Pharmacy systems for pharmacies are evolving to meet the demands of new ownership, new regulations, and new products. Health care reform will also affect pharmacy systems and how medicines are dispensed. Factors that will impact pharmacy systems in the future include revised accreditation standards for pharmacies; changing delivery methods; shifting locations of care from hospitals to doctor’s offices, clinics, and retail-based settings; patient cost-sharing requirements and drug pricing reforms.
Pharmacy Systems for Pharmacies
Pharmacies will remain the most important source of delivery of prescription medications. The main mode of pharmacy service delivery will continue to be the dispensing of individual doses, directly from a pharmacy technician to a patient. All drugs dispensed will be in unit dose forms (i.e., pills, oral dosage forms, tablets); only limited amounts of traditional liquid formulations and prefilled syringes will be dispensed by pharmacists as needed (e.g., as a replacement for an individual unit dose). System changes that occur in pharmacies can affect the entire healthcare system and may extend to other healthcare settings if they are adopted in all locations within a health care system or chain.
New regulatory requirements, including the implementation of California’s new AB-132 and state pharmacists’ self-administration for controlled substances, will have both positive and negative effects. In general, pharmacy systems have responded to such changes by making adjustments in their dispensing practices that accommodate the new regulations. Pharmacies may need to adapt more than other facilities.
For example, many drugstores and large retail pharmacy chains (typically acquired by larger chains) have significantly increased their role in the prescription filling process through the assignment of an employee to each patient’s file and the integration of computerized order entry (e.g., such as Medco), electronic refills (e.g., through electronic transfer), direct access to retail pharmacies, etc. In addition, pharmacies have expanded their role in the management of controlled substances. Pharmacies will continue to be the most important source of prescription drug delivery, but there may be an increasing number of home-based and small-practice pharmacies that are not affiliated with large chains.
Changing Patterns of Care
Widespread changes in healthcare delivery and the demand for primary care from patients as a result of health reform legislation has prompted many providers to move into non-traditional settings (e.g., retail pharmacy locations) that deliver health care services.