Creating a 'Digital Pharmacist' for the Future of Pharmacy Care
The time is quickly arriving for the pharmacy profession to consider how we are going to integrate all of this digital technology into patient care from a pharmacy perspective. To emphasize this point, let me give you a rundown of major areas of development in the past two years that I think will have a large ripple effect shortly:
Digital Medicines - The FDA is now clearing the use of bioingestible sensors in medications. The first was Abilify MYCITE, and there are probably 40 more in the works. This will focus on ID, psych, and oral oncology for now I feel. Along with that, we got the first digital inhaler from Teva, and we know that Novo Nordisk and Eli Lilly have plans to bring their smart insulin pens to market.
Digital Therapeutics - The FDA is clearing prescribable apps for patient care. Most of these are focused on chronic therapeutic management areas, and will likely tangently interact with how drugs are prescribed for patients. This includes Pear Therapeutics reSET and reSET-O for substance abuse disorders, but we will see other companies like Voluntis and Click Therapeutics bring other DTx products to market. Who will prescribe and monitor these things are still up in the air.
Remote Patient Monitoring - I feel we will see a combination of the above two areas filter into using pharmacists for RPM services, as it may become an attractive means to bill for services for the pharmacy to monitor medication adherence and therapy progress.
New Technologies of Interest - Too many, but several companies products and services are seeing an uptake in pharmacy. Items like Tabula Rasa and others looking to get into the digital MTM space are growing. The use of pharmacogenomics for medication drug interaction (23andMe) is interesting with some possible implications.
So what is a pharmacist to do to keep abreast of all these rampant changes and updates? Our pharmacy societies are not really doing much to support pharmacists across multiple spheres to know about these developments. More often than not, when I tell other pharmacists that we have such sensor-enabled medications coming to market they are shocked. And yet, the day is going to come when it is on our shelves and we will have to dispense and educate patients on how to use them.
Personally, I think we need an intermediary solution to this problem. I am proposing the creation of 'Digital Pharmacists' who are highly knowledgeable about digital health and related technologies to serve as resources for their colleagues and work environment.
How to Create a Digital Pharmacist
There are several areas I think that need to be addressed to create a pharmacist with the knowledge and skills to understand digital health and then teach colleagues and facilitate training but also interacting with others to keep updated themselves.
Organization Focus - I think if an organization wants to invest in having digital pharmacists on staff, they need to identify what they want these individuals to accomplish first and from that emphasize what they should learn about.
Hands-On Training - Probably goes without saying, but similar to an EPIC superuser, perhaps having digital pharmacists responsible for understanding in and outs of digital health products. For example, understanding how to set up a digital medicine and how it works intrinsically to pass that knowledge on to peers.
Formal Training - I suspect pharmacy organizations and others will start creating digital health training certificates or other associated items. I think it is important to scope out which seem practical and add value to digital pharmacist training. If this is onboarding a person with little knowledge, then perhaps a course on the background material is warranted for instance.
What can a Digital Pharmacists do for an Organization?
So this is perhaps what intrigues me the most. I see a digital pharmacist almost like an MSL or similar, they go between different companies making digital health products, and can bring it back to their organization, and provide training for staff, and help in the decision-making process of how to integrate tech into business models or services. I think there are some ideas on how this could work in different areas.
Community Setting
A digital pharmacist in the community setting I think would be highly valuable. Take for instance the push from Walgreens and CVS to have more digital health products. CVS is opening up pilot HealthHUB stores that are focused on bringing more patient care opportunities and this seems right up that alley. I could see digital pharmacists in pharmacy chains that work with pharma to learn about new products, and then training pharmacists in their local regions on different products coming out for instance. They could provide updates and new knowledge, and help in making training materials. These individuals would be the touch points for pharma or other companies like Omron who are making new digital health products being sold at pharmacies.
InPatient Settings
Very similar, but I say they would be more geared towards digital therapeutics or related products prescribed for a patient at discharge. They could help patients set up apps and related technology, and help with digital care coordination. In the same sense, they could help their pharmacists that work in ambulatory care clinics to seek technology to integrate into patient care.
Pharma and Related Tech Companies
Having digital pharmacists on board could serve multiple roles. One would be the education of other pharmacists and health professionals. Two would be the facilitation of communication across multiple fronts on possible technology to pursue. Lastly, using their knowledge to facilitate with patients and outside organizations on new technology developments.
Overall, this is just an idea crafting on my end and would welcome your own thoughts if this is something you think that should be developed or other items to consider.