With AI dominating healthcare headlines, it’s straightforward to dismiss this know-how as being all hype that’s not prepared for primetime. Nevertheless, not like extra forward-looking functions for this know-how, incorporating AI into drug diversion know-how is not a “good to have.” With more and more advanced treatment workflows, siloed treatment info throughout disparate methods, tighter compliance expectations and stretched scientific sources, it’s turn out to be a vital part of affected person care, colleague security and operational efficiency.
Throughout the broader healthcare system and at St. Jude particularly, we’ve seen firsthand how AI-enabled diversion detection can assist rework what was a reactive course of right into a proactive technique—supporting functions from compliance to billing and customised coverage improvement.
The Perceived IT Burden
One of many greatest issues round adopting this know-how boils all the way down to the perceived ongoing burden of adopting new IT options. Definitely, organising new methods is an extra carry for informatics groups—however with AI-powered monitoring instruments, the know-how decreases the burden post-implementation. Relatively than needing to drag reviews on an advert hoc – and unpredictable – foundation, IT groups can now spend money on the profitable implementation of this know-how to cut back their workflow burden within the long-term.
These instruments depend on the info feeds from a number of methods—automated meting out cupboards, EHRs, wholesaler transport feeds and reverse distributor methods—to allow them to monitor the complete lifecycle of a drugs. It may flag documentation gaps or discrepancies, corresponding to Affected person-Managed Analgesia (PCA) pump entries that don’t align with administration information, surfacing potential manipulation or workflow breakdowns. IT stays an important piece of the puzzle, enjoying a significant position in organising methods for achievement from the beginning.
In case your information is incomplete or inaccurate, AI doesn’t repair the issue—it will probably amplify it. Algorithms will draw conclusions from no matter they’re given, and if that enter is flawed or lacking information, so is the output. Clear information and human oversight are non-negotiable. However when thoughtfully, rigorously and strategically carried out, issues down the road could be considerably mitigated. At St. Jude, round 80 behavioral-pattern alerts assist detect not simply lacking medicines, but in addition suspicious exercise—corresponding to customers back-charting, accessing drug cupboards or vaults when not on shift, or manipulating entry ranges.
Earlier than utilizing diversion detection know-how, even figuring out and accessing the correct information required unpredictable and time-intensive requests to IT. Right this moment, with upfront alignment, the system turns into repeatable, scalable, and much more environment friendly. That’s particularly precious in advanced EHR environments, the place essential info could be buried in less-structured scientific entries relatively than clearly outlined information tables. As soon as dwell, the system turns into a dependable device not just for the pharmacy and compliance groups—but in addition for decreasing threat and limiting institutional legal responsibility.
Advantages That Go Far Past Diversion
In 2023, St. Jude had over 15 million managed substances transactions – all of which have to be monitored in an effort to have a full image of the availability chain. Implementing AI is like utilizing a magnet to discover a needle in a haystack. It nonetheless takes loads of focus, however the activity turns into much more manageable. And with out it, you’re much more more likely to miss one thing as it isn’t humanly attainable to assessment that quantity of information inside an affordable time to take motion.
AI helps hospitals extra shortly detect diversion—and sometimes uncover beforehand undetected diversion habits inside weeks of implementation. However the worth doesn’t cease there: AI surfaces medical follow points that give organizations the chance to regulate their inner insurance policies and workflows, particular to their atmosphere and affected person populations.
Remedy-transaction information that powers diversion detection additionally highlights mismatched NDC billing and flags potential false claims—shielding organizations from multimillion-dollar penalties. Dashboards then monitor points starting from missed waste documentation to clerical dosage errors surfaced in information tables, making a strong basis for correct billing and stronger compliance. At St. Jude, unifying these information streams in a single place has proved invaluable, enhancing employees and affected person security whereas streamlining operations and boosting audit-readiness.
What’s Subsequent for AI in Drug Diversion Prevention
The following wave of diversion prevention will depend on generative, agentic AI that goes past recognizing issues to orchestrating their decision. AI-generated prompts can information pharmacy and compliance groups by each step of an investigation, or produce a custom-made audit plan with a single click on—eliminating the hours normally spent drafting emails and compiling reviews. Proper now, gathering all the info factors wanted to temporary scientific employees generally is a scavenger hunt, however AI can mechanically assemble the related details, charts, and context right into a ready-to-send message, so everybody will get the knowledge they should act—with out the executive drag.
Constructing on that functionality, the fast rise of agentic AI—methods that may pursue targets autonomously, guided by real-time context and suggestions—guarantees a good increased degree of help. These instruments can repeatedly monitor for anomalies, triage alerts, and launch preliminary fact-gathering the second a difficulty seems, so pharmacy and compliance groups can commit their experience to essentially the most vital selections relatively than the groundwork.
AI isn’t a silver bullet. However when carried out rigorously and leveraged strategically, it’s a strong catalyst for higher outcomes. AI in diversion prevention is not only about figuring out issues—it’s about creating safer methods, utilizing information extra intelligently throughout the board and liberating up manpower for areas the place individuals are actually wanted.
About Alex Rodriguez
Alex Rodriguez, MHIIM, CPhT, is Lead Compliance Knowledge Analyst at St. Jude Youngsters’s Analysis Hospital, the place he leverages data-driven insights and superior applied sciences to enhance treatment security, regulatory compliance, and operational effectivity throughout the pharmacy provide chain.
Mr. Rodriguez has over 15 years of pharmacy expertise spanning retail, compounding, and hospital settings, with deep experience in pharmacy automation, treatment provide chain administration, pharmacy rules and undertaking administration. He holds a Grasp’s diploma in Well being Informatics and Info Administration from The College of Tennessee Well being Science Middle.
About Karen Kobelski
Karen Kobelski is Vice President and Basic Supervisor of Scientific Surveillance Compliance & Knowledge Options, Wolters Kluwer, Well being, the place she oversees options that present scientific surveillance, threat detection and information normalization to enhance the standard of affected person care, regulatory compliance and operational efficiency of organizations within the healthcare trade.
She brings greater than 25 years of management expertise in software program and providers companies to the healthcare trade. A Six Sigma Black Belt, Karen holds an MBA from Harvard Enterprise Faculty and a bachelor’s diploma from Georgetown College.
