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Mar 9, 2015

We welcome back returning Pharmacy Podcast guest - Dr. Erin Albert, PharmD, JD, MBA. Erin is an entrepreneur, writer, pharmacist, attorney, and associate professor. She is the founder of two companies (Pharm, LLC and Yuspie, LLC), and currently is the Director of Continuing Education, and Director of the Ribordy Center for Community Practice Pharmacy at Butler University College of Pharmacy and Health Sciences. 

Seven Major Trends coming and already here in Pharmacy Practice:

I. Pharmacy in a box. (AKA Vending Machines)

There are going to be more and more pharmacy vending machines coming up.  I’ll tell you why I don’t like them.  In the evenings when I was at law school over 4 years and starving, the only cafeteria options we had at 8 pm at night were the vending machines.  I fed a lot of money into those vending machines.  Sometimes, the food would get stuck inside the vending machine, and I couldn’t get it out.  Now, getting between me and my Snickers bar when I’m hangry, granted, isn’t a pretty scene.  Imagine what the sick, tired and angry patient will be experiencing when the prescription doesn’t come out of the vending machine?  Who’s going to be there to fix it?

Vending machine pharmacies US: http://www.statepress.com/2014/11/19/vending-machine-replaces-asu-on-campus-pharmacy/

Vending machine pharmacies OUS: http://www.pharmaceutical-journal.com/news-and-analysis/news/trial-of-prescription-vending-machines-begins/11019857.article

Skills needed for the pharmacist:  Pharmacists are definitely going to need to get tech-y here if they want to dominate in this area.

II. Your house is watching your health

…is going to not only rule our homes, but it will integrate with our health. This is already happening. 

a. It’s in iOS 8. HealthKit and HomeKit are already in your iPhones.  You’ll be able to keep everything on your phones and run your life via this tech.  I’m just in hopes that Apple’s HomeKit has smart tech integrated into the refrigerators and medicine cabinets to simply send off the alert to you and/or your pharmacy when you need a refill on something (and not just Rx, but OTC stuff too).

b. other smart tech for homes monitoring Alzheimer’s patients: http://www.cnn.com/2014/08/25/tech/innovation/alzheimers-smart-home/

Skills needed for the pharmacist: Tech. Again. And make sure that the pharmacy world is talking to the developers.  And vice versa.

III. The drones will drop off your prescription:

I’m actually kind of baffled as to why Jeff Bezos hasn’t gotten into the pharmacy space just yet.  Once he has his drones up and running, it would make a lot of sense to send prescription drugs through the “drone” channel, particularly to the elderly who no longer drive.  Unless, we go Star Trek and someone invents a drug synthesizer, like the food synthesizer on the show.    

Jeff Bezos & the drones: http://www.cbsnews.com/news/amazons-jeff-bezos-looks-to-the-future/

Skills needed for the pharmacist: Unless we’re going to require more physics here, I’m not sure what we can do. Physics wasn’t my strong suit.

IV. Pharmacy as a space will need to be first as a third space to survive:

I’m not sure the idea of “grocery shopping” and “running errands” will exist in the future.  This could free up a lot of our time from stuff we have to do (LIKE run errands) into stuff we WANT to do (like, hang out at cool third spaces other than at home and at work).  Or, maybe because of the internet, we won’t have a work space that much longer, which would free us to work WHERE and WHEN we want.  If that’s the case, third spaces are going to need to get a lot cooler for us to WANT to hang out at them.  I still think a bookstore/pharmacy hangout would be a good combo.  A bank/pharmacy would be a good combo for security’s sake.  But, if the medicine cabinet is ordering your refill, and the drones are dropping it off–WHY would you need to go to a pharmacy anymore?

More on third spaces from our Pharmacy Podcast previously: http://www.slideshare.net/ea6603/community-pharmacy-as-a-third-space-albert

Skills needed for the pharmacist: Pharmacists who understand design, civic and city development, psychology, and what makes people come to third spaces will win here.  Pharmacies that can create one-of-a-kind experiences for their patients will also win here.  (Let’s face it, going to pharmacies right now is an utterly forgettable experience.  But does it have to be?)  I’m also in hopes we have more pharmacist entrepreneurs seizing this opportunity too moving forward.

