Digital health technology is transforming every aspect of pharmacy practice, whether it deploys robotics to fill prescriptions, uses analytics to track medication data, or offers access to digital therapy. Pharmacists in both the hospital and retail settings are using recently developed technology to prevent adverse drug effects, monitor the use of antibiotics, modify unhealthy behavior, and promote medication adherence.
Not only can technology make a pharmacist’s day more efficient by automating repetitive tasks, but new digital health products are providing more insight into data and the opportunity for real-time patient interaction.
One type of digital health technology that helps pharmacists monitor adherence is an at-home medication dispenser that lets them know, in real time, whether the patient is actually taking the medication.
Developed by Catalyst Healthcare and a feature of the Pack4U connected care system, spencer is a dispenser and monitor that not only reminds patients when it’s time to take medication but offers them a way to communicate concerns remotely with a pharmacist, who can then troubleshoot any required solutions. The integrated system offers several advantages in treating high-risk patients, who are often on multiple medications.
“The pharmacy in our model is usually responsible for delivering a specially packaged cartridge to the patient, and then at the patient level, we have the device that sits on the patient’s countertop, called spencer,” said Shane Bishop, founder and CEO of Catalyst Healthcare and Pack4U. “The patient can slip the cartridge into the device. We check and make sure the right patient gets the right cartridge for the right device, and then the pharmacy is connected in real time with the device on the countertop.”
When the patient takes out the medication, a question may pop up on the screen, such as “How are you?” Or the question can be customized to the particular medication or condition.
Prescriptions are packed centrally, then shipped back to pharmacies. Each step of the process is tracked, including who sent the order, where the order is, who received it, and even expiry dates. Spencer also notes adherence problems, while collecting data on medication use, that can prove valuable to research.
“You get the responses back in real time,”said Bishop.“So now you can turn that data into being proactive for that patient and even triage that information for clinicians and physicians, as well as making pharmacy very relevant in the care of the patient, because pharmacists can get access to data faster than anyone else involved in care.”
Telehealth solutions have been invaluable during the quarantine prompted by the coronavirus disease 2019 (COVID-19) epidemic, providing a link to housebound patients who require ongoing care for chronic conditions.
“Our adherence rates run at 98%, and that’s actual medication in the patient’s hand at the time they are supposed to take it,” said Bishop. “It keeps the patient safe at home and lowers the total cost of care.”
Although the system primarily works with retail pharmacies, hospitals can discharge patients with the device so a pharmacist network can remotely monitor the patient. One advantage to this technology, according to Bishop, is that pharmacists have more time to focus on patients.
“I believe there is a lot of capacity in pharmacy to do much more than they’ve been tasked with,” he said.
Digiceuticals and Behavior Modification
When it comes to behavior modification therapy, there’s now an app for that—an app that requires a prescription.
Technology-based therapy, known as digiceuticals, uses FDA-approved apps on smartphones, tablets, and other mobile devices to gather data and provide patients with real-time guidance.
Digiceuticals can be used as monotherapy or in addition to medication. Pear Therapeutics created reSET, which can be used as an adjunct to a contingency management system, to treat some forms of substance abuse. The company’s reSET-O targets opioid addiction as part of a treatment plan that also includes medication. Somryst, the company’s newest product, provides cognitive behavioral therapy for chronic insomnia.
“As these products become more and more sophisticated in relation to [their] use in conjunction with other medications, the role of the pharmacist is going to be how to use them in terms of the patient’s overall medication,” said Yuri Maricich, MD, MBA, chief medical officer and head of development at Pear Therapeutics.
A code is required to access these apps. Before dispensing the code, pharmacists need to review the patient’s profile. “With all of these [apps], the way they are dispensed is [by] the prescription [being] sent to a specialty pharmacy where a pharmacist reviews the information,” said Maricich. “A pharmacist reviews every script. If everything looks copacetic, they actually dispense and fill, providing patients with a prescription access code. The patient then goes to Google Play or the Apple apps store. They download the software, input their prescription access code from the pharmacy, and get access to that treatment for the prescription duration. If the patient wants a renewal or a refill, that can be done."
According to Maricich, the difference between digiceuticals and biologic medicine will eventually fade away until it will all simply be described as medicine. “This is something that can be prescribed through a telemedicine visit and filled and used MBA without ever having to physically go to a clinic,” said Maricich. “In an era where we’re moving into virtual care, it will fit more and more into models outside traditional brick-and-mortar care delivery.”