Tech update: Focus on pharmacy technology
After reading this update feature you should be able to:
- Highlight the latest thinking on the use of information technology in the NHS
- Recognise the role technology can play in easing pressures on pharmacy teams
- Identify the recent key developments in pharmacy IT systems.
The Health and Social Care Committee in the House of Commons is currently running an inquiry regarding digital transformation in the NHS. MPs want to explore the current use of digital technology and scope out changes that could improve service delivery and patient outcomes.
As well as considering legacy IT systems used within the NHS, proposed changes include digitising health and care records, and enabling records access across primary, secondary and social care. The Community Pharmacy IT Group (CP ITG), of which PSNC is a member, has submitted a formal response to the inquiry arguing that:
- Pharmacy teams should have access to up-to-date records information (e.g. from Shared Care Records (ShCR), GP Connect and Summary Care Records (SCR) with additional information)
- The Booking and Referral Standards (BaRS) should be extended so that future referrals into and from pharmacy can be communicated seamlessly
- The Community Pharmacy Data Standard should be expanded to enable services information to be recorded efficiently
- IT standards are needed so that suppliers can enable automatic reporting to the NHS Business Services Authority
- The EPS Next Generation project should be further developed
- A framework for the development of pharmacy IT should be developed to ensure systems suppliers are better able to support pharmacy teams and their delivery of services.
Suppliers on board
Fortunately, there are plenty of pharmacy IT suppliers developing and refining their offering to do just that.
“Pharmacists need technology that works in the way they need it to work, but this is almost impossible using old technology that is clunky and labour intensive,” says Tracey Robertson, product and technology director at Cegedim Healthcare Solutions.
“Integration of systems and data is also key to really enable pharmacies to be the gateway to population health,” she adds, “so there needs to be more real-time, one-click access to key NHS and shared healthcare services. The technology must play a key role in automating processes and enabling innovation to drive improved patient outcomes whilst improving customer service through providing new levels of business visibility and understanding.”
Louise Laban, sales and marketing director at Centred Solutions, pinpoints a “growing trend” of pharmacies turning to technology that automates pharmacy workflow, freeing up time for patient-facing services. This, she says, falls into four key areas:
- Automation for storage and retrieval of original packs (robotic dispensing systems)
- Automation for MDS assembly
- Automation for patient prescription pick-up points or kiosks
- Automation and software for repeat prescription dispensing – also known as hub and spoke dispensing.
“Solutions exist that allow pharmacies to automate or semi-automate from as little as 10,000 items per month and begin to see real value,” says Laban, “so they can start small and grow their business before taking the next step on their automation journey.”
Cegedim recently launched its Hub Fulfilment Manager hub and spoke platform to enable pharmacies of all sizes to explore the benefits of remote dispensing. Tracey Robertson says pilot customers have seen “impressive results, with critical staff time already being saved across their stores as prescriptions are now assembled off-site”.
For pharmacies not yet at the hub and spoke stage, improving dispensing flow by driving efficiency is important. Daniel Lee, HubRx founder, name-checks the “new functionality launched to the market from RxWeb including one-click dispensing, trusted dosages and bag tracker”, as well as “companies focused on increasing accessibility to pharmacists for patient ordering and/or appointments including Charac, HAShealth and Healthera”.
“Jelly Software seems to be the go-to clinical system for independent prescribers and is linked to the medical history to allow for centralised IP prescribing as recently announced by Alitam – although Clanwilliam has the iMedDoc platform,” he adds, “and, as ever, the more this can be done interoperably via one clinical system to support pharmacy user experience, the better.”
There are other ways that pharmacies can improve efficiency without dramatic changes to the business model or emptying the bank account, according to Steve Russell of Positive Solutions.
“Examples include innovative uses of hand-held technology to automate and drive efficiency such as our Analyst QuickPick and Analyst Handout apps which, given their scalability, are popular among pharmacies of all sizes,” he says. “Alternatively, the Analyst Central Fill (ACF) solution is a cost-effective way to implement hub and spoke for pharmacy groups.”
With regards to services, Russell says the key is to use technology to develop a patient relationship management system. “Pharmacy needs to connect with its community if it is to compete with internet providers. Engaging patients through sophisticated and feature-rich apps is how technology can help pharmacists retain the patients they have and attract new ones.”
Latest IT solutions
The recent Pharmacy Show saw a host of technology innovations, with Positive Solutions launching its MyHealthHub integrated technology platform in strategic partnership with Charac’s patient app.
With the use of pharmacy robots increasing, Tariq Muhammad, chief executive of Invatech Health, says his customers are seeking integration with more systems. “Over the last year, Titan has developed novel solutions with many machines that do more than just send a one-way message
to tick a box,” he says.
“For example, with the prescription collection machines, we have created two-way integrations, which means Titan not only sends a message when dispensing is complete, but the robot also tells Titan when it has been collected so the claim can be submitted.
“Likewise, our integrations with picking robots and MDS help create a solution that makes the dispensing experience feel more seamless and streamlined. We have also created similar two-way integrations with delivery apps that help pharmacists improve the efficiency of deliveries.”
