The Evolution of Pharmacy Industry
The Evolution of Pharmacy Industry
For years the issue of non-adherence and non-compliance and their economic impact has been discussed at length. However, as data has become more accessible on a greater scale, more effort has been focused on the importance of producing a consensus for standards measuring adherence and the burden that non-adherence places on the healthcare system.
Pharmacies are under pressure to respond to Medicare’s movement toward quality measures for determining reimbursement. Inclusion in payer networks could also be at risk.
In addition, pharmacists’ reimbursement for clinical-based services is gaining momentum, primarily in the form of Medication Therapy Management and other patient-facing services offered by pharmacists. Challenges for the pharmacist include identifying patients in need of these services, understanding how to successfully approach those candidates, as well as workflow changes, time allocation and acceptance of these services by patients. Meanwhile, payers are watching closely for evidence of the impact of interventions. While results won’t happen overnight, and will require patience from everyone involved, the pharmacy should rely on data to improve its reimbursements and quality of care.
Finally, as we encourage patients to take more ownership of their healthcare, and encourage adherence, we must support continued development of new technologies and patient engagement methods.
Obstacles in Pharmacy Industry
I work in the Cardinal Health innovation center, Fuse, located in Dublin, Ohio; I work among 100+ software developers, UI/ UX designers, marketing research and business analysts. Honestly, it is a concentration of some of the brightest people that I’ve ever worked with and a seriously fun place to work. The people are passionate about providing technology-related solutions for healthcare customers—and ultimately, patients.
However, we don’t produce software or technology solutions just for the sake of producing something that we think works. We collaborate with customers to identify what the pain points really are. We build something for users that make sense to them and solve their problems. Then, we update it, and update it again. We can build software and hardware solutions that look really cool and are feature-packed and function well, but if—at its core—it doesn’t connect patients and providers, promote health and wellness, reduce cost and complexity or work to eliminate waste in healthcare, we haven’t done our jobs.
"As we encourage patients to take more ownership of their healthcare, and encourage adherence, we must support continued development of new technologies and patient engagement methods"
Some challenges that may impact the pharmacy extend to other areas of healthcare. I recently read an article outlining the very real prospect of a nurse shortage in the U.S. and that impact will be felt across many healthcare sectors. To think that pharmacy will be immune from any impact is naïve; however, it represents an opportunity to offer expertise in serving the patients who will feel the most pain from the impact. Pharmacy needs to be well positioned to seize this opportunity.
To ensure the pharmacist is well positioned and practicing at the top of their license, there has been progress at the state level in pushing provider status legislation for pharmacists. However, there is plenty more work to do at the national level.
Required Skill Sets for Leaders in this Landscape
Leaders, to be successful in pharmacy, need to continue to be professional and honest with those they serve. Given the rapid pace of change in technology, being agile and adaptable is more of a requirement than ever before. People developing healthcare solutions need to get out and talk to their customers, ask questions and listen to their answers. We have to stop assuming we have the solution to problems before we truly know what the problems are.
Exciting Future Technology Innovations
Augmented and virtual reality, hands down. Currently, the vast majority of applications are focused on gaming and entertainment, so the field is truly wide open for development in healthcare.
The limitations of the applications are difficult to get my head around; if there are limitations, they might only be in the form of processing power and human resources to code the applications, but those are usually short-lived and are good limitations to chase.
Imagine using VR/AR to treat depression and anxiety, relaxation/ distraction techniques for pain reduction, process and workflow creation and evaluation, scenario-based training, and utilizing machine learning algorithms to create new training scenarios. The possibilities are vast, and limited only by imagination and resources. Today, immersive training requires expensive tangible elements and limited occupancy space. Virtual and augmented reality can allow for a similar immersive experience with unlimited occupancy along with virtualized elements.
Technology as a Driving Force
I work in an innovation center surrounded by developers and designers, so most of my work life is driven by technology. I consult internally on multiple projects, contributing from clinical and pharmacy regulatory perspectives.
Most of us are surrounded by technology quite literally in the cars we drive, our smart phones and televisions, integration into our home HVAC systems, and in our wearable technologies, which produces this immersive sense of being always connected. For the most part, these technologies have been very beneficial and fundamentally changed the way we communicate and stay connected with one another. For example, consider how we buy and listen to music, how we book travel, and how we get our news. We can track our nutrition; compete with friends for fitness goals, post vacation pictures and, of course, cat videos on social media. Running low on detergent? Press a button. Need razors? Fire up your app and change your delivery schedule.
However, advances in technology can also produce unintended consequences. For example, manual Drug Utilization Review (DUR) is a losing proposition from every angle for a pharmacist. Automated DUR programs are great, but they can produce alert fatigue, and interactions and inappropriate doses can be overlooked. In hands-on care settings, telemetry units produce thousands of alerts daily, producing this same danger of alert fatigue. The unintended consequences of advances in technology require real solutions in themselves. Will those solutions produce their own unintended consequences? Making the distinction between benefiting from technology and relying on technology is an important one to make and sometimes, we need to just put it down for a while and get outside.
At Fuse, we’re developing software and hardware technology to give retail pharmacists some much-needed visibility into patients’ medication-taking patterns with the goal of connecting patients with their pharmacists to facilitate regular, focused, data-driven conversations about their wellness.