Technology is opening the path for pharmacists to leverage their regular direct contact with consumers, and become an even more valuable partner for patients, physicians, and pharmaceutical companies alike.
Whether you open your iPad’s Flipboard or a copy of the New York Times, you can’t help but read a growing stream of articles about how the worlds of patient and physician are changing as a result of a new gadget and/or cloud technology offering.
But opportunities can sometimes be found in overlooked places. Historically, pharma companies have considered the pharmacist as a healthcare “bystander” and focused their dialogs about their medications on physicians and patients. But new technology now allows pharmacists to serve their patients as much more active navigators of their options in prescription medication, as well as over the counter (OTC) products, vitamins, and other health items purchased at pharmacies. Technology innovation done right can help the technology-augmented pharmacist to be a more valuable partner to patients—and that should give pharma companies incentive to stop and consider how they can be of more value to pharmacists.
THE CHANGING WORLD OF THE PHARMACIST
Pharmacies are experimenting with new, more influential roles for the pharmacist. In 2011 Walgreens started testing its new Healthguide store concept in a number of locations. The pharmacist offers new technology–enabled services that interface with the patient’s iPad or iPhone to coach patients into taking medication properly and to encourage health-promoting behavior beyond “just taking pills.” A Developer Challenge winner, mHealth Coach, has been working with Walgreens to successfully embed a virtual nurse into this care-delivery platform. Getting a virtual nurse’s help with (for example) medication adherence issues appears to be quite effective. It can also make provider-patient interactions more data driven and rich in the long term. This approach has been successful for Walgreens, and CVS has since launched a similar model in three of its locations.
Retail healthcare services are diversifying. Pharmacists may also expand their role by offering patients more advice and additional health services. Competition in providing health services (such as those offered by retail clinics) has been increasing despite the recession. Use of retail clinics among patients with insurance rose tenfold from 2007 to 2009; it now represents 7% of all medical visits for 11 common acute conditions. In this competition, pharmacists have a major advantage: data about patients’ medications.
The force is strong with Walmart. The trade press has covered Walmart’s attempts to leverage its footprint to create a health services behemoth, but the initiative has received little outside attention. This push could be a bane or boon to pharmacists. Walmart has already had success creating new types of care-delivery networks. The company has recently said it is working on preferred-network models with more than 350 employers and with 20 pharmacy benefit managers (PBMs), generating cost savings ranging from 13% to as high as 40%. The retailing giant has asked companies to fundamentally rethink how to deliver care with the requirement to cut down costs per patient intervention by 20% or more.
Doctors as quarterbacks. If the pharmacists have an opportunity to take on a bigger role in patients’ care and lifestyle, the strong growth of concierge-medicine-for-the-masses could threaten that opportunity. In this care model, the pharmacist plays virtually no role; the physician becomes the quarterback, calling the patient’s play. Expect technology to drive costs down further, and expect more concierge medicine to hit the market in the next year or two.
WHAT TECHNOLOGY WILL BRING NEXT
Technology can be the pharmacist’s ally, changing the pharmacist from someone who “dispenses what the physician ordered” to a health coach. What Walgreens and CVS are doing fits this description, but there is much more possible.
We’re seeing new kinds of technological innovation, tools that offer opportunities for more patient engagement, better medication adherence, better use of data, and more.
There are platforms (e.g., MirixaPro, which claims a network of 40,000 contracted pharmacies)— designed “by pharmacists for pharmacists”— that identify patients and facilitate pharmacist coaching, from appointment scheduling to billing and payment.
Other tools (like those from Jiffpad) target pharmacists, physicians, and other medical professionals to improve patient communications. Many patients have trouble understanding or recalling important details of a doctor visit, such as diagnosis and treatments. These patient-education utilities try to do for medical education what the iPad did for the detail call: reinvigorate interest via a sleek and intuitive user experience.
Other applications give consumers information about the medications they take. Treato.com for example, can aggregate hundreds of millions of patient experiences, analyze them, and compare them against medication databases. Tools like this can translate an amorphous laundry list of hard-to-comprehend side effects on a drug label into information that is easier for patients to understand. Patients starting a new medication can see the benefits that other patients experience from the same medication.
It is clear that Big Data in health can have a major impact on patients’ everyday medication and lifestyle choices. Intelligently bolting a friendly interface (a virtual nurse or pharmacist assistant) onto an artificial intelligence system (fueled with high-quality data that accounts for both lifestyle and medication choices) can be another way to augment the pharmacists’ value.
Kaiser Permanente has been experimenting with dynamic avatars (computer stand-ins who gain weight when you do, or shape up when you make better choices). Venture capitalists have started talking about intelligent agents (some have even discussed replacing doctors with algorithms). And I have heard Apple’s intelligent assistant, Siri, mentioned in more than one conversation about the future of health.
When HP acquired Autonomy, the search company’s CEO said that the (non-health) tech sector had been good at dealing with structured data—but structured data represented 15% of all data that this sector should be analyzing. When it comes to health, it is doubtful that we have reached that 15% level yet. And while technology may ultimately close this data gap, pharmacists can contribute now to bridging the chasm between the data we need as patients and the data that is available and interpretable. The augmented pharmacist combines independence with knowledge in a way that is unique…for now. Siri’s siblings, brothers and sisters armed with medical degrees, are certain to come to our world, but not for a while.
The augmented pharmacist can become a valuable resource to patients. By providing insightful new tools, pharmacists can transform themselves into guides who help patients navigate the complexities and challenges of medication-related choices. And just as pharmacists can use technology to become more of a partner in their patients’ lives, pharma companies can bring the right technology to pharmacists in scalable, flexible, and easy-to-use ways.
Physicians and healthcare organizations have systematically reduced their interactions with pharma sales reps, while pharmacists have been virtually ignored. As models like those being tested by Walgreens and CVS continue to succeed and grow, the technology-empowered pharmacist clearly deserves more attention as a potential pharmaceutical-industry partner.
Pharmacists are compensated differently and motivated differently. Technology is opening the path for newer, smarter approaches than sales representatives have traditionally used to reach physicians. Technological innovation—done right—can help the technology-augmented pharmacist be a more valuable partner to patients—and an important audience for pharma companies. We have covered a virtual Florence Nightingale, a Genius Bar for health, and Siri’s future, but there is a lot more that pharmacists can do to become the patient’s coach, and in a way that a physician cannot. What is next in your dialog with your augmented pharmacists?