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May 2023
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Health Tech for the Next Generation

Thinking differently about technology

I have two passions in my life. One is my family and the other is my work, in pharmacy and technology. Both give me inspiration and perspiration in equal measure.

My children inspire not least because I want a better future for them, but also because watching their behaviour is simply fascinating. I often watch my kids and see how they interact with technology, and can't believe how lazy it makes them become. These days, they press a button and food comes to them via Deliveroo - anything they want, any time, day or night. They spend their day on Snapchat and Instagram with friends. And for their homework, they type in their questions into ChatGPT and it gives them the answer.

As fascinating as all this is, it is also very scary. Not least because we don’t know what a future society that has been brought up in this way, will actually look like. It’s like we are living through a social experiment. A key question we have to ask ourselves is how will this future society interact with healthcare services when they do need healthcare.

Let’s be clear, we are not driving technology. Technology is driving us. One thing is for sure, GenZ will not consume healthcare services in the same way as GenX.

Our Current State of Pharmacy

Our healthcare service right now is not fit for the present, let alone the future. Primary Care has not evolved to meet todays demands. Record numbers of GPs have been leaving the profession just as workload volumes have risen.

It’s good to see the government finally recognising the role that pharmacist can play. The news of the additional funding is welcome and a step in the right direction, but it’s a small step and we still have a lot of issues in pharmacy to resolve.

The current model of pharmacy is outdated. I would argue it became outdated a long time ago, but we have remained wedded to the dispensing bench and finding it difficult to let go. We have somehow managed to convince ourselves that there is something still clinical about supplying prescriptions. But I’m afraid it’s not. Checking a label has been put on the right box is not clinical. Correcting the dosage on a prescription is not clinical.

I’m not saying this job is not important. But let us not kid ourselves that this job is somehow so highly specialised that it cannot be done by others, or that you need 5 years training to do it.

I sometimes see pharmacists arguing with members of the public on Twitter explaining all the checks they do when a prescription comes in and how they save the public from near death experience each day. I’m sorry but if you have to argue with people on Twitter about how important your job is, then I’m afraid you have lost the argument already.

Our dependency on prescriptions has put the sector in a weak position and allowed others to take advantage of us. We have this illusion of freedom, yet the profession is entirely controlled. 90% of our income still comes from dispensing. The manufacturers control what they charge us for the drugs. The government controls what they choose to pay us for the drugs. And we are stuck in the middle, unlike any other business, unable to control our margin.

We are controlled like a public sector department but without any of the protections afforded to a public sector service and carry all the risks of running a business. I’m not saying we let go of dispensing, but we need to build a new world where we at least control our own destiny.

I’m not the first to say pharmacy needs to change. You’ve heard it all before, we need to free up our time, less time on dispensing, more time clinical services. But we need to start thinking beyond this rhetoric.

Even now, when we think of technology we only think of robots, PMRs, CD registers and machines that label faster, etc. But we need to think bigger than this and we need to be way more ambitious!

The Potential of Technology

The good news is that unlike any point in history the technology exists to do anything you want, today. We live in times where technology can send people to Mars and cars can drive by themselves.

In Pharmacy, technology already exists [in Titan] today which can ensure everything leaving the pharmacy is safe. We already have AI that can check the appropriate. But that’s nothing, technology can solve so much more. Technology is no longer a barrier or an excuse. Our imagination is our barrier and we need to open our minds.

Let’s take Resourcing as an example. We know the NHS will continue struggling and our workload will increase. Resourcing is our problem, but the resources exist, just not at the right time in the right place. For every pharmacy that is inundated with work, there is a pharmacist somewhere else that’s got some time. I believe, technology can allow us to distribute our workload amongst each other. Services that do not need physical presence such as Rx checks, DMRs, NMS, Prescribing, Consultations with patients, can all be outsourced and done remotely with technology.

Today’s patient Apps order your repeats. I believe tomorrows apps will collect information. We already volunteer everything we have eaten into Instagram, so why not use apps to get diet, exercise routines. If we then join up the data from PMR to data from patient App, with diet and exercise, we can start predicting which patients are at high risk of ill-health or hospitalisation. This way we become proactive with health rather than reactive.

I believe tomorrows pharmacies will be health hubs. Patients will walk in to have complete health check. They will have their bloods, vitals, urine samples, DNA samples taken by pharmacy staff. We will have built AI algorithms which will not only tell the risk profile of the patient, but create an entire recommended prescribing regime that is customised for that patient. The pharmacist will consult with the patient and issue the prescription.

Healthcare Reimagined

Pharmacists have the skills to shape the future of healthcare. Pharmacists can prescribe and diagnose. Pharmacists understand business. Pharmacists understand efficiency. Pharmacists understand customer services – Look at how we run around for the patient, keep our doors open, and don’t make patients wait 2 weeks for an appointment.

So as we reimagine pharmacy, we need to reimagine healthcare. There is a healthcare revolution coming, underpinned by changes in consumer behaviour as the GenZ grows up with wildly different expectations, demands and interactions with the system. It will be shaped by technology, just like technology is shaping the lives of our children today.

The healthcare professionals that evolve to embrace this will be the winners. Pharmacy must be more like Netflix and less like Blockbuster. We need to think beyond the current pharmacy contract. We need to prepare beyond 5 year plan. We need to negotiate beyond the pharmacy global sum. We need to reimagine a future where pharmacists are at the centre of healthcare delivery, using technology to provide ‘medical’ services.

Of course, it would be nice if the government paid for this, but we shouldn’t wait for that to happen or be shy about going direct to the public. People will pay for convenience and innovation.

We need to reimagine a new type of pharmacist. Not a community pharmacist or Retail pharmacist or even a Clinical Pharmacist. But a General Pharmacist. Or how about “GP” for short?

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