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Preventing Opioid Theft: WasteWitness

Published by Microsoft in March 2020:

When an opportunity arose to reduce medication errors and prevent opioid theft using Raman spectroscopy technology licensed from MarqMetrix, Seattle-based PharmID used Windows 10 IoT Core, Azure, and Power BI Embedded to build the drug-verification solution WasteWitness. The app enables customers to easily verify if patients are being administered the right medication and dosage, resulting in better patient and healthcare worker safety.

“With Azure, we now have a central place to store and analyze data for every medication scanned on a per tenant basis. Simple, non-destructive verification is a real paradigm shift for healthcare.” – Scott Van Vuren, PharmID CEO

A big problem—and big possibilities 

Every year, medication errors and opioid theft injure and kill millions of people around the world. The annual cost reaches billions of dollars, and without proper verification of the medication they receive and dispose of, medical providers risk being complicit in its leakage onto the black market.

It’s a big problem, and PharmID wants to help fix it. So, in 2017, the company sought to bring MarqMetrix Raman spectroscopy technology—including TouchRaman®—to healthcare providers, enabling reliable compositional medication analysis.

By combining MarqMetrix technologies with Windows 10 IoT Core, Microsoft Power BI Embedded, and Microsoft Azure, PharmID introduced the WasteWitness® solution in 2018. WasteWitness enables healthcare providers to verify drugs at the point of disposal, and it is the only healthcare solution of its kind that provides hard evidence if drugs have been appropriately handled, controlled, and administered.

By using Power BI Embedded, PharmID is also able to analyze spectroscopy data remotely, helping provide hospital administrators with insights into patterns and trends that highlight where opioid theft or drug mishandling may be occurring. And by using Raman spectroscopy, non-specialists can optically identify, precisely measure, and authenticate chemicals in seconds—without disrupting packages or destroying the sample.

Simple, accurate, low-cost drug verification

Current big pharma practices verify safety, efficacy, and accurate labeling of medications when they are manufactured and packaged.  But once the medication leaves the manufacturer, its chemical composition is rarely verified again, leading to uncertainty and sometimes error. By using PharmID’s WasteWitness, healthcare professionals can close the loop of uncertainty by verifying medications at the end of their lifecycle. This unlocks significant knowledge that was not previously available, enabling healthcare organizations to identify internal vulnerabilities that may allow for opioid theft or drug mishandling.

“Many hospitals spend millions of dollars a year on pharmaceuticals, and they don’t have any way to check the products they receive,” says David Williams, Vice President of Product Development at PharmID. “Without any medication quality control, the opportunity for medication errors and drug diversion grows as medications move from the hospital’s receiving department, to the pharmacy, to dispensing stations, to the patient and finally at the waste station.”

A medication error is intolerably dangerous, and the fallout of drug diversion can be devastating for both patients and healthcare workers. When a hospital used a PharmID solution to test 15 vials of expired, seemingly unopened hydromorphone, it found that only four vials contained the chemical. Closer examination, requiring a microscope, revealed that 11 of the packages had been pierced and the hydromorphone replaced with saline.

Without the economical, accurate, and connected Raman spectroscopy solution to verify the medication, that diversion would not have been discovered—and that’s just one random sample from a single hospital. Consider the societal impact when street users fall victim to stolen, pharmaceutical-grade opioids, such as hydromorphone.

A complete verification architecture

PharmID used the Windows 10 IoT Core operating system, Azure cloud resources, and Universal Windows Platform to build drug-validation solutions that healthcare professionals can use to collect medication data from PharmID spectroscopy devices for remote analysis. With WasteWitness, they can monitor and validate expired and other unused medications at disposal, and in the future, use PharmID Verify to validate medication for distribution and patient intake.

When combined with Azure Cloud Services, the verification processes can be easily integrated with a customer’s existing workflows for fast, accurate analysis across multiple tests. PharmID used Azure Service Fabric to manage the platform in multitenant cloud services, spin up new services, and ensure data isolation. To help its customers unlock insights from their spectroscopy data, PharmID chose ASP.NET Core to build a web portal for the platform with Power BI Embedded to create interactive, contextual reports for hospital administrators.

These reports help health professionals visualize data quickly and clearly. For example, at a glance, they’ll be able to identify whether a medication is present, its concentration level, and who scanned the medication.

To support the development of the platform and applications, PharmID used Azure DevOps to manage code, implement CI/CD practices, and automate deployments. It optimized development productivity by connecting Visual Studio directly with DevOps and other cloud development services.

“I’d worked on other cloud platforms, but for me, Azure is the best for resource deployment,” says Jeff Scherrer, Enterprise Architect at PharmID. “We’ve got everything automated through Azure DevOps, and it’s the most streamlined approach for managing our organization’s software.”

Better drug validation

In the future, healthcare professionals will be able to use the PharmID Verify solution, running on Windows 10 IoT Core, for verification prior to medication distribution. When used alongside WasteWitness, this helps prevent clinical errors in healthcare environments—including surgical centers, recovery rooms, nursing units, and pharmacies—in the post-patient waste stream.

Doctors, nurses, and other clinicians can eliminate medication uncertainty, enhance quality control, and monitor the medication life cycle. Just as important, they can prevent tampering and interrupt drug diversion.

With Verify, manufacturers and healthcare providers can ensure safety, efficiency, and accurate labeling,” says Williams. “Once the medicine expires, or unused medication is ready for disposal, an operator can use the WasteWitness instrument to accurately fingerprint the chemical at the point of disposal.”

With the help of Windows 10 IoT Core and Azure, PharmID is ready to transform the way that healthcare providers handle and record medication storage and disposal. Now pharmacies and clinics can validate shipments of medicine upon arrival without disrupting packaging or destroying samples. Hospitals and providers can also help eliminate the loss of problematic medications, such as opioids, into the illegal market.

Better business

With Windows 10 IoT Core, Azure, and other Microsoft resources, PharmID and its customers can rely on enterprise scalability without enterprise-scale resource requirements. PharmID can continuously build and quickly deliver new application services and features to new and existing customers, without large R&D investments or disruptions to customer operations.

By using Microsoft technology to build and automate provisioning, deployment, and multitenant architecture, PharmID can support customers with a small, agile staff. And now that it has paved the way for a transformation in how healthcare organizations validate medications, PharmID plans to expand its Azure-powered spectroscopy solutions to address additional verification needs in hospitals, such as quality control for compounding and medication verification at patient administration.

“I like to think MarqMetrix is industry agnostic,” says Brian Marquardt, CEO of MarqMetrix. “With this platform, we can help others inspect things like oil and gas, bioprocesses, food quality, and more. We’ve even got people working on a way to identify fatty acids in salmon, in real-time, using optical interrogation. It’s an exciting time.”

Read the full customer story here.