Drug diversion is a legal and medical concept which involves the transfer of any legally prescribed drug from a person who was prescribed that drug to another person. Often legally prescribed medication is obtained and/or used illegally within healthcare facilities, which include hospitals, clinics, outpatient and specialized care centers. Drug diversion results in multi-victim exposure which affects the clinician who diverts the drug, the patient who isn’t administered the drug, the resulting recipient of the diverted drug, as well as the healthcare facility from which it was diverted. Advancements in the automation of the healthcare medication-use-process to facilitate the timely distribution of medication between pharmacy, nursing, and patients was introduced in the late 1990’s. With this technological advancement, drugs get from the central pharmacy within the healthcare facility to the patient in an expedited manner. However, these automated dispensing cabinets require less administrative oversight by pharmacy and nursing, which have manifested the growth of drug diversion. With the introduction and subsequent adoption of pharmacy automated dispensing throughout the healthcare industry, the need for advanced monitoring, surveillance, and detection of potential drug diversion originated.
Countermeasures developed to monitor, detect, and deter potential drug diversion from automated dispensing systems were innovated as a solution to this problem. These software solutions were designed to handle large volumes of pharmacy dispensing transactional data by aggregating, transforming, and statistically evaluating that data through advanced algorithms. Prior to the innovation of drug diversion analytics of this level, it could take weeks or months to identify a potential drug diversion case. Many investigations were usually first triggered by the identification of behavioral abnormalities of a healthcare practitioner.
Over the past years the nation has become more aware of the opioid crisis. There has been a call for solutions to contest this epidemic that has caused an unprecedented number of deaths due to the misuse and overdosing of controlled substances. To combat the opioid crisis and close the gap in drug diversion, data science has advanced and contributed enormously as an ally for pharmacy and nursing administrators of healthcare organizations large and small.
This is a very complicated space as controls and tracking are often incomplete. Diverters are also quite sophisticated in their behaviors, which sometimes makes it difficult to detect. However, when paired with drug diversion algorithms, machine learning models are able to find additional patterns in large datasets to further enhance results.
Medacist Solutions Group is a healthcare analytics company focused on big data with a concentration in drug diversion analytics. Medacist is based in Connecticut and was founded in 1998. Since its inception, Medacist’s core mission has been to establish analytics platforms for healthcare professionals to use to combat potential drug diversion within their organizations. Medacist’s first healthcare analytics offering was RxAuditor, which was created based on a need from inpatient pharmacy leadership within one of the largest teaching hospitals on the east coast. This institution had the foresight to recognize the need for advanced surveillance of the newly adopted Automated Dispensing Systems which they implemented in late 1996.
In 1996, automated dispensing systems were new in the industry allowing healthcare facilities to distribute medication to patients across patient care areas in larger distributed volumes. This technology became the favored method for medication delivery in the industry, and early adopters of these systems soon realized that there was a void in analytics. Pharmacy administrators felt that there was a “false sense of security,” although the medication was secured in a cabinet, who was monitoring the activities? In 1998, Medacist developed RxAuditor to measure, monitor, and manage clinical, economic, and operational metrics and deliver actionable information associated with these ADS. RxAuditor’s primary focus was on drug diversion. This led to the development of a patented algorithm for monitoring and ultimately detecting users who were potentially diverting medication.
David J. Brzozowski, Sr. is the CEO and Founder of Medacist. He spoke about the company in an exclusive interview with The Silicon Review. Below is an excerpt.
Q. What are the areas covered by your patent?
The 736 Patent “Drug Auditing Method and System,” provides a method and system to audit pharmaceutical transactions within a healthcare facility, which generates a comprehensive set of analytics delivering actionable information regarding the distribution and usage of drugs within a healthcare facility. Whereby identifying healthcare providers or practitioners who overprescribe or overuse drugs and this ultimately leads to determine whether the drugs are being diverted.
Q. How well the patent has contributed to your success?
Medacist’s patent entitled ‘Drug Auditing Method and System’ patent number 6,842736 itself was a marker for identifying who the innovator in drug diversion analytics was. The automated dispensing vendors soon recognized that our patented algorithm was much more effective in the detection of drug diversion. The automated dispensing vendors took notice and looked to partner with Medacist in order to effectively compete. Medacist was making large inroads into their customer base.
The key differentiator, however, was the implementation of the methods that fueled the algorithm, later commercially known, as RxAuditor. Our industry-exclusive centralized data warehouse of pharmacy automated dispensing system data and electronic medical record data, and our patented algorithm together comprise our diversion detection expert system.
Q. This knowledge base of over 2000 U.S. acute and long term care facilities coupled with the meta-data of over 22 years of verified diversion outcomes fuels the most powerful and unparalleled diversion behavior machine-learning algorithm in the world.
