By Kim New
kimberly@diversionspecialists.com
When personnel divert controlled substances within healthcare facilities, it is vital to consider the potential for patient harm. We often think of harm in terms of physical injury, but there is one type of patient harm we often don’t consider, namely patient privacy.
Diverting staff often snoop through PHI of patients they aren’t caring for, looking for a patient identity under which to divert medication. The practice is a common part of the scheme used by nurses who offer to “help” their colleagues by administering medication for them. In several cases I have investigated, there was evidence that the diverting staff member searched the EHR database for former patients, and used their identities to create a false encounter in the emergency department and divert medication. There have also been numerous cases reported in the media of healthcare personnel forging prescriptions under patient identities they have found through snooping.
Patient harm aside, HIPAA violations by healthcare personnel can result in fines for institutions. Personnel who inappropriately access patient information in order to divert can face criminal penalties, including incarceration, for obtaining PHI for personal gain.
In order to ensure a robust response to diversion, it is important to consider all possible aspects of harm that may occur, including physical harm to patients, harm to the community from personnel driving impaired, healthcare fraud, and privacy violations, just to name a few.
Diversion schemes are complex matters that require the involvement of many stakeholders within an institution. That is why it is critical to include a variety of stakeholders in the oversight of the diversion program. Doing so will ensure that the institution’s response includes consideration of all the potential ramifications.
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