I have been more than a casual observer, perhaps voyeur, of the flack and general hubbub created by the Woolworths matter.
An issue that has lots of heat and passion well mixed in with a fair dose of politics.
Regardless of what happens today, next year and beyond, the spectre of grocery competition should be seen against the way things will be - not the way things are.
Then work out what the battlefield will look like and then decide how best to cope, one way or another.

The key landscape issues will be the electronic use and the sharing of information and knowledge to deliver improved patient care, reduce misadventures and to track and trace both the money and clinical returns of these activities.

Centred primarily on implementing online electronic health records (EHR) for all citizens.
With EHR as the hub, every other task and application will become integrated spokes of this information utopia.

From a perspective of the grocery threat it is worthwhile remembering that this massive hub will require the seamless connectivity of shared data across all providers of clinical care - that is, in the big picture it will not be just a retail turf war matter.
It will be far more a health sector e.information reticulation matter.

Consider the benefits that will be realised when discharge summaries are accurately, safely and usefully exchanged between doctors and pharmacists in the community and doctors, pharmacists and nurses in hospitals.
Not the natural environment of the grocery sector is it?

At the same time community pharmacy is a retail business that can adapt to the emerging Internet influenced circumstances so as to remain viable.
Given that a keen eye is kept on all the separate issues, the future can be worth looking forward to with the optimism of the half-full glass not the half-empty view.

A way to do that is to recognise and focus on all the other 'Ps' that will matter over the coming years. Although the competitive retail debate is sure to continue it is not so clear whether the other 'P' issues are even on passionate or political radar.
Passions wane and politicians come and go but other matters will be with us for decades.

Ignoring the need to cope with a new and emerging, electronically shaped marketplace will prove to be as threatening and as illusory as relying on politicians to 'save you'.

Eventually the time honoured outcome of the current competitive conflict will see a compromise agreed. At that time the winners and the losers will be determined by multiple and overlapping, practical issues.

It is not a trivial situation and as such it should not be left to chance, or just passion, to reach the eventual resolutions. The next five years will shape the scene for decades to come.
Until the yet unseen, unknown, next 'big-thing' supersedes the Internet.

Look back five or ten years and then try and see five, ten years down the track, as one twenty-year block and snapshot of time.
What was nice and comfortable in 1995 will not be the same in 2005 and less so in 2015.

So what?
See it and react to it as progress rather than a burden.
To do otherwise is a certainly a choice, but one that history tells us won't end happily.

Sooner than later I feel the penny has to drop with our 'leaders' that the nature of the Internet will greatly influence what pharmacy will look like from 2005 and beyond.
Grocers are just one factor. Granted a serious one, but to focus solely on them could let worse things come to pass.

In the meantime, taking into account the following 'P' items can help to reinforce the viability of the retail pharmacy community.
Be it as a stand-alone business or as a banner group operator.
The list you can consider is:

* People issues
* Process factors
* Practice habits
* Platforms (of ICT, broad band, standards, data and information management)
* Professional pride and self interest
* Power of knowledge
* Pharmacy's profile
* Prescriptions
* Productivity and performance values
* PBS
* Product track and trace
* Partners
* Profits
* Payments
* POS/PC
* Patient records and privacy
* Policy
* Public interest
* Place
* Politics, and
* Passion

My personal view is that the current sparring and the energy spent in the media and elsewhere in point scoring may feel good, but is not the answer.

To settle the competitive threat in terms of win/win, lose/lose or win/lose will be eventually resolved and measured in terms of who handles the 'Ps' best.

The list is in this descending order above - that is, starting with the most important factor being 'people' and ending with the most wasteful being 'passion'.
Naturally, the statistical model of human nature says a third of you may agree, a third will argue passionately a differing point of view, and the remaining third couldn't give a continental.

Doesn't matter really how we see what is and what is not critical. Or in what order you see them. Someone's 'most compelling' hot button is someone else's fizzer.
The important thing is to know what these functions and attitudes are and act accordingly.

The truly central factor is the Internet. Particularly the ability of all participants to engage in an interoperable manner. And it will remain the one thing that will define major change in our society.
Of this there is no debate, no options, no compromise - save doing something else in another enterprise or leisure activity.

The rules, if that is the right description, have changed.
No matter where people choose to take a stand.
There is an invisible tsunami of information exchange functionality washing over us that are certain to dominate events.

If that is the case, and please fell free to challenge the prophesy, then it is probably wise to face the future by maximising the opportunities and minimising the threats in the context of integrated, electronic, information management reticulation.