I also think this third space concept is an opportunity for the pharmacist as teacher and coach.  I see classes and offerings here as a community hub for wellness.  But pharmacists are not only going to have to bring their clinical knowledge here, but also their creativity in bringing in people to listen to their courses on living better lives.  In this busy world, that could be a hard sell in the beginning.

V. Will live healthcare need to be “edutaining”?

This is one area that I think we humans can beat the machines.  We are more creative than they are; hence, I think pharmacists will, as educators, have an amazing opportunity to provide value by not only educating, but entertaining as well.  In an attention deficit world, I’m sorry to say, mortality really isn’t a “hook” anymore.  Learning about your health and wellness needs to be like anything else–fun–otherwise, we’ll all fall asleep from boredom.  I’m not saying this is right, but I am speaking the truth.

Gaming in healthcare: http://www.healthit.gov/sites/default/files/IFTF_SR-1494_Innovations_in_Games.pdf

Skills needed for the pharmacist:  Teaching. In a variety of ways.  One of the areas of teaching in pharmacy I’m most fired up about is writing.  We focus a lot on oral communication, but we don’t do much in the realm of writing.  So, I’ve personally made it my mission to help students stretch their writing talents–like through this creation of BU Well, and for students writing children’s books on healthcare topics.  This year, we have two that students are producing.  One on vaccines The other for 4th graders in Indiana on STEM leaders of Indiana in time for the Indiana Bicentennial in 2016.  I’ve said it here many times, but I will say it again: writers. Are. Leaders. If you are considering pharmacy programs–ask, “What writing communication courses and co-curricular opportunities do you offer?”  I won’t, however, tell you what to do if you see blank stares…

VI. Labs/tests and wellness checks at the pharmacy:

Point of care testing labs.  They are a pain to find, then find the hours of, then schedule to go to when your doc orders labs.  Instead, I think smart pharmacies will start offering lab and tests inside pharmacies on a regular basis, to help patients avoid the headaches of one off lab testing. This could be for Fido too.  Check out Abaxis and their Piccolo machine.

Articles: http://www.ncbi.nlm.nih.gov/pubmed/20441470  and http://www.medscape.com/viewarticle/549259

Skills needed for the pharmacist: Pharmacists need to fully understand labs, lab values, when patients should get labs, and clinical aspects of disease management with labs here.  This is the only instance thus far where I think more clinical wizardry comes into play.

VII. Big Data:

I think in the future, pharmacists will be interacting with a lot of big data to assess and seek trends–in the data for patients, and for populations of patients.  Large self-insured employers already hire one pharmacist to oversee and manage the health of the patient employee population, and manage the drug formulary that an employer offers to its employees.  These days, the drug formulary alone in terms of costs can suck up to 20% of the total healthcare spend for an employer. Keeping a tight reign on this is important.

How Twitter tracks the flu: http://www.nationaljournal.com/health-care/how-twitter-tracks-the-flu-20140318

Big data on public health campaigns: http://www.healthcareitnews.com/news/big-data-offer-new-strategy-public-health-campaigns

Human Nature Lab (Christakis): http://humannaturelab.net/

Skills needed for the pharmacist: Pharmacists here need to understand pharmacoeconomics and analytics here.  They need to be able to see whether or not a drug is worth the spend.  And, in the era of specialty drugs – managing specialty drug spend alone is going to be a huge opportunity to reign in costs.  They also need some acumen around bioinformatics.  Are pharmacy students learning how to manage and run a drug formularly in school?  Are we handing a blob of data over to students who can find trends and suggest better management of patients based upon an analysis of those trends?  Are we teaching students to PREDICT trends in a population?  Predictive modeling: http://en.wikipedia.org/wiki/Predictive_modelling 

http://erinalbert.com/etc.php