Question for pharms

[ku06]

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This is not meant as an insult. ----- Disclaimer

What do you think of the possibility of a computerized system that can scan barcodes on prescription forms (or whatever method is chosen), checks for drug interactions with a databank, and dispense a drug. How hard would it truly be for a computer to do this work because how much "creative" work is really involved. There are lots of memorization and knowledge requirements, but can't a computer "memorize" much better than any human? IMHO, I do not think this is that out of the question for a retail pharmacy to have. Of course you would still need pharmicists to compound the more unusual drugs, but how many of the "popular" drugs are even compounded anymore?

 

[Glycerin]

This is not meant as an insult. ----- Disclaimer

What do you think of the possibility of a computerized system that can scan barcodes on prescription forms (or whatever method is chosen), checks for drug interactions with a databank, and dispense a drug. How hard would it truly be for a computer to do this work because how much "creative" work is really involved. There are lots of memorization and knowledge requirements, but can't a computer "memorize" much better than any human? IMHO, I do not think this is that out of the question for a retail pharmacy to have. Of course you would still need pharmicists to compound the more unusual drugs, but how many of the "popular" drugs are even compounded anymore?

I know you mentioned retail, but let me throw in compouding at hospitals. I work at a pediatric hospital where dosages are much smaller in general than adult dosing. There are things that aren't manufacturally (is that the right word?) available in oral liquid form, so we have to do that ourselves. Examples of this are captopril, baclofen, valacyclovir, hydrochlorothiazide, rifampin, clonazepam, and omeprazole, just to name a few that we compound ourselves daily to weekly.

I know that retail is different, and I haven't worked in retail in over 5 years, so there could have been many changes since. But, we compounded quite a bit of topicals for skin and scalp ailments.

The thing you have to remember with computers is that they are created by fallible humans and are capable of making mistakes if not programmed correctly or breakdown over time. 😉

 

[Trancelucent1]

Honestly, I don't necessarily disagree with this. The biggest problem is with liability. How many people would honestly trust this? Computers make just as many mistakes and what happens if it crashes. Then who's going to be checking for drug interactions? I think that pharmacists should be there for counseling patients. I think that this should always be the main focus of a pharmacist. Unfortunately, in many retail settings, money is driving the operations of the pharmacy. For these reasons (and others), I will not work in a retail setting. I would rather take a pay cut and be able to counsel patients such as in a Coumadin clinic or an ambulatory setting. A computer would never be able to take away those jobs either.

 

[kwakster928]

Answer to OP's Question is simple.

Do you rather trust a system where computer checks all your medications or a system computer dispenses and pharmacist double check's computer's work?

Computer has so much potentials. It is there to ease our life style but never to take over our lives. then we have situation like matrix. heck i surely do not want that to happen. You are thinking about medication bending machine. sure it sounds good. we can have soda bending machines because drinking a bad pepsi dont ncecessarily kill people but DRUGS DO. Please do not forget that medication is a "controlled poison." you are welcome to put all your fate on the computer. but not for me. I rather have my meds to be checked and double checked or triple checked by the pharmacist, physicians, and computers. Personally, 10 years from now, I see a pharmacy run by one pharmacist and his/her alone. i see computers taking over tech's job not necessarily the pharmacist's.

Honestly, I don't necessarily disagree with this. The biggest problem is with liability. How many people would honestly trust this? Computers make just as many mistakes and what happens if it crashes. Then who's going to be checking for drug interactions? I think that pharmacists should be there for counseling patients. I think that this should always be the main focus of a pharmacist. Unfortunately, in many retail settings, money is driving the operations of the pharmacy. For these reasons (and others), I will not work in a retail setting. I would rather take a pay cut and be able to counsel patients such as in a Coumadin clinic or an ambulatory setting. A computer would never be able to take away those jobs either.

I am same way. I really do not like coporate driven retail pharmacies. that's why i would rather take a paycut and work someplace in the hospital.

 

[ku06]

I guess it boils down to whether you believe more in people's fallibility or machines. Personally, I really think there would be ways to integrate safe two or three tier system of safe guards against errors. (Maybe at the front they scan the drugs you just received and scan the prescription and it recalls info from a whole other database). What I see as a very real possibilty that is going to hurt the job market very soon is that companies are going to start staffing more pharm techs and less pharms. They will only need one pharm to go around and make sure everything is being done correctly (acting as a supervisor). Of course the growth of more pharmacy chains might offset this.

