Clinical Data Intelligence & Advanced Analytics to Reduce Drug Diversion across the Care Delivery Cycle and Drug Supply Chain in Health Systems

临床数据智能

• 批准号: 9927826
• 负责人: Thomas Knight
• 金额: $ 46.73万
• 依托单位: INVISTICS CORPORATION
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9927826
• 关键词: Address; Algorithms; Behavior; Blinded; Caring; Certified registered nurse anesthetist; Clinical Data; Computer Systems; Computerized Medical Record; Computers; Cover-up; Data; Data Analytics; Databases; Detection; Effectiveness; Employee; Equation; Equipment and supply inventories; Failure; Feeds; Health Insurance Portability and Accountability Act; Health Personnel; Health system; Hospitals; Injury; Intelligence; Investigation; Legal; Methods; Overdose; Patients; Pharmaceutical Preparations; Pharmacists; Pharmacologic Substance; Phase; Privacy; Public Health; Regulation; Reporting; Research; Research Methodology; Running; Sales; Scanning; Small Business Innovation Research Grant; Substance abuse problem; System; Testing; Theft; Time; Update; Urban Hospitals; Workplace; care delivery; career; cloud based; electronic data; experimental study; feeding; innovation; pain score; patient safety; prevent; programs; software as a service

This SBIR project will research mechanisms to detect when Health Care Workers (HCWs) in hospitals steal or “divert” legal drugs either to abuse themselves or to illegally sell to others. We focus on HCWs in hospitals because of the alarming rates of substance abuse and diversion in hospitals, with multiple studies finding roughly 10% of our nation’s nurses, anesthesiologists, and pharmacists are currently diverting drugs in their workplaces. HCWs are becoming addicted, destroying their careers, jeopardizing their patients’ safety, and increasingly dying from drug diversion overdoses. Diversion continues even though most hospitals already lock­p addictive drugs in Automated Dispensing Machines (ADMs), and run monthly “anomalous usage” computer reports to try to detect diversion. Hospitals broadly agree these current methods have two main weaknesses: 1. Data in the ADM only show part of the equation: the dispensing of the drug from the locked cabinet, ignoring drug administration data in the Electronic Medical Record (EMR), as well as other data available in other existing hospital computer systems. 2. Motivated diverters can game the system with falsified data entries to avoid detection. This SBIR project will conduct research to address these two problems by building a computer system with (a) automated data feeds from multiple existing hospital computer systems and (b) advanced analytics to flag potential diversion for investigation. We will test the following four hypotheses: • Data Consolidation hypotheses and experimentation plan: Phase 1: If we consolidate data from two systems (EMR & ADM), then we can detect diversion that would have been undetected using data only from the ADM (Hypothesis 1) Phase 2: If we consolidate data from five systems (EMR, ADM, Purchasing Systems, Internal Inventory System(s), and Employee Time Clocks) then we can detect diversion that would have been undetected using only EMR & ADM data (Hypothesis 3) • Data Analytics hypotheses and experimentation plan: Phase 1: If we create and test algorithms on blinded, consolidated, historical data from EMR/ADM, then we can detect known cases of drug diversion that that current methods do not detect, with fewer Type II errors (“false negatives”). (Hypothesis 2) Phase 2: If we refine and test additional algorithms using near­real­time, consolidated data from the five computer systems above, then we can detect drug diversion that current methods do not detect, faster, with fewer Type I errors (“false positives”) and fewer Type II errors. (Hypothesis 4)

该 SBIR 项目将研究机制，以检测医院的医护人员 (HCW) 何时窃取或“转移”合法药物以滥用自己或非法出售给他人。我们关注医院里的医护人员，因为医院中药物滥用和转移的比率惊人，多项研究发现，我国大约 10% 的护士、麻醉师和药剂师目前在工作场所转移药物。医护人员正在上瘾，毁掉他们的职业生涯，危及病人的安全，并且越来越多的人死于药物转移过量。尽管大多数医院已经将成瘾药物锁在自动配药机（ADM）中，并每月运行“异常使用”计算机报告以试图检测转移情况，但转移仍在继续。医院普遍认为这些当前方法有两个主要缺点： 1. ADM 中的数据仅显示方程式的一部分：从上锁的柜子中分配药物，忽略电子病历 (EMR) 中的药物管理数据以及其他现有医院计算机系统中可用的其他数据。 2. 有动机的转移者可以使用伪造的数据条目来欺骗系统以避免被发现。该 SBIR 项目将进行研究，通过构建一个计算机系统来解决这两个问题，该系统具有 (a) 来自多个现有医院计算机系统的自动数据馈送和 (b) 先进的 分析以标记潜在的转移以进行调查。我们将检验以下四个假设： • 数据整合假设和实验计划： 第 1 阶段：如果我们整合来自两个系统（EMR 和 ADM）的数据，那么我们可以检测仅使用来自 ADM 的数据无法检测到的转移（假设 1） 第 2 阶段：如果我们整合来自五个系统（EMR、ADM、采购系统、内部库存系统和员工考勤系统）的数据，那么我们可以检测到原本无法检测到的转移仅使用 EMR & ADM 数据（假设 3） • 数据分析假设和实验计划：第 1 阶段：如果我们根据来自 EMR/ADM 的盲法、整合历史数据创建并测试算法，那么我们可以检测到当前方法无法检测到的已知药物转移案例，同时减少 II 类错误（“假阴性”）。 （假设 2）第 2 阶段：如果我们使用来自上述五个计算机系统的近实时综合数据来改进和测试其他算法，那么我们可以更快地检测到当前方法无法检测到的药物转移，同时减少 I 类错误（“误报”）和 II 类错误。 （假设4）