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

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

#81
A murder trial for an MD who was over-prescribing opioids just started in my city [1].

How are the developers of this software not being criminally charged? It literally seems like the same thing and if nothing else, they made it easier for doctors to potentially kill people and face charges themselves.

1 - https://www.pressdemocrat.com/news/10643995-181/murder-trial...

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

#82
post #42

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 very du joure to talk bad about Epic (and certainly not without reason re: HHS healthcare interoperability proposed rules) but they have been a huge success from a business perspective. The reason why they provide EHR support for the majority of large healthcare system hospitals is that they provide a lot of flexibility to implimentation.

If you want the ability to support some very unique functionality, they will find a way to help support it. In a business that is almost nothing but edge cases (almost all of healthcare is complex, which is why you need 8+ years of training), you need lots of custom software behavior to fit these needs. The UCSF switch from GE healthcare to Epic about a decade ago is the prime example of what value Epic. [1, 2].

[1]. https://www.wired.com/2015/03/how-technology-led-a-hospital-... [2]. https://www.forbes.com/sites/zinamoukheiber/2012/04/18/epic-...

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

#83

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…

Someone here will inevitably say "I took Cipro et.al just fine".

A lot of my childhood was spent in hospitals, and I've had a variety of antibiotics over the years. And anesthetics, I've become quite the connoisseur. I'm not allergic to anything, I've never had a reaction of any kind to any drug. Not even allergic to any foods. Bring on the shrimp and peanuts!

I was recently given Cipro. My entire back broke out in a rash. Not a devastating side effect, but after a lifetime of a variety of drugs of all sorts without any but the desired effect, it sure made me go "WTF? You sure this shit's safe?"

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

#84
post #77

Earlier quoted context omitted.

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…

A large portion of the tech industry rests on the justification that users are to blame when unethical user interface design does what it's supposed to and shunts some statistically predictable fraction of users towards choices that are not in their best interest.

I think that nobody involved in any side of that argument (the people writing the justification and the people reading it) actually believe it is true. It's just some noise some person came up with to argue in bad faith why they should be allowed to keep doing bad things if it is good for their wallet.

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

#85
post #82
post #42

Earlier quoted context omitted.

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

It's very du joure to talk bad about Epic (and certainly not without reason re: HHS healthcare interoperability proposed rules) but they have been a huge success from a business perspective. The reason why they provide EHR support for the majority of large healthcare system hospitals is that they provide a lot of flexibility to implimentation. If you want the ability to support some very unique functionality, they wi…

They're in a very different market from Practice Fusion though. There aren't many small/independent practices rolling out Epic deployments...

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

#86

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.

The recommendation you are making here has nothing to do with software engineering though. If you were a healthcare software business executive though, I'd be more inclined to agree.

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

#88
"Practice Fusion admitted to the scheme with an unnamed opioid maker, though the details of the government case closely match a public research partnership between Practice Fusion and Purdue Pharma Inc., which makes OxyContin."

Color me surprised that it's probably Purdue. Every asset that the Sackler family owns should be seized.

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

#89
post #21

Earlier quoted context omitted.

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 alon…

So the BAs and managers know too, and a typical assumption is that they know before they ever talk to a developer. They have every opportunity to reject it themselves on ethical grounds before they ever talk to a developer. And yet, they still bring this known-ethically-bad feature to the developer and ask them to implement it!

If devs are talking and developing customer needs directly (a legitimate thing), then that is a situation where developers are the first ones who should be pushing back. But in companies where there are multiple layers before a feature reaches a developer? Devs should not be the ethical enforcement.

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

#90
As a non-American I'm also curious about the mass necessity of opioid painkillers to begin with. From what I hear, people are prescribed opioids post surgery etc. which is bonkers to me as a foreigner. I'm a middle aged person and I have never seen anyone using opioid painkillers anywhere in my life. They give stuff to you when you are having surgery, and when you are in hospital's care, but something very extraordinary has to happen here to have access to those medications outside of a hospital setting. In the USA it seems to me like most people are prescribed these painkillers at least once in their life between 1-50 years but here, it is very exceptional and people are doing just fine.
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