Technology and Pharmacy
The following is a summary of the chapter on “Technology and Pharmacy: Theory, Practice, and the Future Vision” written by Darrin Baines and Zaheer Babar for the Encyclopedia of Pharmacy Practice. (2019). London: Elsevier.
Technology is important to pharmacy practice. The performance of pharmacists working in all setting can be enhanced technologically. The profession needs robust models of pharmacy practice that fully represent technology and its wide-ranging implications for professional activities.
I. Introduction The WHO defines “health technology” as the “application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives”. Technologies should be viewed as part of dynamic production processes involving both humans and machines, changing in time, evolving within societal institutions, redefining professional roles, shifting technical and economic boundaries. In other words, health technologies are designed to enhance human performance at improving human health and well-being.
Pharmacy practice and technology All pharmacy practice relies on some form of technology or another. Most pharmacy practice is “technology-enabled” in the sense that the capabilities and the performance of pharmacy practitioners is enhanced by its use. Sometimes, the technologies utilised are mature and long established (they are “vintage”). Other times, they are novel and previously untried (they are “novel”).
The practice of pharmacy is a “craft” (that is, performed with human hands). Next, the business of pharmacy is a “trade” (that is, profits are made from providing goods and services). Finally, the practice and the business of pharmacy are based upon identifiable and replicable “routines” (that is, fixed working patterns and procedures) not employed elsewhere in health systems.
II. What is technology?
Technology derives from the Greek word “techne”, which means “art, skill, cunning of hand”, but also has the implication of “craftpersonship, craft or art”. Pharmacists are experts in the processes surrounding the use of pharmaceutical objects and procedures.
Baines et. al. (2018a) defines “technology’ as the “dynamic clustering of techniques, methods, skills and processes used in the production of goods or services or in the achievement of outcomes that deliver desired benefits for consumers”.
To help understand how technology could create new possibilities and opportunities for pharmacy practice, the following two concepts are useful:
1. “Intrinsic technologies” are innovations that improve current production processes, without changing the range of outputs produced.
2. “Extrinsic technologies” are innovations that expand the range of outputs that are producible, but do not necessarily improve the efficiency of existing or new production processes.
III. Technology in pharmacy history
Throughout their recent history, pharmacists have undertaken three key roles: compounders, dispensers and (in the last two decades) providers of pharmaceutical care services. During their early history, the evolutionary predecessor of modern-day pharmacists (apothecaries, then chemists and druggists) were “technologists” in the sense of “being experts in a particular field of technology”.
The rapid introduction of a new wave of digital technologies in coming years will again make apparent the importance of the technology-retailer relationship in pharmacy practice. Emerging technologies will create novel opportunities for the profession, which may be a catalyst for a renaissance in pharmacy practice and a redefinition of the primary purpose of community pharmacy premises. However, Baines et. al. (2018b) found evidence of effectiveness and cost-effectiveness to be currently limited.
Baines (2015) proposes a renaissance of community pharmacies based upon emerging health technologies. He suggests five steps:
1. Refit the “front of house” as a technology-hub;
2. Connect patients waiting for their prescriptions to technology-enabled task;
3. Network the pharmacy hub into the wider healthcare community and patients;
4. Retrain pharmacists in healthcare technology not just medicines optimisation;
5. Educate and enable the public to become technology-enabled pharmacy users.
IV. GPTs and TEP
With the ongoing advance of digital, it is vital that pharmacists fully understand the nature of innovative technologies and their potential impact on the profession. Pharmacists could classify technologies into two basic classes:
1. “General purpose technologies” (GPTs) are those that affect an entire economy and have the potential to disrupt the economic life of whole societies.
2. “Enabling technologies” are innovations that are directly designed to improve the capabilities or the performance of specific users not society as a whole.
The concept of “technology-enabled pharmacy”
Baines (2015) coined the term “technology-enabled pharmacy” (TEP) to describe the use of intrinsic and extrinsic technologies within a pharmacy-setting. The concept of TEP is based upon the notion that technology can improve the capabilities of pharmacists to deliver patient services. As a concept, it is based upon “extension theory”, which conceives of technical objects as “some kind of extension of the human organism by way of replicating, amplifying, or supplementing bodily or mental faculties or capabilities.”
Throughout their history, pharmacists have always been technologists. With the evolution of the digital age, a new wave of innovations is emerging at a time when the profession is looking for new roles and health systems are seeking to better manage costs. In response, we presented a performative perspective on pharmacy practice and highlighted the importance of taking an institutional approach to analysing the development of pharmacy-related technologies. In sum, we conclude that pharmacy practice is inseparable from technology and now is the time for the profession to rethink its technological worldview.
Baines D, Stig Nørgaard L, Babar Z and Rossing C. (2019). The Fourth Industrial Revolution: Will it change pharmacy practice? Research in Social and Administrative Pharmacy. Research in Social and Administrative Pharmacy.
Baines D and Babar Z. (2019). Technology and Pharmacy: Theory, Practice, and the Future Vision. Encyclopedia of Pharmacy Practice and Clinical Pharmacy. London: Elsevier.
Baines, D. L., Gahir, I. K., Hussain, A., Khan, A. J., Schneider, P., Hasan, S. S., & Babar, Z. U. D. (2018). A scoping review of the quality and the design of evaluations of mobile health, telehealth, smart pump and monitoring technologies performed in a pharmacy-related setting. Frontiers in pharmacology, 9, 678.
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Baines D. (2015). Dispensing: it’s time to let go. The Pharmaceutical Journal. 294, No.7847, pp.113-14