Drug Diversion in Healthcare: Video and Access Control Practices That Make a Big Difference

Here’s how video and access control can bolster your healthcare organization’s drug diversion prevention and detection efforts.

Drug Diversion in Healthcare: Video and Access Control Practices That Make a Big Difference

Image via Adobe, by Jacob Lund

Drug diversion, the theft or misuse of controlled substances by healthcare workers, is a serious and growing problem in hospitals worldwide. According to a report by the National Institutes of Health (NIH), it is estimated that drug diversion affects 10% of healthcare workers and costs the healthcare industry up to $72.5 billion annually.

The consequences of drug diversion in healthcare facilities can be severe. Healthcare workers who divert drugs for personal use may develop an addiction or experience an overdose, impairing their ability to care for patients or it can—in the worst cases—be fatal. Patients may be harmed by receiving inappropriate doses of medication from healthcare workers who are under the influence, or they may develop an addiction to the same drugs that are intended for their treatment. Healthcare workers who are caught diverting drugs for personal use or financial gain may end up with criminal charges.

Typically, healthcare workers who have access to controlled substances carry out drug diversion in healthcare facilities. Today’s most diverted drugs in healthcare settings include opioids, benzodiazepines, and stimulants. According to a 2022 Drug Diversion Trends Report by Kit Check, nearly 8% of controlled substance medication transactions in U.S. hospitals have suspicious characteristics that may be indicative of drug diversion, which according to the report, translates to about 4 million transactions.

It is difficult to determine the exact number of healthcare drug diversions that occur annually as many incidents may go undetected or unreported. However, studies have shown drug diversion is a significant problem in healthcare settings. For example, a report published by the Pharmacy Times indicates some researchers say as many as 10% of all medical professionals will divert drugs from their workplace at some point in their career, with the most common reason being for personal use.

While these numbers do not provide a complete picture of the extent of drug diversion in healthcare settings, they suggest that it is a significant problem that requires attention and action from healthcare organizations and regulatory agencies.

Technologies Help to Detect and Prevent Drug Diversion

To combat drug diversion, hospitals and healthcare organizations are increasingly turning to video technology, including integrated access control systems and AI-enabled data analytic tools. Working together, these solutions can help detect and prevent drug diversion and ensure the safety and well-being of patients and healthcare workers.

By cross-referencing data, generating alerts, monitoring medication administration, conducting audits, and enhancing investigation, hospitals can prevent and detect drug diversion more effectively. AI-powered, data-driven, integrated video and access control systems can significantly enhance drug diversion monitoring by recognizing objects, analyzing staff behavior, detecting anomalies, and analyzing historical data to identify patterns.

It is essential to use these technologies in compliance with HR regulations and other measures, such as staff training and collaboration between departments, to ensure the safety and security of patients and healthcare workers.

Data-driven video technology can be a powerful tool in detecting drug diversion. Cameras can be placed in medication storage areas and other areas where controlled substances are used or stored. The video data from these cameras is reviewed to detect suspicious behavior or unauthorized access to the medication. For example, if a healthcare worker is seen accessing a medication cabinet outside their regular shift hours, this could indicate drug diversion. Cameras can also be used in waste disposal areas to monitor the appropriate and secure disposal of controlled substances. Healthcare organizations must dispose of controlled substances safely and appropriately to prevent them from being diverted.

4 Video Surveillance Practices to Implement

Leading practices for the effective use of cameras and video data to combat drug diversion include:

  1. Install cameras in key locations: Security cameras should be installed where medications are stored, prepared, and administered, such as medication rooms, supply closets, and medication carts. Cameras should also be installed where staff may attempt to divert drugs, such as nursing stations and break rooms.
  2. Monitor for suspicious behavior: Security cameras can monitor for suspicious behavior that may indicate drug diversion, such as staff members accessing medication carts or supply closets outside of their regular duties or administering medication to patients who are not assigned to them. Cameras can also monitor for unusual patterns, such as dispensing medication at unusual times or in unusual quantities.
  3. Use video analytics: Video analytics software can be used to analyze camera data and identify potential instances of drug diversion. For example, the software can be programmed to detect when medications are removed from a medication cart without documentation or when medications are administered to a patient outside the regular dosing schedule.
  4. Conduct regular reviews: Healthcare organizations should conduct regular reviews of video data to identify potential instances of drug diversion. Reviews can be performed manually or by using video analytics software to flag potential incidents for further investigation.

