In AnalysisIt’s time to delve deeper into health discussions. Broaden your understanding of a range of pharmacy news and topics through in-depth analysis and insight.
It is 18 years since the first electronic prescription was received by the Co-op pharmacy on Scott Street in Keighley, West Yorkshire.
It was hoped this would herald a new era of seamless digital patient care but, to date, progress has been disappointing.
This is particularly true when it comes to community pharmacy’s IT connectivity and support. Without the digital tools and connections to enable clinical services from pharmacies to enhance patient care, progress
will remain slow or even non-existent.
So what are software and PMR suppliers doing to help create the right environment for this change to happen? And with so many interested parties, who are they talking to in order to move things on?
Dialogue and discussions
The main players in the pharmacy tech space say they are communicating widely across the piece. Clanwilliam Health managing director Eileen Byrne says the company regularly feeds back to the various bodies that represent pharmacy – such as PSNC and AIMp. “We also have ongoing dialogue and regular calls with the IT and clinical people in NHS England, Scotland and Wales, to understand and implement any mandated changes,” she says.
Sandra Carnall, group sales and marketing director at Cegedim Healthcare Solutions, says her company is “engaged in continuous discussions with bodies such as NHS England, the National Safeguarding Service and NHS Wales, the Community Pharmacy IT Group, and others, and is very much focused on putting data, digital and technology at the heart of the healthcare sector.”
Communication with the NHS is happening “very regularly, on a weekly and, in some areas of the business, daily basis” – but access to ministers is “more rarefied, as you might imagine”, says Steve Russell, chief commercial officer at Positive Solutions.
For his part, Russell believes “the NHS is acutely aware of the gaps preventing a joined- up interoperable technology ecosystem in our industry and how a lack of pharmacist read-write access [to clinical records], poor integration with shared care records and the absence of a national standard all contribute to dampen the ability of technology providers to deliver the real potential that exists”. But, he admits, “it is one thing being aware of the issues, quite another for the NHS to have the capability to change them”.
The Government needs to adequately recompense pharmacy contractors for delivering services
Talk to the people at the top
“Talking to NHS officials or even civil servants is futile; the decisions need to be made at the top,” claims Tariq Muhammad – former community pharmacist turned technology entrepreneur and the person behind Invatech Health’s Titan PMR system and Titan.X pharmacy AI.
“For years, the sector has been asking for things like read-write access to the SCR and even integration with the NHS app [but] these are actually not the pressing issues. If anything, they are symptoms of an underlying problem, which is that the pharmacy sector simply is not valued or perceived in the same way as doctors or nurses by those in power.”
Until there is a real shift in these perceptions and “true recognition beyond lip service” of what community pharmacists can offer, “we are wasting our energy on campaigning for these basic things”, says Muhammad.
So if the technology suppliers and software providers are struggling to be heard, who else should be leading these discussions?
Santosh Sahu is the founder and chief executive of Charac, an online platform that enables patients to order repeat prescriptions and book consultations and services. He says being a pharmatech platform developer gives him “first-hand insight into the needs of community pharmacies and how they can best be aided”, but that future policy development has to be “a collaboration between pharmacists, NHS decision-makers, entrepreneurs and Government ministers – and it is vital that we can develop and action solutions together”.
Steve Russell is also a proponent of collaboration between users and providers, stressing that without the “anchor point of sector input” there is a danger that technology suppliers build things because they can, rather than because they should.
IT developers have a duty to really understand the needs and challenges of their users, he says, and to “build technology that focuses exclusively on solving those problems, delivering tangible benefits and ultimately, in community pharmacy, better patient outcomes and experience”.
Russell cites pharmacy clinical services as a great example of where technology can have “tremendous positive impact both for the healthcare professional and the patient”.
Tariq Muhammad would like to see an extra pair of hands at the table. He believes his role as an industry leader in tech is to “develop the tools and innovations the sector needs in readiness to support pharmacists as and when the opportunities arise”.
The role of pharmacists, he says, is to “deliver the best services they can to patients, take on the challenges and set an example”. But it is “the responsibility of the profession’s leadership to set the long-term direction of travel for the sector and ensure its future viability”.
This is clearly the bit that’s not working since pharmacists are working harder, getting paid less and are more disillusioned than ever before, he says. “I believe the leadership in our professional bodies need to rethink their approach and do something different to whatever they have been doing for the last 15 years.”
Interoperability is another common theme. Sandra Carnall says “national bodies and suppliers need to work to agreed shared standards putting interoperability at the core”. Eileen Byrne agrees that interoperability is, and has been for some time, “the key aim and driver for healthcare, so any future policies and technology need to continue to focus on this”.
But could there be a more basic issue that needs addressing first?
There is a lack of confidence in the Government and how they value pharmacy, along with a fear that any efficiencies created today could be taken away in clawbacks and cuts tomorrow
Feeling that existing PMR systems were not meeting his needs, Paul Mayberry – managing director of the Mayberry pharmacy group in Wales – created his own cloud-based PMR system (Pharmacy-X) and pulls no punches when explaining why.
“I always say tech within community pharmacy is really backward and I struggled for a while to understand why things didn’t progress,” he says, “but I think it is because of the complacency of the incumbent PMR suppliers as there is no driving force for them to move forward.
“These PMR systems are basically not fit for purpose and pharmacists know they aren’t great, but if you look at the alternatives and think they are just as bad, you may as well stay with the devil you know.”
This, Mayberry says, results in “a pretty sticky product” with system suppliers seeing “no burn of customers, which makes them think – ‘our product must be great so we don’t need to develop it any further’. No matter how little they innovate or move forward, they pretty much know their customers won’t go anywhere else.
“I was fed up with it and my team were fed up with it. We said, ‘surely there is a better way, so why don’t we build our own system?’ And that is what I did.”
We need a clear view of [the Government's] priorities for healthcare and, more specifically, pharmacy
Future policy development
While not everyone has the capacity to create their own PMR system, the results achieved by those who do are helping incrementally to improve pharmacy technology overall and even influence policy development. “Since we launched Pharmacy-X I’ve had lots of conversations with the Welsh Government about how things can be more efficient in Wales so we can deliver on what ministers want,” says Mayberry.
Having spent 30 years working in technology in other industries, Steve Russell admits he found it “something of a shock” to discover just how far behind technology in pharmacy is compared to other sectors – “10 years at least” in his opinion – but says there are disruptive tech exemplars that policymakers should be taking note of.
“Having seen the transformative impact of open banking in the financial services market, imagine what a single view across all healthcare settings could do for patient experience and outcomes? This will remain out of reach, however, without both the NHS and central Government committing to make it happen. At the heart of what is needed is an investment in technology.”
His hope, he says, is that pharmacy technology becomes “more professionalised and truly recognised for its critical importance in delivering healthcare strategy at a government policy and practice level, and much less of an afterthought as it sometimes appears to those of us at the sharp end.”