Tackling Drug Diversion and Medication Safety in Outpatient Care

Summary

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Podcast Summary

Podcast: Becker’s Healthcare Podcast
Episode Title: Tackling Drug Diversion and Medication Safety in Outpatient Care
Date: February 14, 2026
Host: Scott Becker
Guest: Alex Yampolski, Chief Clinical Officer at Medserv

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Episode Overview

This episode explores the ongoing challenges of drug diversion (the siphoning of prescription medications for non-medical use) and medication safety within outpatient care, especially Ambulatory Surgery Centers (ASCs). Alex Yampolski, a pharmacist-turned-entrepreneur and now Chief Clinical Officer at Medserv, shares industry insights, personal stories, and solutions for modernizing medication management, as well as advice for healthcare professionals and young leaders.

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Key Discussion Points & Insights

1. Alex Yampolski’s Background and Medserv’s Mission

Timestamps: 01:01 – 03:29

• Career Journey:

  • Pharmacist by training, transitioned to business and entrepreneurship after seeing inefficiencies in healthcare.
  • Previously part of telemedicine startups, including one acquired by Cardinal Health.
  • Chief Clinical Officer at Medserv, focusing on digital medication management in outpatient and ambulatory settings.

• Medserv’s Focus:

  • Addresses the outdated, manual processes (e.g., key-locked cabinets, paper logs) used to track narcotics and high-value meds in ASCs.
  • Medserv’s platform digitizes and automates compliance, making narcotic management traceable and auditable.

"For those of you who are familiar with the outpatient world... a lot of things are stuck in kind of the archaic stone age... we're revolutionizing medication management in ASCs and outpatient facilities." (Alex Yampolski, 02:06)

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2. The Evolution and Reality of Drug Diversion

Timestamps: 03:29 – 07:31

• Changing Nature of Drug Diversion:

  • Previously, large-scale thefts (e.g., armed robberies for resale) were common, especially during the opioid crisis peak.
  • In outpatient settings, diversion is usually by employees for personal use due to opportunity and lack of controls.
  • Outpatient facilities often lack the oversight and staffing of hospital systems, creating vulnerabilities.

• Impact and Underreporting:

  • The ripple effect extends beyond the individual staff—there’s patient harm (e.g., fake medications, increased infection risk).
  • Drug diversion is “extremely underreported.” Facilities often handle cases quietly to avoid DEA attention and reputational damage, enabling repeat offenders.

"In the moment of weakness... that's where you have something in front of you that you take advantage of and then it completely spirals out of control." (Alex Yampolski, 05:07)

"Most organizations, if they can, try to do it quietly... And then that employee can go from facility to facility... and repeat the same pattern over and over again, putting everybody at risk." (Alex Yampolski, 06:38)

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3. Medserv’s Solution: Automation and Digital Reporting

Timestamps: 07:49 – 09:55

• Prevention & Simplification:
  • Medserv helps “flag and prevent” diversion events and makes investigation much easier for both administrators and external auditors.
  • Unlike hospitals, most ASCs still rely on paper logs—difficult for compliance checks and inefficient.
  • Everything with Medserv is cloud-based: record-keeping, audit trails, and reports are easily accessible.

“Our whole goal is making it easy and seamless for clinicians to practice. Take away the paper and administrative burden... we automate all of that. Plus, we secure the medications and... improve safety.” (Alex Yampolski, 08:19)

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4. Context of Adoption in Outpatient Settings

Timestamps: 09:55 – 11:01

• Technology Lag in ASCs:
  • Many facilities lag behind hospitals in digitization—about half aren't even using electronic medical records yet.
  • The administrative burden is significant, but solutions like Medserv can free up staff time and reduce errors.

“There’s still so much time being spent and wasted on these manual tasks that don’t need to be there. They can be automated, they can be done more efficiently and safer with technology.” (Alex Yampolski, 10:24)

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5. Leadership & Career Advice

Timestamps: 11:01 – 13:37

• Finding Fulfillment:

  • Seek out work that energizes and brings joy—whether building companies, helping people, or improving care.
  • The entrepreneurial path is hard and full of trade-offs, so loving the journey is key.

