The bright future of pharmacies

Although pharmacies play a key role in the healthcare process, patients' impression of pharmacists and pharmacies is often that they offer a purely commercial type of service. The doctor prescribes the appropriate medicine with the appropriate instructions and the pharmacist provides it in exchange for money. Point.

However, the medical technology revolution is changing the boundaries between roles in the healthcare system. For example, through patient empowerment, it balances the patient-doctor power relationship that was previously more asymmetrical. The pharmacy of the future will be no exception, observing a redefinition of its role in the system. A simple “drug store” will not suffice in a shared, community-based economy.

The portrait of the pharmacy of the future

The Royal Pharmaceutical Society published a report on future models of care delivered through the pharmacy, and made several recommendations that I consider noteworthy. In their opinion, the pharmacy of the future should:

• Shift the focus from distributing medicines to providing a wider range of services;
• Help people get the most out of their medicines;
• Take the initiative and drive change at a local level, don't wait for national solutions;
• Be part of a collaborative network involving other pharmacies and other health professions.

From pharmacist to pharmacist

To summarize, the pharmacy of the future is a mix between the ancient galenic shop and the 21st ^° century of tech gurus. The “pharmacist” will occupy a special place in a given community, will know the histories of his “patients” and will provide basic care for their illnesses with appropriate medicines. He will know how to decipher data from health trackers and wearable devices, and will be able to provide the necessary care based on this data. In short, a true scientific professional who knows the basics and latest developments in the pharmaceutical sector and medicine in general.

Such a “pharmacist” would come in handy in rural, remote or smaller communities that have significantly less access to pharmacies. This phenomenon also has repercussions on hospital readmission data . In rural areas, where people can't find pharmacies that are open when needed, researchers found that readmission rates were higher than in urban areas. If the ultimate goal is to improve the quality of healing, this phenomenon must also be modified. And technology is available to us to do so.

Here are potential future scenarios and technologies that could have a big impact on pharmacies.

Health management centers, not just drug distributors

The pharmacy of the future will not have to act exclusively for the distribution of medicines. With the help of technology it will gain more importance in filtering patients. Pharmacists of the future will act as healthcare managers helping healthy patients and patients with medical conditions manage their treatment. They will also manage medication administration for people with multiple conditions, provide advice for minor ailments and provide public health services.

To get to the scenario where pharmacies focus on health management rather than drug distribution, organizational and even technological advances must be made.

Technologies such as computer systems for labeling and inventory control e packaging of unit doses (already used in hospitals in the USA and UK) should be used more widely (in Italy excellent signals come from projects such as FidMed). In this way the time dedicated to the selection and storage of medicines will be significantly reduced.

With the spread of wearable sensors and health trackers the pharmacy of the future can help patients interpret data from their wearable devices by recommending minor health corrections or medications based on that data.

In summary, the organization of work and the distribution of tasks could transform the "old" pharmacies into advanced health management structures. A range of services delegated to specially trained members will free up the pharmacist's time to provide other services, such as basic patient care.

Health consultancy and support for telemedicine

Have you ever stood in one of those huge queues at the pharmacy, only to receive a drug without clarification on its use (there is always some doubt)? The pharmacy of the future will provide specific expertise to provide healthcare consultancy, not just the sale of medicines. Pharmacists will have the opportunity to provide primary care to patients with simple problems or provide health management consultations. They will constitute an intermediate link between the old pharmacy and the general practitioner, decongesting his work in many cases.

One of the most important factors for this development is the basic approach to healthcare. Healthcare providers, as well as pharmacists, will provide proactive patient care at the location most convenient for the patient. When the actual presence of pharmacists is not possible, solutions such as telemedicine will make up for it. For example, IntouchHealth and its telemedicine network patients in remote areas of the United States have access to high-quality emergency consultations for suspected strokes, cardiovascular problems and burns. Consultations at the exact moment they need it. 

Telemedicine will provide good support to the medical professionals themselves in cities and rural areas, to enrich the range of specialized services available to the community.

This is the so-called point-of-care diagnostics, which allows the patient to be diagnosed in the doctor's office, in the ambulance, at home, in the field or in the hospital. The results of the treatments are timely and allow a quick treatment to the patient. A range of next generation medical sensors such as Scanadu Scout  they will measure heart rate, respiratory rate, blood oxygenation and body temperature. Others like Viatom Checkme will provide data for ECG, pulse, oxygen saturation, blood pressure, sleep quality and daily activity. All of them will help healthcare professionals diagnose diseases more precisely and easily, even in the pharmacy of the future.

Personalization of therapies and printing of drugs on request

Let's take a step forward in imagining the pharmacy of the future: the old "Apoteke" has been successfully transformed into a health management and consultancy center thanks to technology and organization. How else could pharmacies take on a more effective role in a patient's recovery journey?

The pharmacy of the future will have more freedom in the personalization of therapies. By having access to cloud-based algorithms and digital health solutions, the pharmacist will be able to obtain the same quantity and quality of medical information available to a medical center, and “print” drugs on demand. Maybe also participate in clinical trials, or conduct them.

Does it seem impossible to you? Last year, the FDA approved it* an epilepsy drug called Spritam, produced by 3D printers. The drug was molded from a powder, layer by layer, to make it dissolve faster than regular pills. Imagine how fast drug distribution could be with a 3D printer in every pharmacy of the future. And no waste on dosages, too.

With the help of artificial intelligence, clinical trials will take much less time. For example, the company Atomwise uses supercomputers that derive therapies from a database of molecular structures. Last year, Atomwise launched a virtual search for existing, safe medicines to repurpose to treat the Ebola virus. In less than a day they found two already on the market. This analysis would normally have taken months or years. Imagine how efficient drug creation would be if such clinical trials could be performed at the healthcare level, particularly in pharmacies.

In any case, pharmacists (or pharmacists) will be able to embrace the technological revolution and bring it into their daily work. The signs of a transformation that increases opportunities for patients and reduces costs and times are all there.

* https://qz.com/471030/the-fda-has-approved-the-first-drug-made-by-a-3d-printer/