Additionally, the integration of artificial intelligence (AI) into video technology offers a transformative approach to drug diversion monitoring in healthcare settings, significantly augmenting the effectiveness of these strategies. For example, AI-driven video analytics offers one crucial function: object recognition. By identifying and tracking the movement of objects like medication vials, syringes, and other medical equipment, it provides a vigilant eye that can detect unusual movements, signaling potential drug diversion. By observing and tracking staff movements and comparing them with access control logs, video analytics can pinpoint when staff members access medication storage areas at atypical times or outside of their scheduled hours. This added layer of monitoring can identify and flag potential irregularities.

Today’s AI-driven predictive analytics brings a new dimension to drug diversion prevention efforts by analyzing recorded or archived video data (and access control logs) to recognize patterns that may hint at drug diversion. AI can identify potential risks by reviewing data from various sources, helping to enhance the proactive measures taken against drug diversion.

5 Access Control Practices to Implement

Access control is another technology that can prevent and detect drug diversion. Electronic locks or biometric scanners can restrict access to medication storage areas, ensuring that only authorized personnel can access these areas. If a healthcare worker is accessing medication storage areas outside their regular shift hours or accessing medication that is unnecessary for patient care, this could indicate drug diversion. Here are some ways access control systems are being used:

  1. Restrict medication access: Access control systems can restrict access to authorized personnel only, such as pharmacists and nurses. This can be achieved by using electronic locks on medication storage areas, such as medication rooms or cabinets controlled by key cards or biometric authentication.
  2. Require a two-person rule when accessing Schedule II drugs, thereby requiring two people with designated authority to badge into the cabinets and storage areas together before gaining access. This ensures supervision and audit control of access to these highly restricted drugs, which are known to be commonly abused.
  3. Implement strict policies within the access control system to mirror the organization’s standard operating procedure (SOP) to ensure the right access is given to the right people at the right time automatically via the access control software. This eliminates human error in assigning access to these restricted automated dispensing cabinets (ADCs) and Pharmacy areas.
  4. Monitor access logs: Access control systems can keep logs of who accessed medication storage areas, when they accessed them, and how long they were accessed. These logs can be reviewed regularly to identify unusual access patterns, such as staff members accessing medications outside their regular duties or during off-hours.
  5. Use alerts: Access control systems can be configured to generate alerts when medications are accessed outside of normal parameters, such as after-hours or by staff members who are not authorized to access them. These alerts can be sent to security personnel or management for further investigation.

How One Hospital System Incorporated These Practices and Technologies

Serving a population of over 5 million people across multiple states, a large hospital system decided to address the problem of drug diversion—an identified threat to their operations and reputation. They had existing safety protocols, including secure storage of controlled substances, medication reconciliation, and employee drug testing. However, it became evident that incorporating data-driven video technology could substantially enhance drug diversion detection and prevention.

The hospital system installed access control across all drug storage locations, such as pharmacies, medication rooms, and automated dispensing cabinets. They gave employees access via recorded badge scans, thus maintaining a constant tracking of who accessed what and when. They installed a comprehensive network of high-resolution security cameras stationed at strategic locations within the hospital. Monitored by an AI program, these cameras watched for abnormal behavior, such as badge-less entries or accesses made outside of regular work hours. The data-driven video management system functioned as the core, analyzing data from the access control system and camera footage in real time. Video technology was able to detect unusual patterns, alert security personnel about potential threats, and even predict future incidents of drug diversion based on behavioral trends.

The hospital’s implementation of this holistic approach produced impressive results. The real-time detection and alert system allowed hospital administrators to take swift action against suspicious activities. They thwarted several potential incidents of drug diversion, and employees who engaged in such activities were identified and investigated. This new preventive measure noticeably bolstered the existing safety protocols.

Successful Prevention and Detection Requires a Comprehensive, Proactive Approach

Several important lessons emerged from this new drug diversion initiative. The hospital system acknowledged the value of comprehensive prevention programs that combined traditional safety protocols with video technology. Recognizing the essential role of its staff, the hospital stressed the importance of educating employees about the risks posed by drug diversion to patient safety and the integrity of the healthcare system. Additionally, administrators underscored the need for continuous monitoring and evaluation of the prevention program to identify potential improvements and ensure its ongoing efficacy.

As the healthcare industry continues to evolve, the need for effective drug diversion prevention programs becomes more critical. Data-driven video technology, which includes smart cameras, access control systems, and AI analytics tools, can provide hospitals with a comprehensive approach to combating drug diversion and lessening a very costly problem.

Mark Johnson is the National Business Development Manager, Healthcare at Milestone Systems, and Doug Coppola is the Senior Director of Healthcare Solutions at LenelS2.

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