PHARMACY IN THE NOT TOO DISTANT FUTURE

It’s 7 am and your alarm rings. You wake up, walk into the bathroom, and look in the mirror. The mirror, Alex, lights up, and softly says, “good morning.” Alex proceeds to detail your work schedule and updates you on your health issues. She also informs you that there is an 88% chance of sunshine so you should apply sunscreen as you are currently on amiodarone, and have sensitive skin. Alex then reminds you to take your morning medication and tells you what your current heart rate is. She also updates you on how many tablets you have left, and that more medicines will be available by the end of the day at your local pharmacy.

It is 9 am, and you are the first pharmacist at work. You open the door, and the pharmacy lights up, you are greeted by the holographic virtual healthcare assistant, Andrew. He welcomes you to work and informs you of the tasks, and patients you need to deal with today. As you walk towards the counter, more virtual healthcare assistants appear. As you walk into the dispensary, the dispensing robot, Anna has already downloaded and dispensed 150 prescriptions, prepared your coffee, scheduled your appointments, and has arranged the delivery drone to arrive in time for you to have clinically checked all prescriptions.

Once you have had your coffee and looked through your appointments and tasks, you are ready to start checking your first ETP prescription. You screen Mr. Khan’s prescription, and the system advises you that his medication needs optimisation. He has been prescribed carbamazepine which is likely to cause side effects such as Steven-Johnson Syndrome and Toxic Epidermal Necrolysis due to the presence of the HLA-B*15:02 allele on his genetic profile. The system then offers some alternatives based on his past medical history, laboratory results and genetic profile. As you continue to look through each patient, the system provides the best drug combination and dosage for the individual patient and where possible gives the option to 3D print the drugs on site.

It is now 10 am and the second pharmacist starts her shift. As she walks in, she is also greeted by the virtual assistants and given her days schedule. She is running a long-term disease management clinic today in the second consultation room.

Does all this sound like a fantasy? Or what pharmacy may look like in 20 years? What if I told you we are possibly only 5 to 10 years away? Well, for a start the talking mirror powered by artificial intelligence (AI) which has facial recognition software, natural language processing (NLP) algorithm, weather reporting and linked to the GP surgery and local pharmacy has already been designed and is being tested as we speak. The hardware capable of processing the information is readily available and so is the software. Holographic projection is now so advanced that we can project a person’s image as a full hologram anywhere in the world. Combined with AI with advanced NLP algorithm and a system that can project a hologram anywhere in a room you can have a holographic AI healthcare assistant that can help customers choose the right product and give basic advice. Before you ask, yes life-size holographic assistants are already here.

An AI prescribing support software that can help you make clinical decisions by understanding a patient’s genetic profile, medical history, drug side-effect profile and also explain itself is also being tested. It is an immensely complicated task so will take a little longer to reach but given the aging population, increasing cases of polypharmacy and comorbidity and more and more complicated drug regimens it is a tool that’s urgently needed by the healthcare profession.

3D printed drugs are not a sci-fi fantasy they have been here for some time. The FDA (Food and Drugs Administration, USA) approved the first 3D printed drug for epilepsy in 2016 called Spritam. The next step would be to make the printing technology cheap enough to be used in pharmacies.

If all this seems like a far-fetched comic book fantasy then I have news for you, we are living in exciting times! Not so long ago humanity dreamed of sentient robots and now we are very close to superintelligent AI and AI-powered robots. The big question for us as pharmacists, however, is, are we ready for the future? Our software and hardware capabilities are improving at an exponential rate. We now have access to quantum computers and AIs that harness the power of quantum computers. The future is coming at us faster than we can imagine. We as a profession must be ready for a day when AI will claim it can do our job better, faster and safer than us. Not just pharmacists though, every job that can be done by humans.

The only way to improve patient care is to ensure pharmacists are  readily accessible with a minimum of one physical pharmacist per pharmacy — ideally a new model where more than one pharmacist per pharmacy is needed, moving away from purely supplying medications to direct patient care looking after long-term conditions, providing out of hours common illness services.

How do we move to this model? The simple answer is AI and technology.

AI and AI-powered dispensing robots will reduce the need for dispensers, technicians and Advanced Checking Technicians so that money can be reinvested to move pharmacists to be able to provide the care these new models require.

In our next article, we will discuss the implications of AI in pharmacy practice and how we can harness the power of AI, big data and blockchain to improve patient care.