Inpatient pharmacies go to great lengths to ensure that their high-risk medications are properly stored, managed and accounted for. Hospital pharmacies deploy technology such as video cameras, smart stock cabinets, and drug management software that tracks inventory. Outpatient settings, on the other hand, often lack the technology, processes and procedures to limit the risk of diversion.
In an article titled, “Fighting Diversion in Outpatient Settings,” author AI Heller, highlights quotes from Carlos M. Aquino, a former Drug Enforcement Administration investigator and the founder of PharmaDiversion LLC, a consultancy in Philadelphia. Mr. Aquino stressed the importance of taking drug diversion seriously as the DEA acts quickly against pharmacies not taking precaution.The article goes on to describe two case studies. The first case study talks about the payoff Lakeland Health, in St. Joseph Michigan, was able to see after implementing diversion prevention technology in their outpatient setting. The technology has allowed them to increase count accuracy and staff accountability, reduce inventory, and free up pharmacists’ time to consult with patients.
The second case study describes Massachusetts General Hospital’s approach to managing diversion in the outpatient setting. The outpatient pharmacy at Mass Gen fills approximately 800 scripts per day and nearly 20% of the scripts are controlled substances for postsurgical and cancer patients.
Karen Ryle, RPh, MS, is the director of outpatient pharmacy services, and the past president of the National Association of Boards of Pharmacy and the Massachusetts Board of Pharmacy. “Ms. Ryle, who authored diversion regulations in her former roles, oversees a culture in which staff is trained to watch for diverter behavior, and multiple technologies help her team adhere to strict drug handling processes (pharmacy).” She utilizes a mix of human resources and technology to reduce risk of drug diversion. Each day, a specific pharmacist oversees the dispensing of narcotics. In addition, the pharmacy uses a controlled drug waste receptacle, a pharmacy management system, strict reconciling processes, locked cell columns, barcoding, and FRID tagging.
