Under lock and key. How Blockchain secures controlled drugs

Controlled drugs are heavily regulated across the healthcare sector. They are drugs controlled under the Misuse of Drugs regulations 2001, that are open to abuse, misuse, illegal activity or can cause harm, i.e. morphine. Why is regulation important? To protect the general public from harm. One of the most important rules in any health professional’s code of ethics.

Even with registers logging the movements of a controlled drug, there are still instances of theft and misuse, as well as discrepancies due to human error. Most pharmacies use manual paper ledgers that record controlled drugs supply, delivery and destruction. Manual entry also causes delays in the dispensing process. Blockchain technology has the potential to transform this.

Who enforces controlled drugs regulations?

As mentioned before, standards and procedures are monitored by regulators. This can range from:
  • Responsible for completing certain tasks for the responsible officer.
  • Responsible for managing controlled drugs and all the governance relating to them within their organisation, i.e. a pharmacy chain.
  • Responsible for inspecting if the regulations in place are appropriate and are being used consistently.

Where can the pharmacist go wrong?

  • Discrepancies can occur in the controlled drugs register.
  • Increased pressure on the pharmacist could increase dispensing errors, where the wrong drug could be given, the wrong quantity, etc.
  • The pharmacist has many tasks to complete, there is little time to consult patients so she must manage the time for each consultation, potentially limiting her ability to effectively diagnose and increasing the risk of error.
  • The pharmacist could accidently choose the wrong drug, strength, quantity or label the prescription incorrectly. This could cause major inconvenience for the patient, having to return to the pharmacy or even damaging the patients’ health, with potentially fatal consequences. Although this seems drastic it is a real possibility and does happen. It can occur when pharmacists are under pressure with workload, staff and time demands.

How can we make procedures more efficient?

If we look at Blockchain as a solution, we can create a secure distributed ledger that allows witness ID to be recorded at the appropriate times. It allows real time access for authorized individuals to view controlled drugs transactions and interventions. Authorised individuals, such as the pharmacist, can update records with ease and staff members are able to perform other duties hence improving the pharmacy efficiency. Through this the pharmacist can focus on ensuring patient safety and quality of care. Blockchain offers the ability for IoT to be implemented to automate the recording of the register. If IoT is implemented, every time a drug is put into the safe it could be recorded onto the ledger. In some cases, where a pharmacy robot is already in place, perhaps in a hospital dispensary, this would be easy to implement. Blockchain allows Pharmacy to move forward in technology while still allowing room for improvement in the future.

A future with Blockchain…

In order for Blockchain to be successful, six criteria must be met:

  • Multiple parties need to share data
    • Regulators need to see controlled drugs registers to monitor controlled drugs transactions
  • Multiple parties need to update data
    • Users need to update register in order to keep the running balance accurate
    • Deliveries, dispensing and destruction need to be recorded and updated onto the register
  • Verification is needed to ensure information can be trusted
    • Witnesses to any controlled drugs transactions need to be recorded
    • Information needs to be trusted due to highly regulated drugs
  • Intermediaries add complexity
    • Only authorised individuals are allowed access to controlled drugs
    • If many users are involved in the process, errors will occur
  • Interactions are time sensitive
    • Prescriptions must be dispensed at an acceptable pace
    • Controlled drugs safe should not be open for longer than necessary
    • Records need to be updated as soon as possible to ensure there are no discrepancies between register and physical stock
  • Transactions interact and are dependent on each other
    • If a prescription is dispensed, the running balance of physical stock must match the register
    • Regulators need access to the register
    • Deliveries, dispensing and destruction all affect the running balance of the register and need to be recorded. One affects the other

Benefits of Blockchain

This is an example of how Blockchain can be used to benefit the system. There are five key areas that would improve from adopting Blockchain technology:

  • Reduced complexity and cost
    • Time management is improved
    • Process becomes simpler
  • Reduced errors
    • Drug Accuracy
    • Record accuracy
  • Enhances security
    • Drug secturity is improved as safe opening and closing is date and time stamped onto the register
    • Regulators have visibility and hence can monitor controlled drugs transactions in real time
  • Has proven resilience
    • Transactions must only be visible to authorised users
    • Only authorised users will be able to open the controlled drugs safe therefore tighter regulations
  • Creates shared trusted transactions
    • Regulator and pharmacist need to trust each other interactions
    • Transactions must be trusted as controlled drugs are highly regulated
  • Creates and audit trail
    • Every transaction is accounted for with a time, user and date stamp
  • Enhances transparency between authorised parties
    • Regulators can access the register in real time to monitor transactions

Conclusion

By creating a digital ledger, using Blockchain technology, there is the ability to link the register to the future controlled drugs supply chain and streamline the whole procurement and delivery process, creating further benefits for this sector and transforming the way medicines are dispensed.

Contact us

Quentin Cole

UK Leader of Industry for Government and Health Industries, PwC United Kingdom

Tel: +44 (0)7770 303 846

Johnathon Marshall

Partner, Health Industries, Procurement and Supply Chain Management, PwC United Kingdom

Tel: +44 (0)7736 350 447

Steve Davies

Global Blockchain Leader, PwC United Kingdom

Tel: +44 (0)13 1260 4129

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