In order to streamline the management of their patients’ medical treatments, some hospitals have hired software developed by the startup Practice Fusion . Through the use of algorithms, the software estimated the type of drugs and the ideal dose to be administered in each case.
Based in San Francisco, Practice Fusion was created in 2005 and had become very popular with clinicians because the software they offered was free – it only showed advertising as a way to profit. Thanks to it, tens of thousands of physicians could manage tens of millions of patient records .
However, when the software began recommending the prescription of more pain relievers than usual, some doctors suspected that something was wrong.
Finally, after analyzing the software , it was discovered that it did not harbor any errors, at least not accidental: its bias in prescribing pain relievers was deliberate .
As reported by the US Department of Justice, it was a pharmaceutical company, Purdue Pharma Inc , that had bribed Practice Fusion to modify its algorithm and interface. Something that had happened in the version of the software that was used from 2016 to the beginning of 2019.
In this way, the company sought to increase profits in the sale of its opioids, drugs known for their effective analgesic properties to relieve pain.
The opioid problem
When the doctor opened the program to manage the patient’s health record, a pop-up window appeared and asked about the patient’s pain level (something that happened especially in those who did not yet have opioids prescribed). After answering the question, the software then suggested the prescription of opioids.
If the clinician accepted the suggestion, then the software automatically displayed a treatment plan with the amount and time of opioid use to most effectively relieve pain. The suggested time tended to be longer than usual. There was also a tendency to prescribe this particular opioid, which could be used to treat pain caused by cancer, trauma, or major surgery, versus other less profitable products for the pharmaceutical company .
In exchange for a fine of $ 145 million, possible civil and criminal penalties have been avoided, although the case is particularly serious given the problem of opioid addiction already experienced by much of the US population .
In fact, there are more Americans taking pain relievers than smoking. More than 300 million prescriptions for drugs of this type are issued each year and almost two million people in the country are dependent . The biggest problem, however, is overdose deaths, as some estimates speak of tens of thousands a year. According to the Centers for Disease Control and Prevention, an average of 115 Americans died of an opioid overdose each day between 1999 and 2016. In 2017, President Donald Trump declared the epidemic of opioid abuse a national public health emergency. .
