The pandemic has amplified the talk of new pharmacy models such as hub and spoke, and online services. There has been a ramping up of repeat ordering on apps, and click and collect services. Who’d have thought, but even remote supervision is back in our daily discourse.
Whether you agree or disagree with the ideology of these new models, you ignore them at your peril and would be kidding yourself if you think they are going away. The ignition is on, trajectory has been set and this is the direction we are headed. The only question is whether you jump on board, or spend your energy trying to stop a train that’s already left the station.
Evolution of PMR
When PMRs were first introduced into pharmacy, their only function was to print labels and transmit orders to wholesalers. You would get a terminal installed, and in busy pharmacies, a server would be thrown in allowing a few terminals to connect to a single database on site. Life was simple and so were the systems. If community pharmacy is to now embrace future opportunities, the PMR must adapt to becoming the platform upon which these new models of service can be successfully enabled. Crucially, this evolution involves a fundamental shift away from local systems and into the cloud.
The impact of cloud computing on our lives cannot be overstated. The behemoths that we see before us, such as Google, Amazon et al, did not get to where they are with a few terminals and a local server. They owe their entire existence to cloud based technologies.
Whether personal use or in business, most of what we now do these days relies on cloud services. It has become much more than just email, file storage and backup. Software As A Service (SAAS) gives possibilities for local systems to tap into unlimited processing power, infinite storage and instant data transfer from your machine to anywhere in the world.
Leading the way in cloud services are the likes of Amazon Web Services (AWS). They have allowed businesses that host client facing applications to leverage the vast resources available on their colossal infrastructures. They are the platform of choice for mega-corporations such as Uber, Netflix, Twitter, LinkedIn and of course Amazon itself. When applied to PMRs, such as Titan, SAAS gives rise to endless possibilities.
Many of us have ideas about the future of pharmacy but no one really knows which innovations are going to be the best. Right now, community pharmacy needs the ability to rapidly develop and try out new ways of working. We need to keep the ones that work and discard the ones that don’t.
Normally the process of innovation, development and deployment would take years. Pharmacy does not have the luxury of time. However, with today’s cloud technologies we can leverage a host of services so a PMR can ‘spin up’ resources, databases, infrastructure, enabling us to innovate new services and models of pharmacy faster than ever before.
As soon as the lockdown was announced, many pharmacies went into overdrive as people started to stockpile their medicines. Some online pharmacies experienced such growth that they had to switch off polling new EPS prescriptions because their PMR servers were unable to handle the volume. These are classic side-effects of operating technology which is built for steady-state business. The future of pharmacy is going to require us to be able to flex our technological capabilities in line with our demand. If we want to grow our businesses then only true cloud-based services offer exactly this type of ‘elasticity’. We can flex the PMR resources to meet the needs of the business on a minute by minute basis.
Traditional PMRs have required us to invest in local servers and networking which can be a costly affair. The advent of cloud technologies allows us to outsource that heavy investment in infrastructure and pay for just what we use, when we use it. This has introduced fair pricing based on business size and demand, rather than the typical model of paying for an arbitrary set of PMR terminals. This liberation frees us to think differently about how we run our business.
If models like hub and spoke and patient ordering apps are to succeed in community pharmacy, we need instant data transfer. Information sharing across platforms, systems and businesses, needs to be real-time and cannot rely on old models of ‘file-transfers’ etc. One of the most important aspects of cloud services is that it has removed all physical boundaries. Rather than being hosted on local servers with file-transfer, PMR data is instantly shared and available across multiple sites. The use of Application Program Interfaces (API) allow systems to communicate with each other in real-time.
Naturally, the question on everyone’s mind about cloud-based services is what happens when it goes down. Indeed, there is a risk that either the service goes down or the connection to it. However, a lot has to be said about the PMR providers and the way the solutions are built. In the same way that two cars can look the same on the outside, the engine under the hood reveals the true power. There are numerous mitigations, such as coding standards, back up lines, mirrored data centres etc, that can be put in place to ensure any disruption is kept to a minimum. With these mitigations in place, the overall advantages of cloud far outweigh the disadvantages.
In previous articles I have talked about how businesses need to get the basic foundations of the operating model right. We need systems that re-engineer our processes, redistribute our skillmix so we can release the time we need to focus on services. If community pharmacy is to thrive, we must also be able to offer patients a new experience as well as taking advantage of innovations in dispensing and supervision.
A crucial part of this foundation is the very platform we operate on. Regardless of which version of pharmacy you believe in, one thing is for certain, the future of pharmacy will be hosted in the cloud.