Pharmacies can no longer wish away technological innovations such as robotics and artificial intelligence, but pharmacy owners should be clear about what they want to achieve through automation, and there is no one size fits all solution.
This was the broad consensus reached by the panellists during a discussion on "Embracing technological innovation" at the tenth annual Pharmacy Business Conference on 19 April at the Wembley Hilton.
The discussion was moderated by Amerjit Singh, Managing Director, Skills4Pharmacy, and the panellists included Patrick Gompels, who runs Gompels Pharmacy, Cyrus Hodivala, managing director, Meditech UK & I, and Tariq Muhammad, CEO, Invatech Health (Titan).
Gompels said to bring about any technological change in an establishment, one should bring their team on board.
"If your team see anything as a threat or a chore, it will die. It doesn't matter if it's software, hardware, robots, anything else."
He said that at Gompels they always strive to build a team that is obsessed with finding a better way to do things and using tech to achieve it.
Gompels claimed that AI has become a dreaded word with many fearing it would take away their jobs.
He remarked, "AI will take away your jobs if you don't use it, if you don't embrace it, and if you don't play with it.
"It is not about spending lots of money or being scared of it, you just have to use it in little ways every single day to make things marginally better."
Citing a recent example at Gompels, he said they have now created two-minute videos of all their SOPs, and it was well received by the team.
"The opportunities are endless. We just need to play with it. So, my advice is: try something, make mistakes, make more mistakes, have fun - but it will all add up to a safer, more efficient pharmacy," he said.
Right type of automation
Hodivala, who claims to have seen "every type of automation you can imagine" during his career spanning over two decades and across many countries, said the motivation to automate varies from pharmacy to pharmacy.
"It's about buying the right automation, and making sure it's integrated throughout everything that you do."
He said workflow is crucial while implementing any type of automation, ranging from a simple batch picking for individual prescriptions to managing a hub for multiple stores.
Hodivala said that though the returns from dispensing have diminished, each pharmacy is saddled with more prescriptions.
This is because over the last decade, the number of prescriptions has gone up by a quarter of a billion, while the number of pharmacies has gone down nearly 20 percent.
Hodivala, who also runs a pharmacy, said he has seen these challenges 'inside-out'.
Before going for automation, pharmacy owners should figure out what they want to achieve? Buying a robot or a software because someone down the road did so is not efficiency, he said.
"You should be thinking, how can I leverage what's available to me," he added.
Pharmacist turned technology entrepreneur Tariq Muhammad said there is little change in the woes faced by pharmacies from three decades ago.
"The same frustrations, NHS, funding, all of those things, those have not changed. And it's very sad that we are still talking about those things."
He said that over the years he has learned that the change has to come from within us. "No one else is going to actually hand things to us on a plate. We have to make those changes in the grassroots."
Muhammad claimed his company has developed a business to bring technology to pharmacies, and they want the pharmacy owners to "bring the enthusiasm and the willingness to make that change to go forward."
Return on investment
When Amerjit Singh queried the panellists about the return on investments, Hodivala said they model automation around the demands of a particular pharmacy to ensure that they are getting exactly what they need.
This means having a robot that is neither too small or too big, but also matches their growth plans. Good quality automation releases time, he added.
Hodivala said his company also offers robots on rent. For pharmacy it means no major investment, they can pay rent from their revenue and the staff can be redeployed for other services.
He felt that if automation is done in a right manner, "you should get return on investment on the capex within a year."
Gompels said that for businesses it is crucial to decide where they are going and their purpose. "If you do not get purpose right in your business, you are due to failure."
"If you've landed wrong, if you don't know what you're doing, your costs will go up because you need more staff to do something, and you don't even know what you're doing."
"So our guidance for everyone is, firstly, work out your purpose."
That purpose has to be decided by leadership. "No one else will do that job for you. That is your job as leaders. Then you need to sell that vision to your staff, your team, Gompels said.
He said that once it is sorted, technology is a means to an end. "It is simply a vehicle that helps you get to that vision, get you to that guidance, get you to that end goal."
Gompels said at this stage it becomes easy to decide whether you need robots or AI. "Do you even need a new PMR system?
"If you get it the wrong way around, then you're in a heap of trouble, but if you get that right, the journey is much easier."
As for measuring the returns, Gompels said every single bit of data should be captured, so that you know in minutest detail what is working and what is not and then take a call on whether to pursue them or not.
Muhammad said there is a lot of data out there and it is crucial to keep close tabs on it.
He said while some contractors are absolutely "on point with regards to how they manage the data being generated, the profitability of their businesses, the profitability of their services and their dispensing", there are others who are totally unaware of that.
"They are so focused on trying to stay alive as a business, but they don't necessarily know how they're going to manage that."
Harnessing the data
Muhammad said data is a 'library' for pharmacy contractors, and they should make optimum use of it to develop their businesses.
Citing his own experience at Titan, Muhammad said they capture large amounts of data regarding prescriptions, patient history, their interactions with pharmacies, the financials of businesses and other aspects.
"Half our problem is, how do we actually interpret that data? That's a different problem we've got.
"The problem is not the source of data and the amount of data available. But what do we do with that data?"
However, Muhammad said the pharmacy contractors can act only on data which is in their control, and can do little about the data over which they have no control.
So they need to identify that data and decide on what course of action needs to be taken, he added.
When queried about the amount of sales needed to get a return of investment on robotics and automation, Gompels said some of his pharmacies are making massive returns on investment by hub-centralizing their dispensing, freeing up time, and increasing their revenue from services.
But he cited the example of three pharmacies that are doing 4,500 items a month, but had installed robots.
When he questioned them and the responses were different. One contractor, based in Scotland, said he is facing staff shortage and sees robot as a dependable ally.
Another one in South Wales said he is getting most of his tasks done by one person and the robot, whereas his pharmacists are free to do clinical services and doubled his revenue.
"Everything that he was getting from his dispensing, he has now doubled that in private services."
Though the motivations in the two cases are different, the end result is same - revenue generation and freeing up time for other services.
Evolution of technology
Muhammad said technology is an enabler. "We now have technology that we could only have dreamt about 10-20 years ago."
He said we should not fear it and embrace it wholeheartedly.
Hodivala said the technologies available to us now are "monumentally different" from where they were five and ten years ago.
"So revisit it with an open mind. Don't be closed off to it."
He observed that he quite often hears "It is something I can't invest in right now."
"But standing still has a consequence as well. Not doing something has a consequence as well. So make sure that you open your mind to what's available and see where you can end up because of it."
Gompels advised to think big and small. "When you think big, think about your systems, think about your automation, and that's where you've got to make really informed decisions."
As for thinking small, he said, "We've got to be thinking about those marginal gains every single day. How can we use tech, whether it's a spreadsheet, ChatGPT, recording minutes, whatever it is, think small, do it quickly, and don't be afraid of making mistakes, because that's how you iterate and that's how you innovate, and that's how you'll be better in three or six months, twelve months' time."
