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Using Blockchain Technology for Managing the Life Cycle of Opioid Medications

Omid L. Shabestari, M.D. Ph.D., Director Health Analytics, Carilion Clinic
Omid L. Shabestari, M.D. Ph.D., Director Health Analytics, Carilion Clinic

Omid L. Shabestari, M.D. Ph.D., Director Health Analytics, Carilion Clinic

In the recent years, control over opioid medication is one of the most important priorities in the US healthcare. Depending on the Morphine Milligram Equivalent (MME), of the drug and level of pain in the patient, these medications are prescribed as a mandatory or Pro Re Nata (PRN), as needed, on a certain limited schedule. In many cases, patients are advised to try to tolerate their pain so that these medications will not subdue the symptoms of any potential complication. As a result of these recommendations, a considerable percentage of prescriptions may not be utilized.

Medication process has several steps, including prescription, dispensing, administration, and disposal. This chain may break at any of its links. Patients may not collect their prescriptions; they may get them but not use them or they may not properly dispose the remaining medications.

Figure 1–Technologies for controlled medication

For many drugs the maximum threat with this breakage will be passing the expiry date and non-effectiveness of the medications, whereas for the opioid drugs or as we like to call them controlled substances, there does not seem to be enough “control”.  Although there are many good new initiatives such as providing safe boxes to return the unused opioid medications, they are mostly passive processes and dependent on collaboration of the patients. A more active initiative can enhance our management of the process. This is where blockchain technology can shine.

  The output of AI solutions empowered by tracing functionality of Blockchain will give us the opportunity to reduce the side-effects of opioid medications while taking into account the level of pain-tolerance in patients. This is a great example of personalized medicine  

Blockchain technology is very well capable of securely tracing items in a process. It will allow feedback mechanism at different levels. It can help providers trace the amount of medications not used by patients. It can also allow proper planning and coordination for collection of unused medications and reduce risk of improper usage.

Blockchain Technology Solution Companies

You may ask how the chain can be controlled to find out whether a medication is used or not. There are two revolutionary technologies that can help close the loop. Kodak has patented edible RFID tags for tracking medications in 2007. This invention is a system that uses intentionally fragile tags to provide useful information by identifying when such tags are destroyed. These RFID tags dissolve when exposed to gastric acid. Both active and passive RFID tags are patented in this invention.

To collect information from those tags, mobile phones or smart home devises with RFID reader can be used to submit information to a central data repository.  Some of the vendors in this domain are Samsung, Apple, andTurck or Technology Solutions UK Ltd for legacy phones. They can also be implemented in Bluetooth-enabled pill-dispensers that can connect to smart phones for data submission. You can find many examples for this on Amazon.

Collectively, these technologies can not only close the loop on these medications, they can also provide more granular information on the pattern of using these medications without the need of keeping a log file by the patients. This information can also be used as an input to artificial intelligence solutions for personalized recommendation on adjusting dosage of opioid medications. The output of these AI solutions will give us the opportunity to reduce the side-effects of opioid medications while taking into account the level of pain-tolerance in patients. This is a great example of personalized medicine.

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