As well as increasing take-up of Invatech’s Titan.X AI driven clinical checking system, which launched last year, Tariq Muhammad says he has also seen a demand in streamlining prescription ordering processes for patients. “While there are more apps now available for patients to order medication, pharmacists have been demanding better solutions to help manage repeats,” he says, “and for this reason we launched Titan Repeat Flow at the Pharmacy Show.”
Tracey Robertson says Cegedim’s approach to product development is to constantly redesign and rebuild its technology as pharmacies evolve, evidenced by the launch of four new products, all of which integrate into its core Pharmacy Manager solution. “We have made a number of improvements that address key industry pain points, such as financial forecasting of reimbursements, and stock inventory challenges relating to the ordering and visibility of stock,” she says.
“For example, our new Pharmacy Manager PMR solution offers a flexible approach to dispensing that allows users to perform key parts of the dispensing process in a way that works for them, depending on a whole host of factors such as SOPs, workload, stock management pressures and even seasonal changes.”
Cegedim’s Pharmacy Services Platform, available on any device, has been designed to eliminate manual tasks and the re-keying of data through intelligent automation and critical integrations directly into the core PMR and key NHS systems. The Pharmacy Intelligence Hub Management and Reporting Platform digitally connects a pharmacy head office to its network of individual stores.
Strategic partnership announced
Positive Solutions and Charac have joined forces to help transform patient engagement, says Steve Russell, chief commercial officer at Positive Solutions.
“This is an exciting time to be working alongside Charac to guide community pharmacies through the significant challenges they are facing,” he says. “The strength of our relationship is founded on our common desire to develop a true patient relationship management platform and our vision for how technology can bring [the] community and pharmacy closer together.”
“Positive Solutions customers can expect an outstanding product which provides support on patient prescriptions and appointment booking while also offering a range of marketing packages to drive services business, as well as our Royal Mail delivery option to save money and improve patient experience,” says Santosh Sahu, founder of Charac.
Digital health innovations
While digital innovations are working well in healthcare environments that can afford to implement them, these benefits don’t always translate into the patient-user experience of digital health – something community pharmacies can help with.
In its recent report (‘How lessons learned during the Covid-19 pandemic can help to support better integration in NHS primary care’), the Pharmacists’ Defence Association (PDA), points out that many patients are still not digitally enabled, potentially leading to inequality.
“With appropriate funding and premises” pharmacies could “support digital inclusion by providing access to communications devices and the internet, enabling patients to engage with other parts of the NHS in a virtual way and improve health literacy,” says the PDA.
In its recommendations the PDA proposes that the community pharmacy “becomes a link to the wider NHS virtual system (be it the GP, community nurse, hospital or other yet to be established virtual arms of the NHS), providing the hands-on support and the leadership needed to show members of the public how to navigate these new virtual services” as well as “the personnel to act as the patient’s champion in supporting and facilitating their efforts to engage with the new NHS technology-led revolution”.
“I believe we will see pharmacy embrace technology more and more as they continue to be asked to do more for less,” says Louise Laban of Centred Solutions. “There is the shift from traditional dispensing models to delivering care services. Then there are the workforce challenges currently impacting community pharmacies across the country including flat rate funding and issues with resourcing. The pressures on staff recruitment and retention means pharmacists’ time is even more valuable than ever before.”
Finding what suits you
With change always on the horizon, it can be difficult to stay up-to-date and make the right decisions about investing in technology.
The Community Pharmacy IT Group keeps an updated pharmacy system ‘wish list’ and briefing, setting out commonly requested features in pharmacy IT. It recommends pharmacy contractors and their teams firstly make best use of their existing systems by:
- Learning about and using settings and customisation options that could assist their pharmacy workflows
- Asking questions about system functionality and providing feedback to suppliers, as this helps to shape plans for the development of their system
- Making best use of system training opportunities to become familiar with the software and optimise use and benefits obtained from it.
For contractors looking to further invest, Louise Laban suggests looking at the areas of the business that are absorbing most time and exploring if there are ways to make this more efficient with technology. However, she warns, “while investing in technology can be hugely cost-effective, saving time, money and driving new revenue streams, it should not be done without a robust business case, a thorough assessment of what is available and without being able to deliver a strong return on investment”.
As an example of this, each pharmacy needs to keep an open mind when it comes to hub and spoke, she says. “It doesn’t mean having to pay prescription assembly services leading to an erosion of profit that cannot be recouped by any amount of patient-facing services. Explore your options now and get ahead of the game so you can drive the change you want to see in your market.”
“Before you go down the route of hub and spoke, do your homework to see if it really is going to give you any efficiencies at all,” says Paul Mayberry, managing director of Mayberry Pharmacy. “Ask yourself – what do you want out of it? How can you do more for less money and offer services?
“Hub and spoke is not the efficiency answer for most people, so look at your dispensary processes first to see how you can make those more efficient, especially to free up pharmacists to deliver more of the services, and look at robots and PMR systems with the same critical eye.”
“While no one wants to disrupt the dispensing process or risk upsetting patients, to ensure long-term profitability and success it is essential that community pharmacy takes a strategic, holistic view of the entire business – not just the dispensing process,” advises Tracey Robertson.
Tariq Muhammad agrees. “The challenge for pharmacists is to pick the right solution that suits their present and future business needs and, while technology should be seen as an investment, the decision should be based on many factors. For those pharmacists who make the right choices, invest time and deliver leadership, the future of pharmacy is bright indeed.”