seem too far afield for a doctor to trust a software engineer on software.

Besides Practice Fusion's shady deals with pharma companies, I'd be surprised if you could articulate the major differences between it & Epic with regards to how the doctor uses the software day-to-day. This isn't about being a subject matter expert as a software engineer; it's really about being a patient and advocating for what's best for you (which is the correct thing for any patient to do).

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

#65

Post by segmondy »

vsareto wrote: post #21
chadmeister wrote: post #15

This is one of the most comically evil things I've ever heard of. I bet you the person who designed this feature is on hacker news as we speak. If you are and you see this I hope you get run over by a bus today.

Always good to throw the line developers under the bus and let the executives get away with it. I mean, as a developer, I'm always going business to business to pitch my dark-pattern UI features to companies and by gosh I just wish someone would stop me!

I don't wish that the developer to get run over by a bus, but I also don't buy that the line developer shouldn't be held accountable if they know that what they were doing is wrong. I don't care what your job is, we all must be good humans and have ethics and standards and say no if what we have been told to do is wrong even if it means losing our job. It would of course be terrible, but in the long run, the world would be better off.

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

#66

Post by nkrisc »

banads wrote: post #32
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 want to think this is bad, but the way it is described here doesn't really seem like a dark pattern to me. Maybe if "perscribe opiods" was the first or default selection, it would seem worse

It's a dark pattern because it was placed there at the behest of pharmaceutical company that paid for it to be placed there because it would benefit their sales, and not because it would be good for the patient. So it doesn't really matter how it was implemented, it's unethical from the start. The only variable is to what degree.

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

#67

Post by eddywebs »

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…

This qualifies for /r/assholedesign

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

#68

Post by throwaway55554 »

vsareto wrote: post #21
chadmeister wrote: post #15

This is one of the most comically evil things I've ever heard of. I bet you the person who designed this feature is on hacker news as we speak. If you are and you see this I hope you get run over by a bus today.

Always good to throw the line developers under the bus and let the executives get away with it. I mean, as a developer, I'm always going business to business to pitch my dark-pattern UI features to companies and by gosh I just wish someone would stop me!

The products I work on, I know which customers are asking for which features. I also hear from the managers and BAs why features are requested. It's not a stretch to assume the developers in question knew what they were adding and who for. And at the very least they could intuit why.

What's really hard to imagine is developers implementing features without understanding what they're implementing.

Not saying they alone should be thrown under the bus, but shame on them!

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

#69

Post by JshWright »

banads wrote: post #36
codeulike wrote: post #33

Earlier quoted context omitted.

It was built to be defensible/deniable. The fact that it was paid for by a pharma company is the problem. A doctors workflow shouldnt really be cladestinely influenced by a pharma company

I agree that does seem to be the real problem. Though I'd really like to see the alert myself to see what kind of dark patterns they may have used to incline the user to select the opiod option

Prescribing extended release opioids (which are known to be _highly_ addictive, even when used "appropriately") should never be the first choice for pain management. It should never have been presented as an equal option with non-pharmaceutical and non-opioid interventions.

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

#70

Post by JshWright »

coldcode wrote: post #7

Yet all that happens is they pay a small fine and promise not to do it again. Tell that to all the families who lost people to opioids.

According to the "statement of facts" the US Attorney's office released, this action resulted in "tens of thousands" of additional prescriptions of highly addictive extended release opioids. Without a doubt this resulted in lives and families destroyed.

I'm not sure the fine is "small" though (not that any fine could be sufficient), Practice Fusion was acquired last year for "only" $100M.

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