From purchase to patient: Geisinger’s AI-powered approach to drug diversion prevention
Barbara Zirnhelt
Drug diversion continues to pose a significant and persistent challenge for healthcare systems across the country. Even with strict adherence to professional standards and regulatory requirements, many organizations still lack a fully integrated, systemwide approach to effectively reduce the risks associated with controlled substances. At Geisinger, we have adopted a proactive and forward-thinking strategy — one that leverages advanced technology to improve oversight, enhance accountability and ultimately safeguard patient well-being.
Geisinger’s Enterprise Pharmacy has long been a leader in the use of electronic tracking systems for controlled substances. Our most recent innovation builds on this foundation by incorporating machine learning and AI-powered clinical surveillance software. This cutting-edge tool is specifically designed to identify behavioral patterns that may signal potential drug diversion, offering a more nuanced and data-driven approach to monitoring.
The software aggregates and analyzes data from a variety of sources, including pharmacy purchasing and receiving records captured through electronic vault systems and wholesalers, as well as expired medication returns processed through reverse distributors. It also integrates automated dispensing cabinet transactions, which are reconciled with electronic health record documentation to detect discrepancies such as missed doses or unaccounted-for waste.
Beyond basic reconciliation, the system is capable of identifying more subtle and complex behaviors that may indicate diversion risk. These include:
• Whole-dose wasting
• Repeated dispensing of the same medication in quick succession
• Null transactions
• Delayed medication administrations
• Inconsistencies in time clock entries
• Unusually high usage patterns
• Skipped barcode scans
• Absence of documented pain assessments
Each of these indicators contributes to a comprehensive risk profile, enabling early detection of potentially concerning activity.
One of the software’s most powerful features is its customizable Practice Review Dashboard. This tool allows for the creation of unit-specific scorecards and can even drill down to individual employee metrics. By aligning the software’s parameters with our internal controlled substance policies, we have not only strengthened regulatory compliance, but also advanced our quality improvement efforts.
The following Unit Scorecard demonstrates how performance metrics are tracked and visualized across departments, offering actionable insights that support continuous improvement and accountability.
Example of a unit score card
This technology has enabled Geisinger to expand education and awareness efforts across clinical and operational disciplines. It reinforces a culture rooted in safety, vigilance and shared responsibility. Our approach goes beyond meeting compliance standards — it reflects our deep commitment to protecting patients, supporting our providers and preserving the integrity of our healthcare system.