• Balance & Self-awareness:

  • Maintain balance and pursue interests/hobbies outside of work.
  • Life goes by quickly; don’t miss out on personal fulfillment.

“Figure out what brings you joy, what gives you energy, and do that... if that's all that you get out of this life, it was pretty fun and exciting for you to do.” (Alex Yampolski, 12:32)

“There has to be a harmony where everything works together, where you're doing things you love, you're doing it with people you really enjoy and you have things going on in your life outside of work.” (Alex Yampolski, 13:16)

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Notable Quotes & Memorable Moments

• On Industry Stagnation:

  “Things are stuck in kind of the archaic stone age... help facilities transition from key locked cabinets and paper logs... to a digital solution.” (02:09)

• On Underreporting and Impact:

  “It is extremely underreported because when you report it, you flag the DEA, you may end up in the headlines... so most organizations... sweep it under the rug.” (06:53)

• On the Human Toll:

  “A lot of times it ends up in suicide because these are people whose lives are just coming apart and they just can't handle it anymore.” (05:43)

• On Purpose and Fulfillment:

  “It better be worth it. And not just by the end, terminal outcome of all of this, but by the journey itself.” (12:11)

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Conclusion

Alex Yampolski provided a compelling look into the pressing issue of drug diversion in outpatient care—highlighting the nuances, dangers, and need for better controls. He positioned Medserv’s digital solution as not only improving compliance and safety but also alleviating everyday burdens on healthcare teams. His candid career advice underscored the importance of joy and balance in both entrepreneurial and traditional professional paths.

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End of Summary

Transcript

[A]

This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.

[B]

This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to be joined by a brilliant leader who's both a pharmacist by background and a business person as well, and an entrepreneur. We're joined today by Alex Yampolski. Alex, can you take a moment to introduce yourself and tell us a little bit about yourself and your career? Then we'll talk about trends you're watching, advice for leaders, and where you're most focused in 2026. Yeah, Alex, take it away.

[C]

Thanks Scott. Thanks for the wonderful introduction. So, as you mentioned, I'm a pharmacist by training and professionally. I grew up within a large health system and then after a career there went to business school, kind of hoping to do something more at an administrative level inside of a health system, and got bit by the entrepreneurial bug while in business school. Fortunately, I went to UW Madison for both pharmacy school and then as well for business school and in business school. The ecosystem, entrepreneurial ecosystem has evolved so much in Madison at that time with EPIC and all the little startups that kind of started from that investment money that was coming in. It was very exciting and made me think that, hey, I see so many things broken in health care. Why should somebody who's never worked in health care be the one to fix it? We know people who work frontline. We know what's broken and we know what's usable and what's functional and what needs to exist. And I started pursuing a career in entrepreneurship. So medserve is now my third company. My first two were telemedicine based companies. The first one I was a part of that I joined and then we had a exit to Cardinal Health a couple years later. And then my second company was a company called or is company called Vital Health, which is a online platform for integrative and functional medicine providers. So if you're a patient looking for an integrative and functional medicine doctor, you can get connected with a great one on Vital Health. Currently a chief clinical officer at Medserv and at Medserv we're revolutionizing medication management in ASCs and outpatient facilities. For those of you who are familiar with the outpatient world, specifically in the surgery centers, but really across the outpatient spectrum, a lot of things are stuck in kind of the archaic stone age when it comes to certain things in operations. So, for example, the things we focus on currently primarily are narcotic management and high value medication management in these facilities. And help facilities transition from, believe it or not, key locked cabinets and paper logs and tackle boxes and shared keys to a digital solution that's completely automated and takes their entire medication management in narcotic management and compliance and makes it all digital, traceable and easily reportable, which is a game changer for either an individual center or an organization.

