Computerized controlled-substance surveillance: application involving automated storage and distribution cabinets

A secondary data-reporting system used to scan the archives of a hospital's automated storage and distribution cabinets (ASDCs) for indications of controlled-substance diversion is described. ASDCs, which allow access to multiple doses of the same medication at one time, use drug count verification to ensure complete audits and disposition tracking. Because an ASDC may interpret inappropriate removal of a medication as a normal transaction, users of ASDCs should have a comprehensive plan for detecting and investigating controlled-substance diversion. Monitoring for and detecting diversion can be difficult and time-consuming, given the limited report-generating features of many ASDCs. Managers at an 800-bed hospital used report-writing software to address these problems. This application interfaces with the hospital's computer system and generates customized reports. The monthly activity recapitulation report lists each user of the ASDCs and gives a summary of all the controlled-substance transactions for those users for the time period specified. The monthly summary report provides the backbone of the surveillance system and identifies situations that require further audit and review. This report provides a summary of each user's activity for a specific medication for the time period specified. The detailed summary report allows for efficient review of specific transactions before there is a decision to conduct a chart review. This report identifies all ASDC controlled-substance transactions associated with a user. A computerized report-generating system identifies instances of inappropriate removal of controlled substances from a hospital's ASDCs.