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"Fee" charge @ Wal-Mart pharmacy?

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  • Feb 18th, 2011 4:30 pm
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Kasakato wrote:
Feb 16th, 2011 11:24 am
Who is going to monitor drug interactions, dependencies, advise elderly customers, etc? Robots will only compliment human pharmacists.

A robot can monitor drug interactions and dependancies a helluva lot better than a human can. I've never seen a robot make a 'human mistake'. There is no pharmacist that knows all drug interactions from the top of their head. They need to consult a computer...so why not skip the middleman?

A computer can flag an elderly customer and a human meeting can be arranged with this person. The need for pharmacists will always be there, but will drastically go down. This is being done successfully in many parts of the world.

25 years ago who would've thought we'd all be dealing with a machine with our money 95% of the time? We all wondered back then how in the world we could trust a machine with your hard-earned money.
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elmst200 wrote:
Feb 16th, 2011 10:54 am
A robot (or smart vending machine) would be more knowledgeable than any pharmacist, with virtually no error, much more efficient and and very little cost.

The drug-dispensing robot is coming to Canada very soon, if legislation is changed to fast-track the change.
I think you're confused. The vending machine dispenses drugs, but a pharmacist still has to be present in a remote location to interact with the patient and check the prescription. This takes jobs away from pharmacy technicians/assistants, moreso than pharmacists. You still need a human to practice judgment, because the computers will flag every single drug interaction whether or not it actually applies to the patient's situation. We won't have robot pharmacists until AI develops much, much further and becomes available at a reasonable price.
Cas77 wrote:
Feb 16th, 2011 11:34 am
A robot can monitor drug interactions and dependancies a helluva lot better than a human can. I've never seen a robot make a 'human mistake'. There is no pharmacist that knows all drug interactions from the top of their head. They need to consult a computer...so why not skip the middleman?

A computer can flag an elderly customer and a human meeting can be arranged with this person. The need for pharmacists will always be there, but will drastically go down. This is being done successfully in many parts of the world.

25 years ago who would've thought we'd all be dealing with a machine with our money 95% of the time? We all wondered back then how in the world we could trust a machine with your hard-earned money.

See above.
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It seems that you are a pharmacist, or are working/studying the related disciplines. Can you tell us how a "real" pharmacist checks the perscription? Can it be done with computers? can you elaborate more on this?

The drup-dispensing computers will definitely be connected to e-health record, any medical condition of the patient can be traced and analyzed. The drug interaction can also be checked. the service/decision such computer provide to the patient will be much more comprehensive and a lot cheaper than real persons.

Nobody denies that there are a small percentage patients who either prefer to deal with real persons or whose illness demands complicated decision-making that only real-human being could pass judgement. For these patients, "real" medicare workers needed to be present. But for the vast majority of patients, computers can do much better jobs than real persons.

The healthcare system should give patients choices, majority of patients do not need to talk to pharmist
Takada wrote:
Feb 16th, 2011 1:05 pm
I think you're confused. The vending machine dispenses drugs, but a pharmacist still has to be present in a remote location to interact with the patient and check the prescription. This takes jobs away from pharmacy
technicians/assistants, moreso than pharmacists. You still need a human to practice judgment, because the computers will flag every single drug interaction whether or not it actually applies to the patient's situation. We won't have robot pharmacists until AI develops much, much further and becomes available at a reasonable price.



See above.
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computer can do this much better than real human being. computer can even talk to patients using languages he/she can understand, whereas pharmacists can not. How many pharmacits can speak hundrends of languages? Every computer can.
Kasakato wrote:
Feb 16th, 2011 11:24 am
Who is going to monitor drug interactions, dependencies, advise elderly customers, etc? Robots will only compliment human pharmacists.
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elmst200 wrote:
Feb 16th, 2011 1:43 pm
It seems that you are a pharmacist, or are working/studying the related disciplines. Can you tell us how a "real" pharmacist checks the perscription? Can it be done with computers? can you elaborate more on this?

The drup-dispensing computers will definitely be connected to e-health record, any medical condition of the patient can be traced and analyzed. The drug interaction can also be checked. the service/decision such computer provide to the patient will be much more comprehensive and a lot cheaper than real persons.

Nobody denies that there are a small percentage patients who either prefer to deal with real persons or whose illness demands complicated decision-making that only real-human being could pass judgement. For these patients, "real" medicare workers needed to be present. But for the vast majority of patients, computers can do much better jobs than real persons.

The healthcare system should give patients choices, majority of patients do not need to talk to pharmist

Did you not hear about the e-health scandal? You actually think we'll have electronic health records in the next few years? Well I got no hope of seeing it till what 10 years down the line and wasting billions more!!

