HealthJanuary 22, 2018

Artificial intelligence in pharmacy: Are you ready?

Pharmacy as a profession and business continues to face challenges, and how it contributes value to the overall healthcare industry will determine its ongoing success. A key component of that may turn out to be effective use of technology, specifically artificial intelligence.

Reflecting on the past 25 years, pharmacy has done a great job of addressing the growing demand for prescriptions, even when faced with pharmacist shortages, demands of the Affordable Care Act, growing operating costs, and lower reimbursements. Pharmacy has also done a great job of leveraging enabling technology automation to improve workflow efficiency and lower operating costs while promoting safety, accuracy, and efficiency in every pharmacy setting. Automated dispensing gives pharmacists more time to engage with a greater volume of patients while also enhancing their health outcomes. While these successes have helped pharmacy play a key role in patient care, it is still frequently perceived as a transaction-based business dispensing a lot of prescriptions and not having enough time to care for patients.

Those pharmacies that do rely on being a transaction-based, dispensing-focused business will find that will not be enough to succeed. Driven by public policy, the pharmacy industry is evolving its practice and placing more priority on improving the quality of healthcare and driving value and sustainability in positive value-based outcomes.

Incorporating technology into patient care

As the quality of care offered for our patients continues to grow in prominence, here are some ways pharmacy can leverage the continued technology explosion to impact value-based outcomes:

  1. As the most accessible and affordable healthcare stakeholder, pharmacies can become health management centers instead of only medication fulfillment locations. Technology can help provide more personalized healthcare offerings including advice, guidance, and an expanded suite of services (e.g., immunizations, screenings, MTM, disease state management)
  2. Health trackers and wearables will be able to provide real-time capture of data that can enable pharmacy to follow up with at-risk patients on their conditions and monitor their quality of improvement

The challenge we have as an industry is the effectiveness of these interventions and results. Our current health IT initiatives have certain limitations today that continue to need to be worked out:

  • While the industry continues to develop interoperability standards, we currently have messy and unorganized electronic records across many different types of databases
  • Patient health records are private, requiring patients give specific permission; pharmacists are still not routinely and consistently included among the treating healthcare professionals who have access to them.
  • Healthcare data is distributive among many systems and require professionals to seek out the information and try to “paste the pieces together” to provide quality patient care
  • The retrieval data is typically retrospective and any intervention may not be timely and responsive. Expanding the capture of data to better holistically understand and care for the patient is much more complex than the limited data allows

Artificial intelligence as game changer

Wikipedia defines artificial intelligence — or AI — in healthcare as technology that “uses algorithms and software to approximate human cognition in the analysis of complex medical data. The primary aim of health-related AI applications is to analyze relationships between prevention or treatment techniques and patient outcomes. AI programs have been developed and applied to practices such as diagnosis processes, treatment protocol development, drug development, personalized medicine, and patient monitoring and care, among others.”

Current state of AI in healthcare

AI can be of real help in analyzing data and presenting results that would support decision making, saving human effort, time, and money, and thus helps save lives.

Medical and technological advancements that have helped healthcare-related development of AI include:

  • Overall evolution of computers, resulting in faster data collection and more powerful data processing
  • Growth in the availability of health-related data from personal and healthcare-related devices and records
  • Development of pharmacogenomics and gene databases
  • Expansion and industry adoption of electronic health records
  • Natural language processing and other advancements in computing that have enabled machines to replicate human certain processes

In 2011, IBM estimated that the entire healthcare domain had approximately 161 billion GB of data. Think how much data is in the domain today! With significant amounts of data available, AI is positioned to become a game-changing opportunity to improve care and curb the current trend of unsustainable healthcare spend.

Current technology and its algorithms enable and complement human interaction with patients today. In our current distributive platforms for technology, administrative and clinical healthcare functions are not well coordinated, and in many cases, are handled manually with some degree of success. With AI as the enabling technology, a single platform would collect data from various disparate databases and would sense, understand, act, and learn. It can then play a significant role in supporting healthcare initiatives relating to prevention and treatment plans in real time. As healthcare value-based outcome demands continue to significantly grow, healthcare manpower will be positioned to respond with AI tools.

Current use cases

In the physician space, artificial intelligence from technology companies like Microsoft is breaking into the healthcare industry by assisting doctors in finding the right treatments among the many options for cancer. Capturing data from various databases relating to the condition, AI is helping physicians identify and choose the right drugs for the right patients.

In the pharma space, AI is working with researchers supporting the decision-making processes for existing drugs and expanded treatments for other conditions, as well as expediting the clinical trials process by finding the right patients from a number of data sources. Pharma is even working to predict with certain accuracy when and where epidemic outbreaks might occur, using AI learning based on a history of previous outbreaks and other media sources.

In the hospital space, AI is being used to prevent medical errors and reduce hospital readmissions. By analyzing patient data from medical and medication errors, readmission root causes, and other internal and external databases, AI will one day identify and prevent high-risk patients from developing complications, provide prospective care guidance, and diagnostic support, among many other clinical applications. Additionally, AI will be useful in workflow optimization and efficiency, helping eliminate redundancy in cost from duplicate or unnecessary procedures.

Is pharmacy ready for AI?

We may be further along than we think.

In pharmacy today, we already have an early form of AI in place. It’s called our pharmacy management system, housing patient utilization and drug data, as well as potentially identifying drug-related problems through clinical decision support screening. The next generation in pharmacy technology is the introduction of a technology-based information expert system to identify timely drug-related problems based on patient data captured from the pharmacy system and other external data systems. Consistent with workflow robotics, this would leave less of the work on the pharmacist to shoulder responsibility of identifying serious drug-related problems.

In my view, AI can strongly influence and shift our focus from the dispensing of medications toward providing a broader range of patient-care services. We can leverage AI to help people get the most from their medicines and keep them healthier. Most importantly, AI provides pharmacy an opportunity for more collaboration across many different entities serving the same patient. For the patient, in addition to potentially better healthcare services offered by their professionals, AI may be a useful tool for providing guidance on how and where to obtain the most cost effective healthcare and how best to communicate with healthcare professionals; optimizing value of data from wearables; providing everyday lifestyle guidance; integrating diet and exercise; and supporting treatment compliance and adherence.

David J. Fong, PharmD, is president of Dave Fong Rx Consulting, Inc. A former senior retail pharmacy executive for Fortune 100 and Fortune 500 companies, he is recognized as one of the U.S. and Canada’s business and professional healthcare leaders, leveraging his knowledge and experience working with pharmaceutical manufacturers, distributors, retailers, payers, and healthcare technology companies to bring value to the industry and the consumer.

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