Q. Tell us in brief about your data management system and compliance.
Medacist owns and operates its own world-class primary and secondary data centers from which data is consumed from the customers’ side and it is delivered as a SaaS model. Data is transmitted securely over the Internet and then ingested into Medacist’s network. Medacist has implemented the highest level of administrative, physical and technological safeguards to meet and exceed HIPAA requirements. Medacist follows NIST Compliance standards as outlined in the NIST Framework, 9 steps toward compliance. Compliance is monitored ongoing throughout the year and audited by RSM US a top 5 Accounting & Auditing firm annually and published as a SOC 2 report.
Q. Access management and the privacy of sensitive information is a major consideration around cloud and hosted services. How can we overcome this issue in the SaaS delivery model?
Medacist grew up in the early days of the Internet, where connectivity to the Internet and the integrity of connectivity was of most importance. Medacist was also one of the first to deliver healthcare information services on the Internet, and was an information provider before the term ASP, or SaaS were defined. Medacist has always hosted its own infrastructure; with our belief being the customer wants to know that they have a single point of exposure, which minimizes risk. In the healthcare space, security, privacy, and integrity of data is paramount. Based on surveys of healthcare providers, we found they are most comfortable where the vendor is accountable, which is only achieved from a private on-prem infrastructure. The customers’ perspective is that the “cloud” lacks accountability. We find that healthcare customers are migrating away from cloud-based SaaS vendors and toward on-premSaaS vendors. The on-prem single source of accountability is what Medacist has always delivered.
Q. Data analytics can breach customer privacy as information such as online transactions, purchases, or subscriptions, can be viewed by the parent companies. How do you protect the interest of the users?
Medacist data is classified based on risk level. Segregation of data through data classification and the implementation of data loss prevention measures minimize the potential for a data breach. This strategy, coupled with administrative, physical, and technological safeguards, mitigate the potential for security and privacy exposure.
Q. How does Medacist help its client find the right analytical suite that is suitable for them?
Medacist has three separate analytics platforms. RxAuditor Analytics, which is our legacy dispensing compliance analytics suite that includes RxAuditor OnDemand, RxAuditor 360 and RxAuditor CPA, ScripTrac Analytics that focuses on provider medication prescription compliance and Genesis Analytics which is our next-gen dispensing compliance analytics suite with its first offering being RxAuditor Investigate.
Q. What are some key milestones that Medacist has accomplished?
Medacist is most proud of the service we provide to the healthcare community as well as all the patients throughout the country by delivering drug diversion analytics to help combat controlled substance abuse and the opioid crisis. Hopefully, Medacist has positively impacted the lives of many, has altered the paths of some individuals, and has saved the lives of others.
-Being granted the only US patent for “Drug Diversion Analytics”
-Being the pioneer and lead innovator in drug diversion monitoring and detection
Statistically, Medacist has amassed some unprecedented statistics over the past 2 decades:
-2000+ US Hospitals Monitored
-197 Million Patients Protected
-2,830,523 Clinical Staff Monitored
-1 Petabytes of Pharmacy Automated Dispensing (ADS) & Electronic Health Record (EHR) data
Q. How do you market your services?
Over the years Medacist’s marketing strategy has evolved very much. Our initial market penetration was through hospital administrators from prestigious teaching facilities who were early adopters of RxAuditor. The unparalleled success of RxAuditor Analytics caused word of mouth to spread quickly.
-Direct marketing to directors of pharmacy via direct mailing and email campaigns
-Partnership with leading Automated Dispensing System Vendors
-Pyxis (via Pyxis Partner program)
-Business alliances with Group Purchasing Organizations (GPO’s)
-National Trade Show presence (American Society of Health System Pharmacists - ASHP)
-Business alliances with pharmacy consulting companies
-Re-seller Relationships Automated Dispensing Vendors
Q. Do you have any new services ready to be launched?
Under Genesis Analytics Platform:
-RxAuditor Investigate was commercially available as of October 1, 2019
-RxAuditor Reconcile 360, Beta Q4 2020
-RxAuditor Compliance, Beta Q2 2021
-RxAuditor Insights, TBD
Q. What are your trajectories for the next 5 years?
Continue as the lead innovator in Pharmacy Automation Analytics while further expanding into all sectors of Healthcare Analytics.
Leader behind the success of Medacist
David J. Brzozowski, Sr. is the CEO and Founder of Medacist. He completed his BS Degree in Economics, Minor in Management Information Systems, from Southern Connecticut State University, 1981, MBA, concentration in Computer Science, AI Expert Systems from Quinnipiac University, 1990. In 1981 David was a mainframe programmer and in 1985 he founded Total Concept Data Services, IT Consulting Services firm specializing in mainframe system design and development of Insurance and Healthcare related applications. In 1998 he founded Medacist Solutions Group, specializing in Healthcare Information, focused on Healthcare Automation specific to acute care and long-term care Pharmacy Automated Dispensing Systems (ADS).
This post is related to:Opioid Stewardship & Drug Diversion Prevention