Take the juxtaposition of three technologies that slowly crept into daily use over the past decades.

Supermarkets led and accelerated the use of POS and today most retailers operate some form of electronic point of sale device.
Meanwhile, on one fine day, it just seemed that everyone had a PDE, a tool also pioneered by the grocer cousins and rapidly adapted by pharmacy.
Compare the functionality of a 1990 circa PDE with a PDA today.
Awesome difference in what is in the black box in your hand and what it can do - particularly in realtime, online.

Yet, the dispensary PC, which take-up also started slow and then suddenly became to be in common use, is not the domain of other competitive entities - it is uniquely a professional pharmacy technology tool.
By the way, today's PDAs can pretty much function as a desk top PC and therefore is being used in USA hospitals as mobile dispensing units.

What do all these three technologies have in common?
Essentially they capture, save, store, transmit and receive data - electronically managed information.

Today, and moving forward, all this information is going to be exchanged at warp speed over dedicated hubs rather than as a point-to-point, very slow, phone line connection.

So what?
Go back to the 1970/80 period when none of these things were in use.
Ah bliss - or was it oh blah?

Whatever, the urge and need to 'know', and to know it better, sooner, faster, cheaper and easier, ensured that technology flavoured process and practice changes came to pass during this twenty five year period.

The Internet has brought about almost as much change, or the certainty and picture of change, in as many months.

Question.
Right now, today, which retail community can best harness this beast?

Yeah, scary huh?
Passion alone as a weapon is not going to fly on this battlefield.
It will be a matter of getting, as best one can, all of your 'Ps' in focus against the background of what can not be ignored or owned.
The Internet.

Let's try, briefly, to make some sense of this.

Remembering that pharmacy is rightly and practically not one single personality.

Things that matter for a staunch independent may differ from the interests of a member of a banner group or certainly that of a hospital pharmacist.
The latter are very important in the context of solidarity.
There will not, for example, be separate information management disciplines and regimes based on who dispensed the prescription.

And, that is what this all about.
Defending the exclusivity of the pharmacy turf.
Crude perhaps, but undeniably true.

In the confines of reader's attention time and publication space, the following brief comments may be cryptic for some readers. If that is the case please do not hesitate to ask someone you trust and admire for clarification - there is no such thing as a silly question but the reverse is often not the case, so choose the guru carefully.

People

The single and dominant driver of all change. Nothing, thankfully, happens in a vacuum without a person guiding the effects and outcomes.

You have to decide the importance of the following people to you and your people in an emerging and changing e.enabled landscape.

- your customers
- your suppliers
- your competitors
- your professional and other partners
- your enablers, and
- most importantly the governors and the fee-payers, being:
- the people representing the people who will demand that the Internet be used to benefit all people

Process and practice

Usually go together and centre on the obvious issues of what will be needed to meet the electronic and technological impact in what you do, how you do it, who you share the information with and how often this takes place. For example barcoding will become a rule, not an option.

Platforms

The juxtaposition again of the combined public and private investment in reticulation platforms will be the meeting ground for change. Linking the POS and the PDE online with the supply side and the PC in the dispensary with professional and governing/paying partners, is the future hub and spoke of information electronic reticulation.

In the health sector the drive to accomplish this national ICT platform will be a significant effort.
Once accomplished there will be no where, no where, to hide.

Professional pride and self interest

No need to beat about the bush.
This is important and a fact of life. Perhaps the centre of the whole debate and rightly so.

We can condense the next few issues listed above in with this heading.

The power of your knowledge and the combined collateral of this knowledge is potent. Is this being put to the best use currently in the competitive debate?
Perhaps it is and perhaps it is not.

Regardless, the profile of pharmacy within the community, with it's partners and governors needs to be moulded to best demonstrate the ability to manage and own the knowledge of pharmacy and it's 'Ps" in an electronic age. The longer you look in the rear view mirror the greater the chance you won't see the truck as it rushes to a head on crash.

Prescriptions

Also linked to productivity and PBS issues.
Both issues that have a much more base instinct deep behind the rhetoric of either a supplier spokesperson or a health sector customer.
Because both rely on the true customer and their aspirations and actions - the government.
It is no secret where governments, in all OECD countries, are heading.
Online, online and online.

Meanwhile we all still ask - what's in it for me!
Me, the pharmacist. Me the supplier and me the taxpayer. 'Me', is a very important word.
The Internet is massively changing how many of us go about our daily routines.
Usually because it delivers 'me' something better and more conveniently than what happened before.

This will shape the nature of competitive threats more than any other matter. You have to believe that e.prescribing is how this will pan out. Those that can will, and those that can't won't. Well, certainly not on the same playing field.

