Disruptive technologies in pharmacy, reality or myth?

There was an interesting thread in one of the ASHP practice forums recently. Someone asked whether or not pharmacists were “ready for the future that the opportunities these disruptive technologies offer”. This in reference to technologies that they saw in the exhibit hall at ASHP Midyear.

The simple answer is no. Pharmacists are barely ready for technology that’s 20 years old, much less anything that is disruptive. In support of my quick answer, I give you a brief conversation I had with one of the most progressive pharmacy operations people I’ve ever known (paraphrased, of course):

  • Me: “See anything cool in the exhibit hall?”
  • Them: “Yeah, a change in software that will allow me to capture more 340B costs in the OR.”
  • Me: “Really? What about Kiro, IntelliGuard, and PharmID?”
  • Them: “That stuff? I don’t care about that stuff. It’s meaningless to me because it doesn’t help me. Not to mention that my organization will never go for it.”

The ASHP forum thread produced some interesting responses. One pharmacist pointed out that healthcare disruption will come from outside of healthcare. I agree with that opinion 100%. However, someone responded that they didn’t think this was “… a foregone conclusion” because they think that “…in the short to medium term, in order to actually make meaningful improvements in outcomes, healthcare needs to be disrupted from within”. I almost snorted coffee out of my nose when I read that. It was that funny.

I’ve been a pharmacist for more that 20 years. In that time, pharmacy hasn’t disrupted anything. Nothing. Nada. Pharmacy departments are so busy keeping up with regulatory requirements and chasing elusive “clinical activities” that they don’t have time to innovate and disrupt.

I went back through some of my posts from the past few years. Here’s what I found:

03/02/15: 5 years later, my thoughts on pharmacy practice
“Pharmacy is the same as it was when I left. It’s the same chaotic, messy thing that it’s always been…. Five years out of the game and I don’t feel like I’ve missed much.”

06/04/15: Pharmacy – entrenched in outdated dogma
“…you should be using the most complete solution possible in the i.v. room, and you need to get over the idea that a PharmD is required for a “final check”.”

09/20/15: Will healthcare disruption come easy and fast?
“There are many things being developed to improve healthcare, but the innovation is coming from outside sources. People are literally leaving healthcare to innovate things for healthcare.”

01/08/16: Is nearly universal prospective order review (NUPOR) really necessary? — “… NUPOR is … expensive, time-consuming, and unnecessary … NUPOR is an antiquated practice that needs to be done away with.”

11/10/16: Someone please disrupt controlled substance storage technologies — “Management of controlled substances inside acute care pharmacies is a mess… Based on my observations, the technology is outdated, difficult to use, and has failed to improve the process in any appreciable way. It remains unclear to me what advantage these systems offer.”

04/20/17: A cautionary tale for healthcare. A lesson for pharmacy.
“The pharmacy practice I returned to … appears to have been frozen in time.”

09/21/17: It’s time to disrupt pharmacist order verification   —
“It’s an antiquated process that’s long overdue for an overhaul. The time has come for healthcare systems to make better use of their personnel.”

And that’s just flipping through my posts from the past few years. I can’t imagine what I’d find if I went all the way back to the birth of this weblog in 2009.

I used to think about disrupting healthcare all the time. I recorded my ideas in notebooks and spent years pitching my ideas to companies in the hopes of building a new and exciting pharmacy practice. But it went nowhere, and became nothing more than an exercise in futility.(1)

Is there a healthcare company out there that will disrupt pharmacy? Not likely. As a really smart lady once told me, no one wants to be in this space because it’s hard and you can’t make any money. What about companies from the outside? Also not likely for the same reason.

If it sounds like I’m bitter about all this, it’s because I am. Pharmacy practice could be so much more if we’d just crawl out of our holes and do something different from time to time.

Here’s the bottom line, pharmacy needs to be disrupted — desperately. However, it’s not going to happen. The best we can hope for are iteratvie changes, at best.

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(1) I’ve actually had a few ideas turn into real products. Nothing earth shattering, but cool nonetheless.






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