Medical Software Firm Practice Fusion recently was found to have engaged in unseemly behavior. Practice Fusion provides software for electronic medical records. Their software is used by many medical practices. Practice Fusion allowed an opioid company massage the wording of the clinical decision pop-ups that appear on the screen for doctors suggesting what medicines to prescribe. Practice Fusion was causing doctors to prescribe higher doses and higher quantities of opioid drugs.
By letting a drug company massage the wording in the pop-ups, it is estimated that opioid sales increased by millions of dollars. The pharmaceutical company paid Practice Fusion around a million dollars for the ability to set the wording on the clinical suggestion pop-ups and from a sales perspective, it was money well spent.
This is an example of how far and to what length advertisers went to push opioids. When patients could no longer get legal opioids, many of the patients who had become addicted turned to illegal opioids. Many of these illegal opioids contained dangerous fentanyl. This software company could be directly tied to the opioid epidemic.
It is an interesting question to what extent the software development is constrained. If you develop software that subtly drives behavior what is your liability. Practice Fusion wound up spending over a hundred million dollars to settle their liability with the justice department. They knowingly had pushed opioids in a very subtle way.
As software directs more and more of our life and makes suggestions about what we do, the basis of those algorithms and the logic behind them needs to be open and transparent. We need to know if the algorithm was funded by Purdue pharma with the intent of pushing more opioids. We also need to know if the Amazon algorithms are pushing a certain agenda. There are many algorithms out there that may subtly nudge us to make certain decisions.
We need to understand that Facebook and Twitters’ algorithms have tremendous power by promoting some ideas and hiding others. The public needs to be assured that they are not acting as giant political operatives. It is important that these companies are transparent about what they’re suggesting. The users also need to keep in mind that the suggestions may not be in their best interest. It is important to understand that the first result in Google is not always the truth.
Doctors are well educated and constantly are working on honing their craft, yet they were influenced by a simple pop-up. The problem is, the doctors expected the pop-ups to be impartial and not designed with the help of an opioid maker with the goal of prescribing more opioids. It is necessary to always be on the lookout for attempts to influence our behavior and expect software to provide biased results.