Editorial
Welcome to the first homepage edition of i2P for 2012.
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Volume 2012 Number 1
Health Politics
Neil Johnston: Friends of Science in Medicine
James Ellerson: $75.5 million in 5CPA lying idle. Why is it so?EPublications
Remote Dispensing Expands Globally
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PDF version | Peter Sayers |
Peter Sayers is vitally concerned about pharmacy professional practice - its innovation, its research and development, and its delivery to create an ongoing revenue stream. Delivery of healthcare is increasingly involved with Information Technology systems. All perspectives in IT must be considered for the impact on pharmacy practice and its viability. | |
Systems for dispensing prescriptions remotely have been available in Australia for some time, but have yet to gain traction.
These systems are characterised by having a TV link to a “live” pharmacist who is located remotely from the machine.
One of the first remote dispensing machines built using Australian technology and manufacture was ExpressRx.
An almost identical machine (Med Centre) was launched in Ontario, Canada in 2007 and was legally enabled in December 2009.
It is expected that MedCentres will be deployed to service patients in medical clinics, hospitals, employer facilities, retail locations, and remote communities that cannot economically support a traditional drug store.
MedCentre kiosks provide live, two-way video conferencing between patients and pharmacists. Patients simply insert their prescription, pick up the handset and interact with the pharmacist who provides care and counseling to the patient.
Payment is made and the pharmacist instructs the kiosk to release the medication to the patient.
MedCentres will provide Canadian First Nations (indigenous people) and residents in remote communities with the same access to pharmacist services as those living in cities.
They will no longer have to travel long distances to obtain needed medications.
The model may well prove to be a solution for Australia’s indigenous people who currently have very limited access to pharmaceutical services.
Benefits promoted include
- Pharmacists will be freed up from the physical dispensing process, and will have more time to directly counsel patients
- MedCentres alert patients when their prescriptions are running out, thereby improving drug compliance (it is estimated that 10 per cent of emergency room visits are due to non-compliance)
- the service will be available in more than a dozen different languages(including sign language).
- MedCentres and their network allow pharmacists to extend their patient care practice beyond the store to increase revenues while lowering their costs.
Because of the success in Canada, UK hospitals are now taking an interest and propose to establish a series of trials in UK hospitals.
MedCentre remote-controlled dispensing systems can currently hold up to 2,000 medicine packets in refrigerated storage areas.
A system is currently being developed specifically for the UK, with a target dispensing time of four packages in under a minute — plus the time needed for a pharmacist to check the prescription, consult with the patient and authorise items to be dispensed.
The UK system is also expected to store clinical guidelines from the National Institute for Health and Clinical Excellence and information from the British National Formulary.
Each unit is currently sold in Canada for C$85,000, plus a transaction cost, and can be stocked and managed independently or with assistance from MedCentre management, which incurs additional costs.
UK price structures have yet to be determined.
Around six hospitals in England are currently lined up to take part in the trial, which will be overseen by an as yet undisclosed UK school of pharmacy. The school will ensure enough patients are seen and prescriptions read to get reliable data on the safety and accuracy of the machines. Patient and pharmacy staff feedback will also be collected.
One UK pharmacist commented:
”It is difficult to come up with a sound objection to this new technology other than that it just doesn't feel right. It seems to satisfy legal requirements and includes all necessary professional checks.
But it removes the direct human contact between a health professional and the person needing their advice, who might not realise that that is what they need but signal it by body language.
It is a step on the road towards reducing medicines supply to a pure commodity transaction and, ultimately, to a vending machine retail transaction.
This is a dangerous road to tread and there is a real risk that by the time the dangers are discovered and become real we will have travelled so far that the path cannot be retraced.”
Australia has not had a good track record for adopting new technologies in the health area.
Poor government support for IT innovation has stifled developers keen to promote Australia as a leader in health technologies.
But all they get is obstruction and any enabling legislation lags years behind any new invention or initiative.
Also, government tends to favour global vendors of health systems rather than the “home grown” variety.
The reasons given for this are very dubious, the main being that local vendors are usually too small in size and lack sufficient capital resources.
It’s all very disheartening.
Return to home
Research Reports
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Neil Retallick: Are the discounters impacting community pharmacy beyond margin erosion? | open full screen
Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA: Support services for pharmacists and doctors in the United Kingdom – Part 3 Royal Medical Benevolent Fund | open full screen
Staff Writer: Catch the early wave in 2012 and secure your valuable CPD Credits at the Guild Pharmacy Academy – NSW Convention | open full screen
Information Technology
Dr David More: Australian Health Information Technology LinksIndigenous Health
Preventive Medicine
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Submitted by garry boyd on Fri, 02/07/2010 - 16:13.
Being the inventor of the ExpressRx machine I'm well aware of the frustration innovators/entrepreneurs suffer in Australia. Peter's article is politically accurate because both the industry and government have long denied the indigenous/rural/remote population access to the pharma care taken for granted in urban areas. Variously, the s100 rule, location rule and the depot protocol have consistently denied pharma care to be delivered to in many cases those most in need. Automated solutions are finally getting traction, albeit slow traction. The challenge for innovators and entrepreneurs is to work out where the cracks are before sticking the big toe in the water. Solutions are available, it's a matter of development and introduction.
Submitted by Mark Woltmann on Thu, 01/07/2010 - 10:59.
Hi Peter,
I agree with you that Pharmacy Kiosks is a good viable way of the future. I am very interested to be part of this innovation.
BUT, I can see that this technology will fundamentally change the current shape of pharmacy (i.e destroy the whole "pharmacy PBS licence & licence position (ACPA)" system in Australia) - as such it will be fought by the Guild.
Submitted by Garry Boyd on Tue, 06/07/2010 - 15:49.
Mark, I'd be very keen to understand on what possible basis it could be said that automation would;
(i.e destroy the whole "pharmacy PBS licence & licence position (ACPA)" system in Australia)
The S100 system in no way compromises location rules. Further, to claim a "kiosk" would "destroy" the fabric of PBS licensing is patently incorrect if the activity of the said kiosk is restricted to depot and after hours service from an existing approved location. If you are genuinely interested in such innovation I suggest you understand the application rather than take the less than meritorious stance that it will be fought by the Guild.
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