Written in Chinese the word ‘crisis’ is composed of two characters. One represents danger and the other represents opportunity.
Those famous words, spoken by a president who dispensed many of them, could also describe a recent approach to medication delivery born of the AIDS crisis in South Africa.
The South African government used last month’s International AIDS conference in Durban to announce it would trial the use of ATM-style, self-service medication dispensing machines that would allow people suffering from AIDS 24-hour access to the drugs that prolong and improve their lives.
The new service will include built-in video conferencing equipment to ensure help from a trained pharmacist is always on hand.
It’s a potentially life-changing innovation, and, if proven viable, it could be rolled out across other countries as a safe, accessible way to connect patients with the medical experts that guide them through their medication regimens at any time of day or night.
The Video Pharmacy
Pharmacy by video conference, or telepharmacy, has a longer active history than might be imagined.
Pharmacists first started their online connection with patients at the turn of the millennium. In the intervening years networks of physicians, pharmacists, and patients have been established across North America.
The service has focussed on giving rural and remote patients access to expert care and monitoring, and led to changes in the law to allow pharmacists to dispense drugs without actually being present in person.
In the model created by North Dakota State University, a central licensed pharmacist using video conferencing oversees the work of registered technicians scattered through the state who work at dispensing sites, delivering the final medication to patients.
Their service has delivered pharmacy services to more than 80,000 rural citizens, and is claimed to have added $25 million to the local economy.
However, these services are still tethered to bricks and mortar pharmacies, reliant on people visiting a single location, within specific hours, and waiting in line while the resident authority deals with others.
The South African Solution: An Automated Telepharmacy
The South African model removes this problem by making the medications as readily available as any ATM in a city or town. In consultation with their doctor, the patient is issued a card, similar to a bank card, which authorizes them to retrieve the medication using a private PIN number.
It’s predicated on the drugs being uniform enough to be of use to a multitude of patients, although there is obvious scope to offer different dosages, or simple high- and low-strength variants on the grades of the drug.
The drug dispensing side of the technology can be made available 24-hours a day, while the video conferencing side can be as flexible as the necessary call center-style provision of experts will allow.
And the continued evolution of video conferencing means patient records and medication histories can be stored in movable cloud computing storage and be called up whenever they request assistance.
But if the idea is to be rolled out in other countries, and for the use of more varied patient groups, it might need to take advantage of some other emerging video conferencing technologies.
Safer Healthcare Through Video Conferencing
Even in its trial state the medication ATM improves safety around drug delivery. Obviously the remote pharmacist is no longer at any risk, the drugs themselves are stored as securely as money in a bank, and the patient themselves is in no greater peril than if they were to visit a traditional pharmacy or late-night ATM.
Whether what they’re after will be available does pose a challenge. Commonly requested, relatively homogeneous medications such as prescription-only painkillers, first-aid necessities, asthma inhalers, insulin doses, and basic antibiotics could easily be supplied through an automated service.
However, more exotic medications may need to be specifically stocked by whichever entrepreneurial drug company follows the South African government’s lead. This could be achieved by simply registering the needs and histories of customers likely to frequent the ATM at unusual hours, and giving the patient a card or other electronic means of sharing their medical record with the pharmacist who answers their video call.
But as a tool to serve the most common needs, these medication ATMs could become as ubiquitous as vending machines.
Facial Recognition Video Conferencing
To reduce the risk of fraud or unauthorized access, the machines could be fitted with simple scanners that would enable facial recognition security.
And a pharmacist making a video call with a patient could also act as a layer of security by matching the photo on file for the patient with his or her appearance on camera.
The potential benefits of this project are worth the investment in security and application. In the first instance, the South African trial could ease the burden of people living with AIDS.
And in the second instance, it could create a safe, accessible way for people across the world in need of medicines in places, and at times, outside the current pharmacy system.