[B]

And how has drug diversion evolved over the last several years? I mean, all of us have watched, at least a lot of us have watched movies about the opioid crisis where people are breaking into pharmacies to steal drugs and so forth. What does drug diversion look like typically in a practice or a surgery center? I know you do some work with health systems as well.

[C]

Yeah.

[B]

What does drug diversion look like today? Because, you know, I mean, you see it on the news or at least from the movies, like Dopesick during the opioid crises. And I guess we still have an opioid crisis, but when people were, you know, having real drug problems and breaking into drugstores to steal drugs. And I take it that's all locked up today. But what does it look like today? What is, what does drug diversion look like today in a typical situation?

[C]

So back in my health system days, we had a case where multiple cases, but this one was where somebody walked into a pharmacy midday with a line of people, climbed on the counter, pulled out a gun, zip tied everybody and stole all of the opioids out of the pharmacy. One of many.

[B]

And were they, were they, were they, were they taking them? Was they had a drug on themselves? Or is that typically somebody to steal them, to resell them? Or we don't know.

[C]

In those situations, when somebody's stealing large quantities like that, that's going to be most likely for resale. However, what we end up seeing in surgery centers, typically those are for personal use. And that's where really the story gets. I mean, all of this is very, very sad. And what we see in surgery centers is people don't usually start out in that environment to divert narcotics. They have easy access that oftentimes is unsupervised. Because if you think about the number of pharmacy Staff that are present in a hospital system versus an outpatient facility, it's night and day difference, the number of compliance people, the number of various security checks and balances. So it makes it for an easy environment to be unsupervised and have unrestricted and uncontrolled access that may not even be documented. So it makes it easy for you to. In the moment of weakness, in the moment where you're having the worst day of your life and things are just coming together in the worst possible way, and that's where you have something in front of you that you take advantage of and then it completely spirals out of control. Now, also in surgical environments, and, I mean, this probably goes beyond that, and it for sure goes beyond that. But in the surgery centers, I like to think about the ripple effect of what happens when a drug diversion case happens. Of course, the person who is addicted to the narcotic that steals it from the facility is impacted. They may lose their license, they may lose their job. They will lose their job. They will potentially get prosecuted. A lot of times it ends up in suicide because these are people whose lives are just coming apart and they just can't handle it anymore. But there's also a whole lot of patient harm when medications are being switched. A lot of times where instead of getting fentanyl when going through a procedure, you're getting regular saline or worse yet, tap water that somebody substituted, that can put you at harm. You can get infections, you can die, or you can just go through a procedure with no pain medication on board. And this happens all of the time. And unfortunately, Scott, you know, you made a point that, you know, we see this in the news, we see this in various shows. It is extremely underreported because when you report it, you flag the dea, you may have. You may end up in the headlines in your local newspaper. And nobody wants that exposure or liability. So most organizations, if they can try to do it quietly let go of the employee and sweep it under the rug so they don't make a splash. And then that employee can go from facility to facility to facility and repeat the same pattern over and over and over again, putting everybody at risk.

[B]

I take it, in the best situations, you try and get that employee help. I guess you have to report it, but you're trying to get that person help. So maybe they don't lose their job forever, but they get the help they need. I'm not sure, but tell us where you come in. Where does Medserve come into all this?

[C]

Yeah, we're there to help flag and prevent these events. And if there are ever investigations, we're there to make those investigations go easy and seamless for the administration as well as for the auditing body. If you think about again, the level of sophistication in the hospital system when the DA officer shows up and they're looking at some data or some reports, typically pharmacy departments can get those relatively quick by running a report. Typically they have really good controls, they have cameras, they have records and log access records and door access records. And all of those things they can bring together really quick for the auditor and be able to investigate it, whether it's a DA auditor or an internal investigation. In outpatient world, that is not the case because so much of the outpatient world is still on paper for monitoring and tracking those things that it is extremely difficult. And when you take your sweet time to pull all the records, it makes the auditor feel like, hey, what is the level of sophistication here? What is the level of control? And it makes them question more, trust less and dig deeper. So our whole goal is making it easy and seamless for clinicians to practice. Take away the paper and administrative burden of keeping records that need to be kept and we automate all of that. Plus we secure the medications and we help facilities design processes and implement it in a way that improves safety. And if and when they do need to look into it, everything's cloud based and easily retrievable on our reporting platform.

