Conceptualising production, productivity and technology in pharmacy practice: a novel framework for policy, education and research

Abstract

Context and backgroundPeople and health systems worldwide face serious challenges due to shifting disease demographics, rising population demands and weaknesses in healthcare provision, including capacity shortages and lack of impact of healthcare services. These multiple challenges, linked with the global push to achieve universal health coverage, have made apparent the importance of investing in workforce development to improve population health and economic well-being. In relation to medicines, health systems face challenges in terms of access to needed medicines, optimising medicines use and reducing risk.In 2017, the International Pharmaceutical Federation (FIP) published global policy on workforce development (‘the Nanjing Statements’) that describe an envisioned future for professional education and training. The documents make clear that expanding the pharmacy workforce benefits patients, and continually improving education and training produces better clinical outcomes.Aims and purposeThe opportunities for harnessing new technologies in pharmacy practice have been relatively ignored. This paper presents a conceptual framework for analysing production methods, productivity and technology in pharmacy practice that differentiates between dispensing and pharmaceutical care services. We outline a framework that may be employed to study the relationship between pharmacy practice and productivity, shaped by educational and technological inputs.Method and resultsThe analysis is performed from the point of view of health systems economics. In relation to pharmaceutical care (patient-oriented practice), pharmacists are service providers; however, their primary purpose is not to deliver consultations, but to maximise the quantum of health gain they secure. Our analysis demonstrates that ‘technology shock’ is clearly beneficial compared with orthodox notions of productivity or incremental gain implementations. Additionally, the whole process of providing professional services using ‘pharmaceutical care technologies’ is governed by local institutional frames, suggesting that activities may be structured differently in different places and countries.Discussion and ConclusionAddressing problems with medication use with the development of a pharmaceutical workforce that is sufficient in quantity and competence is a long-term issue. As a result of this analysis, there emerges a challenge about the profession’s relationship with existing and emerging technical innovations. Our novel framework is designed to facilitate policy, education and research by providing an analytical approach to service delivery. By using this approach, the profession could develop examples of good practice in both developed and developing countries worldwide.

The Impact of Technology on Safe Medicines Use and Pharmacy Practice in the US

“…Baines and colleagues has presented a conceptual framework for analyzing production methods, productivity and technology in pharmacy practice that differentiates between dispensing and pharmaceutical care services. They outline a framework to study the relationship between pharmacy practice and productivity, shaped by educational and technological inputs ( Baines D. et al, 2018 ).…”

Pharmacist Segments Identified from 2009, 2014, and 2019 National Pharmacist Workforce Surveys: Implications for Pharmacy Organizations and Personnel

“…Since the time the 2009 and 2014 workforce surveys were conducted, considerable shifts in health services and pharmacist roles in the United States have occurred. For example, the pharmacy profession now performs two distinct types of activities: (1) medicine access and supply, and (2) pharmaceutical care [6]. Work system and process designs for medicine access and supply respond to formal requests from prescribers to supply products and associated services as instructed.…”

“…Work system and process designs for medicine access and supply respond to formal requests from prescribers to supply products and associated services as instructed. In contrast, pharmaceutical care involves work systems and processes that focus on decision-making about medicines therapy and planned consultations between pharmacists, prescribers, and patients that facilitate the aim of improving health outcomes [6]. Baines and colleagues described a "blended pharmacy practice" work system and process design that currently is being used as the pharmacy profession attempts to fulfill both types of activities, often in the same location.…”

“…To help make these transitions, significant changes in work systems and processes are being developed, including (1) tech-check-tech processes [ 34 , 35 , 36 ], (2) patient-tailored packaging and delivery [ 37 ], and (3) technological advances [ 37 ]. It appears that the “blended pharmacy practice” work system and the process design described by Baines and colleagues [ 6 ] continue to evolve. New ways of delivering products, managing inventory, and reimbursing for product costs are being developed.…”

Making the profession attractive for our future and young pharmacists, the game changers for primary health care

“…Pharmacists’ roles used to focus on the compounding and dispensing of medicines, but have transformed into improving health outcomes by ensuring the effective and responsible use of medicines and helping patients navigate an increasingly complex and costly healthcare system, with a specific focus on medications. Both taking on new services as care providers within an integrated care system and collaborating with other healthcare professionals to positively affect and implement healthcare policies present important and exciting opportunities for the future of the pharmacy profession . Furthermore, with the forthcoming Fourth Industrial Revolution, it is possible the profession will change even more and turn to non‐pharmaceutical treatment means, as well as reducing its involvement in medicines supply …”