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.
[deleted]
Health-records software pushed opioids to doctors in secret deal with drugmaker
31–40 of 269 posts
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#32[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
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#33[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 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
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#34I 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…
That would absolutely be a valid reason to build the service like that; the medical community thought that only an excess of opioids would be a problem, and it directly improves the numbers they're evaluated on.
However, once the medical community gets wise to what an awful idea that was, I hope that when the software providers hear about this they try to figure out a way to mitigate the damage they're causing. This feature was added in 2016.
Though, I think we agree that you cannot make an ethical decision on which action you should take unless you have any idea of what the consequences of your actions will be.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#35Remember 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 the doctors never see.
Karen ultimately killed herself from the Chronic Pain cause by the Levaquin and Cerebrospinal Leaks (CSF Leaks). Her saga is one of the five stories in the upcoming documentary Pain Warriors being released to distribution this spring.
I'm now up to 44 people that have told me that their own CSF Leak started after taking Levaquin, Cipro etc. Something that there is ZERO medical research on. The Leak doctors are aware of this as I spoke about it at their first ever CSF Leak conference.
Someone here will inevitably say "I took Cipro et.al just fine". Many people do take it may times until they have a reaction or they don't associate their new health problems with the delayed reaction months later.
Antibiotics in general are a good thing, however we must never assume they are safe in and of themselves without consequences.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#36Earlier quoted context omitted.
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 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
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#37Designing the tools that providers use to treat patients is exceedingly difficult and filled with moral hazards.
What makes this instance so pernicious is that it was involved in what is now a national crisis, but it's not very different to what a flu vaccination manufacturer could do, and which would raise no eyebrows in the eyes of the public or the government.
Medicine is one of those fields where the discrepancy of what patients think it is and what it actually is is wide enough to cause outrage at every single thing.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#38If 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.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#39Earlier quoted context omitted.
Why shouldn’t you implicate the developer? If your manager asks you to implement something that can kill people you have a moral obligation to quit. Whoever implemented this is as much of a shitbag as the executive who asked for it.
As I understand it, a developer could implement this without any knowledge of the secret deal: when opening a patients records a pop-up should appear. That's basically what the physicians would know after a using it for while too.
Sure, not every developer who worked on the application needs to know what would cause the modal to appear and what possible messages it might have.
But I think it likely that somewhere there was a developer who knew what that there was a query | logic function checking the patients pain relievers status etc. and a developer knowing that in the database the text came back with hey you should give this guy some oxy.
And I bet those developers talked together in implementing things so they knew stuff, but over time other people knew stuff too because there were probably little bugs like - the extra oxy recommendation text overflows in the patient suggestions window. or stuff like that.
maybe not everyone that worked on it was fully aware but there was some people that must have been like 99% aware, based on my experience in working in lots of different sized companies over the years.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#40doesn't texas still have death penalty? pity it doesn't apply to corporations. both of them deserve it
"Capital punishment is a legal penalty in the United States, currently used by 29 states, the federal government, and the military"
https://en.wikipedia.org/wiki/Capital_punishment_in_the_Unit...