A lot of pharmacists are very smart people that know more about drugs than your doctor! They are just there and provide service silently and they also fix your doctor's screw up too without you even knowing about it! All the pharmacists I know don't have a lot of time to look up info so they know a lot about the commonly prescribe drugs by memory. For any drugs they don't know a lot about or it's a new drug they look it up for it's list of possible interactions.
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elmst200 wrote:
Feb 16th, 2011 1:47 pm
computer can do this much better than real human being. computer can even talk to patients using languages he/she can understand, whereas pharmacists can not. How many pharmacits can speak hundrends of languages? Every computer can.

How much extra money do you want to spend on drug over what we are paying now because of the introduction of this robot?
So far, I have not met a talking robot I can communicate with properly. Every time I call Rogers or Bell, my blood pressure goes up. It can't even handle English.
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a pharmacist can NOT know more than a computer on drugs, a computer can easily have encyclopaedia knowledge of drugs, no human being can.

computer drug-dispensing system can easily figure out and fix doctor's screwed-up prescriptions. no problem.

setell wrote:
Feb 16th, 2011 2:14 pm
A lot of pharmacists are very smart people that know more about drugs than your doctor! They are just there and provide service silently and they also fix your doctor's screw up too without you even knowing about it! All the pharmacists I know don't have a lot of time to look up info so they know a lot about the commonly prescribe drugs by memory. For any drugs they don't know a lot about or it's a new drug they look it up for it's list of possible interactions.
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what computer needs to tell patients are the drug perscription, usage, side-effect and others. if the patient is so confused after listening to the instruction from computer many times, he/she can easily pickup phone and call a real person. Most people and in 99% of situation would find the instruction from computer is more than enough and are satisfied. The small percentage of people who can not understand the instruction from computer are highly possible can not be advised by real persons, because real persons have the same information to be conveyed to the patient.

The drug dispensing systems available will not eliminate real pharmacists, as I said, there a small percentage of people who would prefer to deal with real person. for those people, they can do with real pharmacists, but are expected to pay much higher dispensing fees than those who use service from computer.
gman wrote:
Feb 16th, 2011 2:23 pm
How much extra money do you want to spend on drug over what we are paying now because of the introduction of this robot?
So far, I have not met a talking robot I can communicate with properly. Every time I call Rogers or Bell, my blood pressure goes up. It can't even handle English.
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You will still be paying out of your pocket for purchase/maintenance of robots. I'd rather pay the dispensing fee than have to deal with a robot that, at this age, is still probably not up to par with human interaction. People will suck at using robots, people will get confused and frustrated. A good chunk of people are not even competent enough to use basic self-checkout automated systems.
You could use both a robot and a pharmacist (depending on how the customer wants to interact), but the fees will remain and may even increase. Plus, at least some people won't be out of their jobs.
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What about the initial input of the prescription into a computer? Will the computer be able to make out the "chicken scratch" that most doctors write in? Is there handwriting recognition software this advanced? I'm not for or against robots...just wondering about this initial integral part of the process. Not that I completely trust a human to do this either - I get A LOT of prescriptions and am well educated about what I'm getting and even knowing what the rx is supposed to say I can't read it and most of the time I am very impressed that I end up with what I am supposed to be getting.
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elmst200 wrote:
Feb 16th, 2011 1:43 pm
It seems that you are a pharmacist, or are working/studying the related disciplines. Can you tell us how a "real" pharmacist checks the perscription? Can it be done with computers? can you elaborate more on this?

The drup-dispensing computers will definitely be connected to e-health record, any medical condition of the patient can be traced and analyzed. The drug interaction can also be checked. the service/decision such computer provide to the patient will be much more comprehensive and a lot cheaper than real persons.

Nobody denies that there are a small percentage patients who either prefer to deal with real persons or whose illness demands complicated decision-making that only real-human being could pass judgement. For these patients, "real" medicare workers needed to be present. But for the vast majority of patients, computers can do much better jobs than real persons.

The healthcare system should give patients choices, majority of patients do not need to talk to pharmist

Yup, I've worked at a pharmacy as a pharmacy assistant in past summers. I've also taken courses in health information systems and know the challenges with e-health records and the holy grail of diagnosing systems that were supposed to replace doctors many years ago. A pharmacist will check the prescription for prescribing errors, which can include drug interactions, presciptions that just don't make sense for a given patient... prescriptions that deviate from the patient's normal regimen and need investigation because the doctor may have made a mistake, prescribed medications that are no longer recommended for a given indication, prescriptions of second-line therapies when the first line option hasn't even been tried, prescriptions that seem to have been refilled too early/late (patient may have over/underused), drug interactions with herbal medications, prescriptions that a patient reveals to the pharmacist (but not the doctor) that they don't really want to take and want an alternative at which point the pharmacist has to call the doctor to suggest changes, etc. Now, not all pharmacists will do their job properly, but that goes for any occupation. I've worked with a range of pharmacists from the just-check-for-major-drug-interaction types to the kinds that do all of what I said and beyond. And, no it's not a small % of patients that need a real person to deal with these problems. Far from it.

