Our digital future

NOVEMBER 2022 – The future is bright for pharmacies that embrace digital health in daily practice—but pharmacists and their teams need to walk before they can run. They can also bang loudly on regulatory doors, urged panelists at CFP’s Pharmacy Forum webinar on November 17.

A recording of the webinar is available here.

Pharmacist Rui Su, co-founder and COO of MedMe Health, a digital pharmacy care platform that experienced explosive growth during the COVID-19 pandemic, kicked off the event by announcing the release of an accredited course, Digital Health in Pharmacy. Co-authored by Su and pharmacists Michelle Yee and Taher Rehmanji, the course aims to serve as a primer on digital health in pharmacy, with a focus on virtual care and its implementation.

The Canadian Foundation for Pharmacy funded the course through its Wellspring Pharmacy Leadership Awards program, from which Su received a grant in 2020. The course is available at no cost to pharmacists.

“We believe this program is unprecedented in the Canadian pharmacy space,” said Su. “It was a learning process for us as well to figure out what information is of best value for pharmacists…and clinically relevant to implement.”

She explained that modern society is in the middle of a fourth industrial revolution marked by exponential technological advancement—accelerated even further by the COVID-19 pandemic. “Digitally enabled experiences are pervasive and expected,” she noted, citing advances in banking as an example. “The challenge is for pharmacy to take that on as well.”

Su was joined by moderator Aska Patel, pharmacist and founder of Acuvise Consultancy, Ashwin Juneja, pharmacist and consultant, and Gurpreet Lall, owner of two pharmacies in Brampton, Ontario. They agreed that the lack of governance through legislation and regulation is a major systemic barrier, which often leads to pharmacies being reluctant to invest in new technologies and training. Even when new rules are put in place, “they tend to be prohibitive rather than enabling,” observed Su.

The lack of interoperability between new and existing technologies, including today’s pharmacy pharmacy management systems, is another big barrier. “If these tools can’t be integrated then it’s very difficult for massive change at scale to happen within our profession,” summarized Su.

However, these barriers need not prevent pharmacists from moving forward, emphasized all four presenters.

“There is always a lag between innovation and regulation,” said Juneja. As long as pharmacies are in compliance with the first principles of the Canada Health Act, which are to support the accessibility and portability of health care, it’s just a matter of time for regulations to catch up. “We have to be the change we want to see,” he urged.

“If we get bogged down on regulation and governance we’re just never going to move forward,” agreed Lall, who has launched apps to assist both patients and pharmacies with home deliveries of medications. “We need to take ownership.”

He added that the changes and new services coming out of the pandemic, such as appointment-based care and COVID-19 vaccinations, have created a momentum that needs to be maintained. “Some of us pivoted and when we did pivot, we realized we can be our own catalyst.”

Before diving into the world of virtual care, however, the presenters stressed the need to invest in basic technologies that lay a foundation. “The drug distribution aspect is completely scaleable and should be automated,” said Juneja. “The things that only we can do are what we need to lean into. Our dispensing clientele have to become our professional services clientele.”

Apps that enable patients to schedule their own appointments and arrange for deliveries should also be table stakes by this time. “The technologies we adopt are what are going to make us Amazon-proof,” said Lall.

Preparation also includes dropping obsolete technologies; namely, the fax machine. In this case, regulatory inaction needs to be challenged. “All of us has to ask [questions of those] who make the rules here,” said Lall. “We know we can e-transfer money; why can’t we e-transfer a prescription?”

Pharmacists need to look at the current tools in pharmacy and call out those that are not able to do they need to do in this new age, agreed Su. “We want to ‘ax the fax’ but as a profession we’re so used to referring to clinical guidelines and regulations to make a recommendation.”

Pharmacy schools have a role to play, she continued. “For the new generation of pharmacists, how can we better structure the curriculum to enable us to challenge what’s out there in order for our profession to change?”

Patel agreed and pointed to the need for advocacy literacy to go hand-in-hand with digital literacy. “It’s not necessarily that pharmacists don’t want to do something about an issue that is of a concern. It’s more that they do not know how to go about starting those discussions and having those actionable items generated that can result in change.”