[B]

Thank you. And I can tell why that's so important. It's almost that the always situation of working with a small to mid sized business versus a large business, a large business is all these resources. So when the DEA comes in or they've got to deal with regulators, they've got people in a small, medium sized business, everybody does everything. And so you're not really prepared for it. So having a real solution, real help on this is really impactful, isn't it?

[C]

Yeah, absolutely. And outside of, you know, the situations where you do get audited, outside of situations where drug diversion happens or mistakes happen, because that does happen. However, every single day there is an administrative burden on the clinicians and nursing staff and administrative staff to keep things properly tracked and properly documented, unfortunately the AC market is plagued with that. Probably half the facilities are still not using an electronic medical record. Even though that's changing. Technology is being adopted and we're seeing change in evolution over time. I'm sure. You know, being involved in the surgery center market as long as you have, you've seen it from basically ground zero. So change is happening, but there's still so much time being spent and wasted on these manual tasks that don't need to be there. They can be automated, they can be done more efficiently and safer with technology. And Medserve and many other companies are working to help facilities do things better, faster, cheaper.

[B]

Thank you. You've had this great career. I mean you were really inspiring to me and to others as well. Talk a little bit about what advice would you give somebody trying to have an impactful and terrific career where they thrive and they're helping? What advice do you have for young emerging professionals trying to have great careers?

[C]

Well, I think it's kind of hard for me to think now as somebody in a corporation building a career. It's much easier for, for me to think about as an entrepreneur, but I think it probably applies across the board. My, my recommendation would be to find areas where you feel energized and where you feel the joy. For me personally, it's building things. It's helping people understand that the value that our solution brings, whatever, whatever the solution may be, I get really jazzed up by that and building something that helps or bringing a service that really truly helps people. So for me that's fulfilling. And you know, as most listeners here who are in the entrepreneurial world can attest, there's, it's, it's a lot of hard work, there's a lot of trade offs in this, in this life and it better be worth it. And not just by the end, terminal outcome of all of this, but by the journey itself. And you know, I personally still struggle with this where it's, where am I trying to get to versus what am I doing on a daily basis and how much am I enjoying it? And so can it all in. But one of the main advice says I would give to people is figure out what brings you joy, what gives you energy and do that because if that's all that you get out of this life, it was pretty fun and exciting for you to do. The other, the other thing that again, kind of from my personal experience, it's trying to create and maintain some sort of a balance and space outside of your career, outside of your business, outside of your professional pursuits, whether it's for hobbies, friends, life goes by pretty quickly. And it's scary to think about maybe waking up in five, 10 years and looking back and realizing you didn't do those things. I think about that a lot and I transparently still struggle with that and having the right level of balance and the right priorities and all of those things. But there has to be a harmony where everything works together, where you're doing things you love, you're spend, you're doing it with people you really enjoy and you have things going on in your life outside of work.

[B]

But I love that. And the reality is, it's like this old adage when you meet somebody and you think they've got all got it figured out and it makes you feel intimidated because they have it all figured out. The reality is most all of us are works in process and there may be some small microcosm of the world, some small, very small percentage that is it all figured out, knows what they're doing all the time. Most of us are setting goals, resetting goals, reestablishing ourselves, working on our life outside of work in addition to our work life and work and everything else too. So I love the clarity and the honesty in that. I think it's beautiful. Alex. Alex, I want to thank you for joining us today on the Becker's Healthcare podcast. It's always great to visit with you. You're a total inspiration to myself. So thank you for joining us on the Becker's Healthcare podcast.

[C]

Thanks Scott. Great to be here.