The computer easily check drug interactions between pharmaceuticals, and it will get every single drug interaction that a pharmacist may not even know (minus the newest discoveries disseminated via journals) but again as I said, it will flag a lot of drug interactions that may or may not be important for a particular patient depending on when/how the patient is taking the medications or it may be a minor interaction where the benefits of the medication are still greater than the negatives. It will flag early refills but it cannot investigate and see if this is actually something to be concerned about. That is all the pharmacy software can cover AFAIK. Even if the software manages to be able to flag everything from improper meds depending on the indication, previous history, herbals, etc with the upcoming comprehensive e-health records, you still need a human element to talk to the doctor or (mostly) patient to see if it's a real problem.

This is why we still have a lot of human tech support to deal with relatively less risky situations like slow or crashing PCs, and this is why those dispensing machines are still going to need pharmacists to interact with the patients and check the prescription unlike what you thought they were supposed to do. It's going to take a long time to design a system that is good enough for dealing with human lives.
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elmst200 wrote:
Feb 16th, 2011 2:34 pm
a pharmacist can NOT know more than a computer on drugs, a computer can easily have encyclopaedia knowledge of drugs, no human being can.

computer drug-dispensing system can easily figure out and fix doctor's screwed-up prescriptions. no problem.
Name one existing system that can do that. And no, I'm not just referring one that flags early refills or drug interactions. It has to take into account unique patient situations and be able to respond to them and carry out a conversation with doctors in a coherent, efficient manner as well.
elmst200 wrote:
Feb 16th, 2011 2:41 pm
what computer needs to tell patients are the drug perscription, usage, side-effect and others. if the patient is so confused after listening to the instruction from computer many times, he/she can easily pickup phone and call a real person. Most people and in 99% of situation would find the instruction from computer is more than enough and are satisfied. The small percentage of people who can not understand the instruction from computer are highly possible can not be advised by real persons, because real persons have the same information to be conveyed to the patient.
The drug dispensing systems available will not eliminate real pharmacists, as I said, there a small percentage of people who would prefer to deal with real person. for those people, they can do with real pharmacists, but are expected to pay much higher dispensing fees than those who use service from computer.

Why do I get this feeling you've never worked with human beings before?

And I do recall having this conversation with you before. IIRC, your argument ended up on focusing on the fact that AI may develop so highly in the future that they can account for all the unique patients and their unique responses. I'll pre-emptively respond by saying we don't have software that can do that well enough right now. We will in the future but how close that is remains to be seen. By that time, we'll also have some nice androids that we can't even discern from humans in a conversation. In the mean time, you'll have to put up with humans ensuring your health.
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Kasakato wrote:
Feb 16th, 2011 11:24 am
Who is going to monitor drug interactions, dependencies, advise elderly customers, etc? Robots will only compliment human pharmacists.

That can all be, and usually is, computerized nowadays.

If your pharmacy does not have a computerized automated drug interaction notification system, that automatically alerts you when you fill two conflicting perscriptions - switch pharmacies. NOW.
Takada wrote:
Feb 16th, 2011 4:22 pm
Name one existing system that can do that.
Shoppers Drug mart, Walmart, Costco, Pharmasave, Sobeys....

I don't know a pharmacy that DOESN'T do that.
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elmst200 wrote:
Feb 16th, 2011 1:47 pm
computer can do this much better than real human being. computer can even talk to patients using languages he/she can understand, whereas pharmacists can not. How many pharmacits can speak hundrends of languages? Every computer can.

One of the major problems of putting an automated system in place is that when something goes wrong (and yes, automated systems have flaws because they are designed by humans) they can potentially kill someone. And, odds are, it will affect a much larger number of people until the mistake is noticed.

Society as a whole seems to be more forgiving of mistakes by individuals than mistakes by an automated (computerized) process. To argue fewer mistakes will occur in an automated system is absurd until real-world data is obtained.
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I would imagine that a mistake by a machine would have the potential of being more detrimental than a mistake by a human, even if the plus side is the mistakes are less frequent. Unless there was some form of verification or double-checking.

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