Look at electronic banking. Who would have ever thunk-it a few short years ago?

Product track and trace

This has always been an interest to the suppliers and their marketing people.
The fact that it currently happens crudely and imperfectly is about to be impacted enormously by the use of the Internet. The drive for this to happen will be compelling.

And this is a coming fact, not a fuzzy opinion. As such, this will inevitably change the fundamentals of product identification and your day to day handling of products.
Bye bye PDE numbers, hullo EAN numbers.

Nothing surer than night follows day. This will be the early step 101-compliance requirement.
Are you ready?

But there is more folks.
The evolution of MediConnect and HealthConnect will reinforce the formal demand for the use of a unique identifier for each and every product dispensed to a patient.
Otherwise how can there possibly be a national online EHR system?

In the context of adopting change, adapting to change and benefiting from change you could ask - 'who uses a EAN numbering regime exclusively today?'
You, your wholesaler and the enabler of your PC dispensing system?
No?
Does a competitive force reliably maintain and use EAN numbers?
Hmm?

Surely this is clearly a problem that has to be faced and fixed. Regardless of whether you are an independent, a banner team member or work in a hospital. As I have stated in these electron-pages before, if the present leadership stays appalling complacent on this single product ID item then it will soon be time to panic. Or revolt. Or perhaps just lay back and accept what happens.

Profits

Ah, the certain attention getter.

But get this.
Your profits will be increasingly influenced by how you use the POS/PC as they electronically record and transacted income along with online claims for incoming payments for fees and such.

As well, the outgoing payments, the banking and other transactions will be electronically processed over the Internet.

Patient records and privacy

For the first time ever, EHR is now an established policy of the governing class.
No longer a gleam in the eye of departmental boffins.
Sooner or later it will happen.
Bit by bit, place by place the journey of a million steps will gradually become the norm.

Online and/or using smartcards the electronic patient history (EHR) application is going to be a reality. Whatever we are told about the 'public interest' the longer-term certainty is that taxes will stay and personal e.health records will be established.
After all, they are part of the same equation - the benefit and cost of healthcare that can be better delivered and contained by electronic means.

Place

Sadly, or realistically depending on your point of view, this is the current impediment to massive and immediate, relatively speaking, change.

Willoughby has the infrastructure in place - Warialda does not. We face a situation of two classes of citizens or should we say taxpayers.
Those that can and those that can't be hooked up, to exchange data at warp speed.

Politics

One "P' step before the feel-good but rather useless emotion of passion.
And, is closely connected to the Place issue.

The important issue is that politicians have control over the wherewithal to universally implement broadband, or something similar, for all.
Until they do everything else is impeded to some or greater extent.
Unfortunately, too many in this club think 'doing-it' is a town in Vietnam.

This is simply a need for political leadership, maturity of actions and responsible funding.
Rare treasures indeed.

The USA, UK and notably the Canadian governments are showing more than a glimmer of hope and example.
The USA is forming cross-sector healthcare leadership grouping of health partners to implement common standards and broadband communications infrastructure.

In the UK the government has opened the purse strings in a spectacular fashion to re-engineer their health sector ICT capability.
The size of the commitment is attracting wide and ever curious attention.

Finally the Canadians have seen the benefit of growing up.
Putting immature boy 'n girl stuff behind them and act as real adults.
Using the overblown but under-used 'collaboration' word they have put aside their fiefdoms, tribalism and proprietary structures.
Thereby changing the nature of data exchange into a common ability to share information.
Radical and dangerous to be sure - no one ever got anywhere by sharing eh?

Passion

And then we have the passion. Save it for your personal relationships, your footy team or your political bents. Any effort spent on the luxury of passionate arguments, letters, meetings and posturing should be (better) spent on benchmarking your beliefs, aspirations, capabilities, weaknesses and the happiness to get out of bed and go to work, against the list of the mighty 'Ps'.

To do otherwise is more or less doing another thing that starts with 'p' and do it into a strong wind.

None of the scenario I am painting is one gigantic, crushing or horrifying, tragedy.
No Sir and no Mam it is nothing of the sort.
Rather, you should see it as the need to take one small step at a time.
Look, recognise, measure, act or ignore and move on.
All the while moving the day-to-day mindset from that of manual transactions to that of achieving full online relationships.

One way to get the mind in tune is to consider the fax to be an old friend that today is as useful as a boat anchor in the desert.
Start with that premise and it is all down hill from there.

Once you have this underway perhaps you can then throw in a bit of passion - just for fun.