 

[OoShimmeroO]

I guess it boils down to whether you believe more in people's fallibility or machines. Personally, I really think there would be ways to integrate safe two or three tier system of safe guards against errors. (Maybe at the front they scan the drugs you just received and scan the prescription and it recalls info from a whole other database). What I see as a very real possibilty that is going to hurt the job market very soon is that companies are going to start staffing more pharm techs and less pharms. They will only need one pharm to go around and make sure everything is being done correctly (acting as a supervisor). Of course the growth of more pharmacy chains might offset this.

This is a really good question because over 80% of pharmacists work in retail settings. At Savons Pharmacy, the computer system allowed us to enter the patient's medical conditions and allergies. The program would then point out contraindications and disclaimers for specific drugs and dosages prescribed to the patient. However, I dont' see how computers could replace pharmacists. At the store I worked at there were usually 3 pharmacists, 3 pharm techs, and 2 pharm clerks working at the same time. The techs would usually fill most of the prescriptions while 80% of the pharmacist's time was spent talking to doctors, patients, double checking dosages, and answering questions from pharm techs and clerks. I see your point, but I think that a majority of the pharmacists already spend most of their day doing things that computers and pharm techs simply can't do.

 

[kwakster928]

one more thought, if we simply let computers do all the medication work without a pharmacist, it pretty much puts computer in charge of patient's drug therapy. the goal of any healthcare professsion is to provide the best outcome for the patients given the condition. for example, even though computer thinks and tell you that tylenol 500 mg is the best treatment for the headache, perhaps the pt just do not like the computer's suggestion but rather have advil or aleve. this is when pharmacist is needed. today's drug comes with not only significant positive roles, but the numerous different side effects along w/ it. patient might not want a drug that induce headache, but pt rather have a drug which has drowsyness as its side effect. my point here is that pharmacist plays crucial role in optimizing patient's drug therapy and eventually puts patient in charge of his/her healthcare. even though computer's ability is undoubtful, it can never think like human nor have human to human interactions or have counseling abilities.

 

[jdpharmd?]

I'm at a compounding pharmacy right now for rotation, and let me tell you: I've never seen so much that a computer CANNOT do. It's wild, and I love it. Hopefully the FDA won't crack down on compounding like they are threatening.

 

[emogrrrrl]

To the OP: There are already computer systems out there that do a run through and tell you if the medication, strengths are correct. It also says whether it will cause drug-drug, drug-food, or drug-lab interactions.
There are also programs out there that help physicians to prescribe- CPOE (it actually takes a physcian through the drug selection process step-by-step).

 

[kwakster928]

dispencing is only half of the story of pharmacy, providing maxium outcome through drug therapy for each specifc patient is whole different ball game. this is why we get PharmD. while using the technology to the maxium, also increase our role in counseling regard: safe usage of drugs, over the counter recommendation and a sort of other things. I beg you not to look at pharmacy as one way street.

 

[pharmdsj]

Honestly, I don't necessarily disagree with this. The biggest problem is with liability. How many people would honestly trust this? Computers make just as many mistakes and what happens if it crashes.

At Walgreens, we have a machine count out the top 100 drugs and boy does it make our lives easier! Recently, we've had a number of problems & for the time being, we've been double countin' the medication to make sure (esp. vicodin). But, I think in the long run, an entirely computerized pharmacy (run by a pharmacist) wouldn't be beyond reach.

The problem with having a completely computerized pharmacy is that it down-plays the profession... ppl learn to associate "pharmacy" with computers... to most of the ppl beyond the health field, a pharmacist is nothing more than a second-rate, wanna-be doctor that didn't get into med school (so not the truth!). They neglect to acknowledge the fact that pharmacists are among the top 5 most respected professionals for a reason.

 

[Trancelucent1]

At Walgreens, we have a machine count out the top 100 drugs and boy does it make our lives easier! Recently, we've had a number of problems & for the time being, we've been double countin' the medication to make sure (esp. vicodin). But, I think in the long run, an entirely computerized pharmacy (run by a pharmacist) wouldn't be beyond reach.

The problem with having a completely computerized pharmacy is that it down-plays the profession... ppl learn to associate "pharmacy" with computers... to most of the ppl beyond the health field, a pharmacist is nothing more than a second-rate, wanna-be doctor that didn't get into med school (so not the truth!). They neglect to acknowledge the fact that pharmacists are among the top 5 most respected professionals for a reason.

I don't agree that the average person considers us a second rate wannabe doctor. Most people do not realize that many pharmacists have a doctorate. Therefore, I definately don't believe that most people outside the health care profession think this way. Maybe some people inside the health care field consider pharmacists second rate doctors, but I don't believe that the average joe actually knows what pharmacists do. Most people consider pharmacists to be the people counting the pills, therefore I disagree that they even consider us close to doctors.