At the Frontline: Former Texas Children's Hospital security chief Robert Owles

Earlier this month, four people in a New York pharmacy were shot and killed by a man who entered the store to steal prescription medication. While this may be one of the most violent pharmacies robberies in recent memory, it has shined a spotlight on what appears to be a growing problem across the nation.

According to RxPatrol, a program launched in 2003 by the pharmaceutical industry and law enforcement community to disseminate information about pharmacy theft, there has been a spike in pharmacy robberies nationwide in recent years. From May 2003 when the program began compiling statistics on pharmacy crime until June 2008, RxPatrol logged nearly 900 pharmacy robberies nationwide. However, as of June 24, 2011, the total number of robberies logged by the program was more than 1,900, an increase of more than 1,000 robberies in three years.

In this "At the Frontline" interview, Robert Owles, president of Owles Security Consulting and the former director of security services at Texas Children's Hospital discusses the steps pharmacies should take to mitigate their risks from external, as well as internal security threats.

What can pharmacies do to better protect their employees and customers from incidents of violence?

Like many, many organizations in the United States throughout different industries, pharmacies need to take a look at training; they need to take a look at continuing education. These are very, very important aspects and that training and understanding of the potential risks and problems associated with conducting pharmaceutical operations is critical. It starts with the pharmacy schools and then moves into the pharmaceutical businesses themselves. Then it goes into the continuing education process to ensure that once they're out in the field and working that they don't become lax in understanding the risks and applying those things that would mitigate those risks. Another part would be internal security inspections and they should also have third-party inspections because it's very typical that even when you conduct these internal investigations, you become lax or you might overlook something because you see it all the time and a third-party inspection would definitely help that.

What types of medication are robbers after the most in these incidents and how can pharmacies mitigate their risks?

Well, first of all, what they're really looking for is Oxycontin. Opiates are also an issue. Some things pharmacies should be looking for is doctor shopping where the patients are shopping for doctors, stolen Rx pads which is a fraud issue, the alteration of prescriptions, fake (prescription) call-ins, overprescribing by doctors, and then there is another issue of impaired pharmacist and techs where they are actually abusing prescription drugs. In these cases, the pharmacists and techs will not be or alert or will even help an exterior criminal perpetrate some of these crimes. Those, in a nutshell, are some of the issues I'm looking at.

When it comes to smaller, independent drug stores that lack the resources of a major chain, what are some procedures and technologies that they can implement to mitigate their risks?

There are a number of (pharmacies) out there that still fail to understand the true risks. Obviously, when you have an incident like the one that recently occurred in New York, it brings these issues to the forefront. First of all, they should have risk assessment done, which will allow them to actually take a look at where they fall out in their community in terms of potential risks. They need to take a look at that risk and boil it down into what they can mitigate without a lot of the expense involved because you can take and spend a lot of money on hardening your facility, but it might not be necessary to spend that much money. So, you need to take a look at what are the risks? Where do you fall out in that risk? And then decide what specific physical security measures you can implement such as locking devices and camera systems. Of course, you need to also look at locking up the controlled substances and the types of cabinets that you use.

What kinds of security technologies and procedures did you have in place at the outpatient pharmacy when you were security director at Texas Children's Hospital?

Outpatient pharmacies are similar to your community pharmacies in a sense that they are subject to the same risks that your other pharmacies have. We took the same type of approach. We did a risk assessment and looked at what the vulnerabilities were and then of course we hardened the target. We used the glass that had the (bulletproof) glaze to prevent projectiles from coming through and we incorporated drawers that could be used to pass the prescriptions and money back and forth where people did not have access to pharmacy employees inside. We also employed off-duty police officers. With those mitigating factors we put what I call an "umbrella" around our pharmaceutical areas, especially the ones for outpatient dispensing to protect them.

Aside from robberies, what are some of the biggest security threats facing pharmacies today?

There are a lot of other things going on and it has to do with drug diversion. It goes back to stolen prescription pads and the fraudulent altering of those pads. We had a program in the hospital specifically to ensure that those pads were always protected and they weren't placed in the doctors' drawer where someone would have ready access to them. I think that fake call-ins are another big (security) risk for pharmacies. A lot of pharmacies do not have the ability to ensure that the person calling in (the prescription) is authorized to do so and they're allowing the dispensing of drugs to an illegal or unauthorized person. Overprescribing by doctors is another big issue... and pharmaceutical organizations need to be very aware and keen to what's happening there. I also haven't seen many people talk about impaired employees and techs and their potential collusion with a criminal element.