A couple of weeks ago I spent the morning with a friend of mine. He also happens to be a pharmacist and the director of a pharmacy IT group for a medium-sized healthcare system. As one might imagine we have similar interests, which means we spend most of our time together talking about pharmacy; where we’ve been, where we’re going, how to make it better, and so on. We both think that pharmacy is moving at a glacial pace when it comes to making important changes and any real change will likely occur long after we’re both retired.
One thing that occurred to us during the conversation was that we always seem to ask the same questions, which always results in the same answers.
- How do make a process faster [to free up pharmacist’s time]?
- How do we make a process more efficient [to free up pharmacist’s time]?
- How do we make a process better [to free up pharmacist’s time]?
As we sat around talking through these questions for the umpteenth time he said something that I thought was very telling. He said that “no one in pharmacy has any vision”. He’s right. Lots of people talk about being innovative, but no one talks about having vision. True innovation is rare, extremely rare. People toss the word around all the time, but most of the “innovation” I see is little more than an incremental improvement on something that already existed. Basically the changes come from answers to the questions above. Vision allows you to see into the future and begin pulling pieces of the puzzle together in a way that will allow you to get there. People with vision are rare. I’ve only met a couple of pharmacy visionaries during my entire career of 15 years.
So what questions should we be asking? Well sit back and I’ll tell you.
- Question 1: Why do we do things this way? – I bet the answers to this question will surprise people. Most processes in pharmacies are rooted in ancient dogma or regularly CYA. I’ve asked this question many, many times during my career, and the most common response is “I’m not sure, we’ve always done it that way.” That’s a terrible answer! Anyone giving that answer should be placed in the corner and forced to wear a pharmacy dunce cap, or a T-shirt that says â€œDonâ€™t ask me, I have no idea. I just work hereâ€
- Question 2: What should this process look like to keep us out of the loop? – Something truly innovative will ultimately take you, the human, out of the equation. Example: BCMA requires pharmacy personnel to scan medications before reaching the floor where nurses scan the medication prior to giving it to the patient. Makes sense to me for several reasons, but ultimately a drug may be scanned two or three times before reaching a patient. In an ideal situation you would never scan a medication because some system would know what you have in your hand during both the dispensing and administration phase. Only incorrect attempts would be acknowledged. Scanning 100 items 300 times looking for a single error is silly, but that’s how we’ve developed the system. Crud, I think an IV hood should analyze everything you do inside the sterile area and let you know when you’ve done something wrong. Look at all the work being done to make the IV room safer. Theyâ€™re all wrong. Here’s another thought for you: how many humans do you think touch and/or move a drug before it ultimately reaches the patient? Three? Four? Five? Again, that’s just silly.
- Question 3: How do we get there? – Â We’ll have to work backward toward a solution that will ultimately change how we do things. Moving forward with the same process only improves the process, and the process you’re working so diligently to improve may be the wrong one. Chew on that.
Many times I’ve heard people tell me something “will never work” for one reason or another. I hate it when people say that. Reinventing the wheel over and over again does nothing more than give you a better wheel. I want my own personalized transporter sitting in my garage. Star Trek had the right idea, and they thought of the idea in 1966. Pharmacy has yet to have that revolutionary vision we so desperately need, and until we have it we’re stuck in neutral. Just sayin’.