Published by Computachem Services

P.O Box 297.
Alstonville. 2477
NSW Australia

Phone:
61 2 66285138

Much has been written about the spectre of machines replacing pharmacists, usually about being located in rural, isolated or remote areas where there is no pharmacy presence.
The reality is that if pharmacists are not prepared to practice in these locations, then an automated dispensing machine is the best alternative. But what about urban areas?
We often read about the unsustainable workload of pharmacists, giving an ever diminished financial return.
What if their labours were replaced by a machine?
Would this allow the time to deliver cognitive services?
Or would doctors see this as an opportunity to have their medical practice assistants develop a new integrated market?

Already we are noticing a variation in the volume and type of questions being generated by patients who have computer literacy, and who are quite comfortable handling e-mail.
Many requests come in after hours, as a result of a website visit, downloading information directly from the site. Others simply generate an e-mail request in the normal way, and receive a reply with some form of e-mail attachment containing the specified information.

Some pharmacists have also begun to use e-mail as a notifying tool, as to when prescriptions fall due for dispensing, and use e-mail to generate a permission to dispense.
If your prescription population is elderly, this service is often appreciated, particularly if it is accompanied with an offer to deliver the finished prescription.
Don't for one minute think that your senior citizens do not have a grasp of Information Technology. Like most people, they will grasp any tool if it gives benefit to their lifestyle.
And the 60 plus age bracket is one of the fastest growing, and highest users of e-mail.
The reason?
Simply to keep in touch with the family.
All around Australia, there are community workshops sponsored by a myriad of organisations, which are delivering Internet skills to senior citizens.
As this group is generally the most medically active group for a pharmacist, why would they not respond to a value-adding prescription service, if it enhanced their lifestyle, by cutting down pharmacy visits for repeat prescriptions?

This is not "rocket science" service, but how many of you have asked your patients if they would like such a service. Are you building up an address book (under existing privacy rules) so that you can offer these Internet services?

The benefits don't just stop with happy patients.
You can use the e-mail notification system as a means of scheduling your dispensing processes, taking pressure off peak dispensing times.
It also gives you a tool, coupled with an efficient delivery system, to reach out past your normal patient catchment.

And don't forget that most doctors have an e-mail system.
Have you notified them of your address and obtained permission to store their addresses in a designated folder in your e-mail address book?

The reason I ask is that if there is already a communication stream between pharmacist and doctor that is timely and efficient, then it means that doctors would be less inclined to set up their own integrated dispensing service within their own practice environment, if the pharmacist can do it better.
If you are holding back on I.T investment in your pharmacy, then when you discover a "leakage" such as described above, it is too late to do anything about it.
Make no mistake, you must become the Health IT Specialist if you are to survive this type of competition

In a GP surgery located in Minneapolis in the US, a machine dubbed "Instymeds" is providing a vending machine dispensing service within the GP precinct. It resembles a giant ATM machine, and is being pilot tested with a range of 80 prescription drugs.
The maufacturer already has a model on the drawing board that will handle 500 prescription drugs, and these machines will eventually be designed to embrace a full local pharmacy inventory.
The system starts with an electronic script being generated by the GP, details of which are sent to the patient's insurance provider (which could be the Health Insurance Commission here in Australia or other private insurer, depending on patient/script type).
The prescription printout is then given to the patient, who is then presented with a card reader to enter data. A patient code is inserted manually by the patient, and a credit card is swiped through the reader.
This latter process activates the Instymed machine to produce a fully dispensed prescription, and the credit card swipe has taken care of the payment.

Curiously, this machine was developed by a doctor (not a pharmacist) called Ken Rosenblum, who was a former emergency department doctor before starting Mendota Healthcare Inc, to manufacture Instymeds.
In addition to providing the machine, Mendota Healthcare handles all prescription claims and operates a 24 hour call centre to handle any prescription rejections.
This removes another time consuming activity, which is a problem both in America and Australia, and represents an opportunity for any aspiring pharmacy service company here in Australia (remember the old National Health manual script claims that were often processed by a similar service provider?).

The other commonality with Australia is that American prescriptions are rising at an annual rate of 15 percent, but the relative supply of pharmacists has remained at a constant level.

Ken Rosenblum admits that while there will be a small percentage of take-up within a GP practice the real market lies with community pharmacies. By generating surplus capacity through automation he is endeavouring to help pharmacists take patient counselling and education to a higher level. He sees his Instymed machine as being a solution to pharmacist shortage and overwork, which has contributed to higher error rates in the existing dispensing process.
Here in Australia, we would see this as an excellent reason for pharmacists to amalgamate, and to share the cost of such a machine, plus provide better pharmacist human resource.

The Minnesota Pharmacy Board has approved the Instymed machine for doctor dispensing and was reportedly very impressed with the bar-code technology that has already demonstrated patient safety. The Pharmacy Board endorsement was based on the fact that it is common practice for a nurse-receptionist to rummage around in a samples cupboard and give the patient an undispensed version of their prescription.
Removing this practice automatically improves patient safety.
However, the Board plans to revisit the machine when it is installed in pharmacies.
Note that Pat Gallagher, one of our writers here in Australia, has been actively involved in developing the EAN product numbering system for the pharmaceutical industry, so we basically have a univefrsal bar-coding system on tap.
All it requires is industry movement and endorsement.

Currently, Mendota are seeking American community pharmacists to set up a trial of the Instymed machine. They can be contacted by e-mail at info@mendotahc.com and although we haven't tested the waters, they may be persuaded to do some of their trials in Australia.

Who will be the first to get their shoes wet?

And if any pharmacy group is seeking a facilitator for such a project, please contact neilj@computachem.com.au

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