
Practice Fusion pushed doctors to prescribe opioids in kickback scheme - JumpCrisscross
https://techcrunch.com/2020/01/27/practice-fusion-backed-by-top-vcs-before-selling-in-2018-pushed-doctors-to-prescribe-opioids-in-kickback-scheme/
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astura
Also discussed here:
[https://news.ycombinator.com/item?id=22165946](https://news.ycombinator.com/item?id=22165946)

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littledorky
It's no secret that a lot of companies value money more than the lives of
middle and low-class people, but to actually see the prices they accept for
this hits hard. You don't know who to trust anymore even when you're ill or
dying.

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kristjankalm
> Practice Fusion solicited a nearly $1 million payment from the opioid
> company, promising that in exchange it would create alerts in its software
> that would cause physicians to write more prescriptions for extended release
> opioids than were medically needed.

wondering whether whoever actually coded up the change in software knew what
he/she was doing. i truly hope not.

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JshWright
The most charitable option is that PF had some sort of tooling to allow folks
other than engineers to create new CDS alerts, and that system already had all
the info it needed to render these new alerts. If they had such a system, and
if they were just using pain related diagnoses or something, it's possible no
engineering effort was required (such a system would certainly already be able
to consider the pt's diagnoses).

In my experience (working with similar systems at a different EHR), these
things are complicated, and you pretty much never get away with zero
engineering effort. That effort might have been limited to "Expose the
patients last three reported pain levels to the CDS system", or it could have
been much more involved.

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kerkeslager
> Practice Fusion has agreed to pay $145 million to resolve the DOJ’s criminal
> and civil investigations, including a $26 million criminal fine and a $118.6
> million civil settlement that “also resolves allegations of kickbacks
> relating to thirteen other CDS arrangements where Practice Fusion agreed
> with pharmaceutical companies to implement CDS alerts intended to increase
> sales of their products.”

So, nothing was taken from the personal bank accounts of the people who made
these decisions, and nobody went to jail. That is to say, nothing was done
about this.

The takeaway here is that you can murder people for money and as long as you
do it behind the paperwork of a large corporation, you can get away with it.

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throwaway_tech
$140 Million dollar settlement on a $1M dollar kickback...finally a monetary
penalty against a tech company that may actually deter future bad behavior
rather than reward it.

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kerkeslager
Okay, it's a step in the right direction, but how did this actually affect the
people who made the decision? As far as I can tell, none of them were
personally fined, and none of them went to jail.

Keep in mind that if some nut with a gun murdered the same number of people,
he'd be in jail for the rest of his life, which might end with a lethal
injection, and people would be calling for gun regulation to keep guns from
getting into the hands of nuts. But because this was done with a pen instead
of a gun, we're incentivizing shareholders to not invest in execs like this
and hoping shareholders can figure out how to identify sociopaths in advance
in the future?

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pbreit
No one murdered anyone. Opioidal medications are entirely legal. Doctors did
and do prescribe them all the time. Your accusations seem a bit excessive.

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bantunes
We should bring back exile as punishment for some crimes. Namely, this one.

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galangalalgol
Exile from a global economy means exile from our globe. Sounds good to me,
call spaceX. Kind of expensive though. The Chinese dealt with the their opioid
epidemic by charging the family for the bullet used. In this case I'd be fine
wih that as well.

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galangalalgol
The Chinese solution executed those who used drugs as well as those who sold.
Emotionally it is a lot easier to blame the seller, but eliminating consumers
is probably even more effective if you "have a certain moral flexibility."

