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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

#91

Post by klyrs »

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

> The San Francisco-based company was founded in 2005 and became known for its unique model of providing free, ad-supported health-records software to independent doctors.

This is a dark pattern. Pharmaceutical companies already have undue influence over what doctors prescribe. Embedding ads within a records system risks biasing both diagnosis and prescription.

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

#92

Post by toomuchtodo »

JshWright wrote: post #70
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.

Civil suits are a possibility. Someone bought a whole lot of liability.

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

#94

Post by bpaddock »

mikestew wrote: post #83
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…

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…

If you look into their history you find that they are decedents of failed chemotherapy drugs.

No, they are not safe.

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

#95

Post by aqme28 »

eddywebs wrote: post #67
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

More than that. This is unethical design. It's a design that probably killed people.

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

#96

Post by ryandrake »

nkrisc wrote: post #6
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…

I’ve never been a big fan of the “I don’t know what my software does—I just move JSON around” excuse. As professionals, we need to be aware of the intended use of the things we make, and that includes weighing the ethical implications.

We also need a professional ethical vow with teeth like the Hippocratic Oath that allows tech professionals to push back against demands to write unethical software, but that’s a topic for another thread.

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

#97

Post by skwb »

JshWright wrote: post #85
skwb wrote: post #82

Earlier quoted context omitted.

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...

Now you're right in that traditionally Epic has served larger healthcare systems and tertiary hospitals, (hell they have even been known to turn down customers), but I think there's potentially a bit of role reversal on the horizon. Some Epic deployments have been creeping into community groups through licensing agreements [1, 2]. Probably makes more sense if you want your clinic pop to have greater access to tertiary services. It's something I would keep my eye on within the EHR business space.

Also, my previous comment was in response to no one liking Epic though, so certainly on topic.

[1]. https://health.ucsd.edu/news/releases/Pages/2015-05-06-uc-sa...

[2]. https://ucsdhn.org/providers/physician-network/advantages/te...

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

#98

Post by logfromblammo »

They put pop-up stealth advertisements, targeted at your doctor, into your electronic medical record, so that he or she would get you addicted to painkillers.

Software developers did this. For drug money. That's just terrible, isn't it? They shouldn't have done that.

But even if the developers had ethical concerns, they had no recourse but to quit, and be replaced by someone else--who might get six months of work in before realizing that they are working for the baddies, and also deciding to either quit or die a little inside.

I would do that job. I would take that money. I don't get a stupidly-inflated Valley salary with bonus RSUs, and I have bills to pay. I don't have a union that can protect me from nonsense. I know it's wrong. I would do it anyway, because I have been screwed by every company I have ever worked for, such that I learned that my ethics don't matter. Money matters.

I want my kids to get an education without student loans, if they want it. I want to drive a car that isn't older than they are. And I want to retire before I die. My ethics would only keep me from that. Apparently, the companies that aren't managed by money-grubbing sociopaths just don't hire where I live. So if you don't want stuff like this to happen, make it actually mean something to have ethical objections, even for people working outside of California.

I build software that has probably contributed in a material way to human suffering. For far less money than a Silicon Valley developer might get paid to make a mobile app for on-demand dog-walking. Everyone in my building does it. Everyone in the building across the street does it. Companies that don't hurt people as part of their business model aren't hiring here. People that have a problem with it--or at least those who can't hide that they do--don't get the jobs.

So if you are currently on a high horse, I hope you enjoy the view from up there. You haven't yet used your influence to help other workers--those with nigh-nonexistent power as an individual to influence the corporate employers that reluctantly hire them, and then reserve the right to fire at any time for any reason, or no reason.

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

#100

Post by Ididntdothis »

conanbatt wrote: post #44
to11mtm wrote: post #42

Earlier quoted context omitted.

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)

”It's made in Visual Basic”

We shouldn’t feed the illusion that old stacks are inherently bad and that new stacks will magically solve all problems.

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