Change has been a near-constant companion to pharmacists and pharmacy regulators over the last decade, with many of those changes accelerated by the coronavirus disease 2019 pandemic. As pharmacist duties and responsibilities have increased, many have experienced greater demand for their services. The resulting strain has made well-being and burnout one of the most concerning issues in pharmacy and pharmacy regulation today, affecting an increasing number of pharmacists, pharmacy technicians, and interns.
While NABP and other stakeholders continue taking steps to address these concerns, some pharmacies are increasingly embracing the use of technologies to help alleviate some of the stressors that contribute to burnout. They include artificial intelligence (AI), immersive technologies such as augmented reality (AR) and virtual reality (VR), and various automation technologies. Pharmacies that embrace these technologies may be able to enhance patient engagement, improve workflows, increase patient safety, and simplify communication.
However, with these potential advancements come challenges. Of these, the largest is how to ensure that these technologies are used safely and in step with current pharmacy regulations, particularly those related to patient privacy. Nevertheless, these technologies are becoming increasingly prevalent in clinical pharmacies.
Pharmacy practitioners, regulators, and other stakeholders in the industry should be aware of these developments and their potential to improve health care performance and outcomes.
The Transformative Power and Challenges of AI
The use of AI in tasks that have traditionally required human perspective and expertise has gained significant mainstream attention over the last year. In pharmacy, AI could be used to help automate routine and traditionally manual tasks that might include ordering, verifying, dispensing, and even administering medications, for example. AI could also provide an elevated level of support for pharmacists and other clinicians across many aspects of medication therapy. In fact, some pharmaceutical companies have already been exploring similar functionality in specific use cases. Abbott, for example, has utilized a coronary imaging platform powered by AI that can detect the severity of calcium-based blockages and measure blood vessel diameter to improve decision making during coronary stenting procedures.
Applications of this technology to pharmacy practice might be used to improve patient outcomes by increasing medication adherence. This includes apps that remind patients to take their medications or pharmacy-based AI systems that prompt patient follow ups. AI may even be used to help monitor patient health statuses, predict and detect risks of adverse events, and even take steps to intervene in certain conditions.
The risk of misinformation and actions taken because of that misinformation are concerns that exist in most applications of AI. Because of these dangers, an emerging area of AI governance commonly referred to as “responsible AI” is gaining prominence among organizations that are pursuing AI technology. Responsible AI emphasizes principles of fairness, transparency, privacy, human safety, and explainability, as outlined in the book Turning Point: Policymaking in the Era of Artificial Intelligence.
Despite the controversy, there can be no denying that AI has the potential to transform thousands of professions and industries, including pharmacy. With that potential comes concern about the potential risks and challenges associated with the way AI technology might be used in pharmacy practice.
Using Augmented and Virtual Reality in Pharmacy Education and Beyond
Over the last decade, AR and VR have become more prolific, due in part to improved technologies and more affordable hardware. As a result, more users than ever are exploring potential applications in a variety of industries and venues, including both clinical health care and education for providers.
Virtual pharmacy education in interactive environments has been explored for well over a decade. Notably, between 2010 and 2015, educators at the Rangel College of Pharmacy at Texas A&M University experimented with utilizing Second Life, which they describe as “an interactive three-dimensional virtual environment that simulates the real world.” In an article published in Advances in Medical Education and Practice, the educators explained that though the Second Life system was limited in certain ways, including requiring access via standard two-dimensional screens, educators were able to create virtual pharmacy school classrooms and even a virtual pharmaceutical science and compounding laboratory. Students who participated indicated the experience was more useful than virtual lectures by video, though they still preferred a live session.
Along with educational applications, AR and VR could also be used to treat patients. According to FDA, “AR and VR may be able to deliver some types of clinical services – including services normally delivered only in clinics and hospitals – to patients in their homes or other non-clinical settings. Further, “FDA speculates that such services could help patients, including the socioeconomically vulnerable, underserved communities, and the elderly or disabled, to access needed health care services when accessing them in person would otherwise be difficult. In turn, this could make it easier, and more likely, for patients to complete treatment and for providers to monitor treatment.”
Wearable Technologies Can Provide Opportunities
Wearable health sensors are being used by an increasing number of consumers. These devices include fitness trackers, smart watches, glucose monitors, and electrocardiogram (ECG) monitors. Consumers use these sensors to monitor their own health and fitness, and, in some cases, to share data with health care providers and insurers. These devices can provide important and valuable insights into a patient’s health, which providers can, in turn, utilize to tailor treatment and care.
According to the Drug Topics Journal, 80% of patients have used the internet to search for health information, and 42% of adults are using digital health tracking devices such as smart watches with health sensors. With this widespread growth, it is no wonder that new smart technologies are emerging at a rapid pace. These advancements are already transforming industries throughout the world. Health care and pharmacy have been no exception.
One of the main advantages of wearable sensors is that they can provide continuous and real-time metrics. Depending on the types of sensors being used, this can include a patient’s heart rate, blood pressure, blood glucose, oxygen saturation, and body temperature. The data can help pharmacists and other health care providers monitor the effectiveness and safety of medications and detect any adverse events or drug interactions. For example, some clinicians are using continuous glucose monitoring (CGM) sensors for this purpose. CGM sensors sit under the skin (typically in the patient’s arm or stomach) and provide constant information on glucose levels to an external monitor, such as an application on a smart watch or phone.
Another benefit of wearable technology is the way they can improve patient engagement and adherence to medications. For instance, some devices can track medication intake and send notifications to patients and their caregivers. Such devices might also connect to online platforms or apps that provide educational resources and other support.
Challenges Facing Technological Advancements in Pharmacies
With the potential for all this new technology, there are some challenges. Most notably is how to ensure that the data collected from patients is kept private and secure and is used ethically. Those utilizing this technology may also need to determine how to integrate the data from AI, AR, VR, and wearables into new or existing health systems. This may require common standards and protocols to ensure the different systems can communicate with each other.
Another challenge is in learning how to ensure pharmacist education and training includes information about how best to use this data. Considering these concerns about personal health information, data integration, and the ethics of use, NABP will continue to monitor the use of these technologies and potential challenges that may arise.
This blog was adapted from an article that originally appeared in the June 2023 Issue of Innovations.