Digital Health

A Digital Pharmacy Revolution.

Times are changing. Efficiencies brought by digitisation of healthcare will have repercussions we can only partly imagine. Much like the candlestick maker prognosticating their future job prospects in the 1900s the community pharmacy industry is doing the same in 2018. Someone once told me that “pharmacy ended the day the pill was invented“, quite right, there is little to no added value in ordering a pharmaceutical from a wholesaler, putting a label on the product and just handing it to the patient. Robots are far more efficient and accurate at this.

The process is already fully automated however the majority of the 14,000 pharmacies in the UK are tentative with their approach to updating their workflow. A simplified process string of running a pharmacy business is as follows:

The pharmacy as an entity which provides work for the public must complete this chain for every prescription so that the government funds them properly. Since the establishment of the pill this has mainly been done by a human:

  1. Ensure compliance with GPhC and NHS – every pharmacy on average has 10+ arch lever files full of hardcopy documentation about running their business. Each arch lever contains 400 sheets of paper multiply this by 10, the pharmacist has 4,000 A4 pages of text, the average human can read one A4 in 2 minutes, so it would take 133 hours or around 2 weeks or work time to read the whole thing.
  2. Order the lowest cost generic – the pharmacist would look at multiple wholesaler prices, much like a stockbroker and then buy at the lowest price and sell to the NHS for the Drug Tariff fixed price. Price lists can vary widely, so the pharmacist will look online, in printed media and call on the phone to negotiate.
  3. Store the product – the stock comes in from the wholesaler. A human must be employed to ensure that the correct product has been sent and then put the box in the appropriate storage.
  4. Label and dispense the product – a human must take the correct quantity of medicine, enter the patient details on the PMR and label the box. The product is then given to a pharmacist who is expected to check every item with 100% accuracy.
Pharmacy SOPs Digital Healthcare
Your average Standard Operating Procedure is a Comunity pharmacy with 3 or more branches.

A digital pharmacy reduces the above workload to less than a third:

  1. Ensure compliance with GPhC and NHS – the hubnet.io stores everything in the cloud and gets all staff to sign the required documentation.
  2. Order the lowest cost generic – using a buying program such as PharmAssist or AviBuyer.
  3. Store, label and dispense the product – use a robot.

It is commonly stated that 8–12% of patients—or ~1 in 10 patients—admitted to a large acute-care hospital in the UK experience an AE from medical treatment; a third of them usually leads to moderate or severe disability or death [1,2].

References

[1] Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ 2001;322:517–9. Erratum in: BMJ 2001; 322: 1395.

[2] Graber ML. The incidence of diagnostic error in medicine. BMJ Qual Saf 2013;22:ii21–7