ALEXANDRIA, VA, October 8th, 2026, NewsDirect
Annual report finds software and AI adoption increasing as dedicated staffing tightens, while compliance and human reporting remain critical to diversion prevention
Bluesight, the leader in hospital intelligence solutions, today released its 2026 Diversion Trends Report, an analysis of controlled substance monitoring, compliance, and drug diversion trends across U.S. hospitals and health systems. The report analyzed more than 295 million controlled substance transactions across more than 1,500 hospitals and health systems nationwide, providing insights into how diversion programs are evolving as healthcare organizations invest in technology, compliance, and cross-functional oversight.
Key highlights from the report include:
- Technology is filling a growing capacity gap. The share of facilities with full-time staff dedicated to diversion monitoring declined from 75% to 66%, while 94% of staff overseeing diversion surveillance now use software to detect discrepancies, monitor behavior, and investigate potential cases.
- AI is emerging as a new layer of defense. Nearly half of surveyed pharmacy professionals use AI to support their work, including 25% who use it specifically to detect drug diversion, as hospitals look for new ways to strengthen monitoring with fewer dedicated resources.
- Diversion programs are showing signs of maturity. Variance rates held at an all-time low of 6%, investigations stabilized at roughly 45 per hospital each quarter, and average investigation time remained at 49 days throughout 2025 — signaling more consistent monitoring and resolution processes.
- Anesthesiology is emerging as a priority for education and compliance. RNs still account for 88.5% of identified diverters, but anesthesiology represented 28% of controlled substance variances in 2025 and had a nearly 14% overall variance rate, compared with just over 4% for nursing.
- Human reporting remains one of the strongest indicators of confirmed diversion. Although patient and colleague reports represent a relatively small share of investigations, patient-reported cases were 13 times more likely and colleague-reported cases six times more likely than software-triggered cases to result in confirmed diversion.
“As diversion programs mature, hospitals are finding that technology, education and cross-functional collaboration all have an important role to play,” said Kevin MacDonald, CEO and co-founder of Bluesight. “AI can help teams work more efficiently and identify potential risks faster, but effective diversion prevention also depends on strong compliance practices and a culture where staff and patients feel empowered to raise concerns.”
Use of Technology and AI Support Expand, Safety & Compliance Driving Investment
While dedicated diversion staffing tightens, hospitals are increasingly relying on technology to support diversion monitoring and investigation. In addition to near-universal software adoption among surveyed diversion professionals, AI is beginning to play a greater role. Diversion teams using Bluesight’s Prism Assistant experienced a 96% faster turnaround on recurring reports and 90% faster pre-investigation triage, highlighting the potential for AI to help teams manage routine work and focus resources on higher-priority cases.
Patient safety remains the leading factor influencing budget approval for diversion technology, cited by 63% of respondents. At the same time, 82% of staff overseeing diversion efforts rank process improvements to drive compliance as a top measure of program success. Cross-functional oversight is also expanding, with 83% of diversion-focused staff reporting a diversion committee at their organization, up from 67% in 2025.
Human Reporting Adds a Critical Detection Layer, New Settings Create Risks
Data-driven alerts account for the majority of investigations, accounting for 83% of cases opened in ControlCheck during 2025. However, human reporting remains an important complement to automated surveillance. While patient and colleague reports accounted for less than 9% of investigations, 39% of patient-reported cases and 18% of colleague-reported cases resulted in confirmed diversion.
The report also highlights opportunities for more targeted education and oversight. Nursing continues to account for the majority of controlled substance activity and confirmed diversion, but anesthesiology roles had a substantially higher overall variance rate. Hospital size, meanwhile, had little impact on overall variance rates but affected how quickly organizations reconciled variances and completed investigations, underscoring the need for diversion programs to account for differences in workflow and care settings.
Report Methodology
The report analyzed data collected by Bluesight’s ControlCheck solution throughout 2025 and, where applicable, includes trend data dating back to September 2018. The dataset comprises more than 295 million controlled substance transactions from 1,593 hospitals and health systems nationwide. Additional insights are drawn from Bluesight’s 2026 Hospital Pharmacy Operations Survey, conducted in February 2026, which collected responses from 403 pharmacy professionals — 210 of whom are directly involved in diversion monitoring and prevention.
The full report can be found here: 2026 Diversion Trends Report
About Bluesight
Bluesight powers hospital operations with intelligence that simplifies inventory management, procurement, and compliance. Through its suite of industry-leading solutions, Bluesight ensures that health systems protect every patient and optimize every dollar. Over 3,000 United States and Canadian hospitals rely on Bluesight every day to have efficient and safe operations. For more information, please visit bluesight.com.
Contact
Senior Account Executive
Amanda Montini
Brodeur Partners for Bluesight
[email protected]