The internet will be an increasingly important communications medium for health care matters, and all practising pharmacists will need to know how to use it, congress participants were told at an FIP symposium on September 8.
Giving an introductory address to the symposium, Dr TONY D'EMANUELE (school of pharmacy and pharmaceutical sciences, Manchester university) explained what the internet was and how it could be used and accessed. It was the future for communications, he emphasised, and pharmacists had to embrace it.
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Tony D'Emanuele: internet is the future for communications |
In the opinion of Professor BILL FELKEY (Auburn university, Alabama, US), the internet would become "the point of patient care for pharmacy". Students at his university were already being trained to use and keep web-based patient records, and the internet could become a "global pharmaceutical care data base".
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Bill Felkey: internet "the point of patient care for pharmacy" |
Symptom recognition could also be achieved on the web. For example, an image of a patient's eye could be transmitted via the internet to enable identification of, say, conjunctivitis. Moreover, every patient would eventually have his or her own web page, containing health and drug information (eg, risks from allergies, drug interactions, etc) specific to that patient.
Dr OTTO WENDEL (Arizona school of health sciences, Phoenix, US), said that the web would become an increasingly important source of education for health professionals. For students, it removed barriers in terms of reducing the need to travel for education, and for teachers it provided exciting opportunities not available with other media. The instructor became a facilitator rather than a teacher, acting as a guide to students to appraise material they were using.
A geriatric pharmacy programme had been developed on the web to prepare pharmacists for the geriatric pharmacy certificate. This programme was less expensive (total cost $200) than more traditional style programmes, and students started with a 100- question assessment, drawn from the 19 modules that made up the programme. Computer graded assessment and feedback informed students what they knew already and identified their areas of weakness. This meant that students did not have to waste time on topics where they were competent, but could instead focus on topics where they were weaker. The assessment could be re-taken as often as necessary until the student was successful in all components and was then ready to take the certificate.
Looking at the status of web-based pharmacies in the US and Europe, Mr HUGH BROWNSTONE (vice-president, IMS Health) said that this sector was not yet quite as vibrant as might be expected. There were 30 web-based pharmacies in the US with a total combined prescription business of $250,000 a month and, although Harvard university had predicted that total prescription business would amount to $966,000 by 2003, this represented less than 1 per cent of the total US volume. Moreover, in Europe, web-based pharmacy activity was quieter still, although a few companies, including Boots, were involved.
But there was no room for complacency. Health was the most frequent reason (after pornography) for accessing the internet. By 2002, some 322 million people would be accessing the internet and 128 million consumers would be ready to buy "wellness products". With the potential availability of free computers and free internet access, the web-based health market would grow.
Worldwide, 44 per cent of physicians had internet access and 75 per cent of physicians in the UK, Canada and the US currently accessed the web each week.
For those who were sceptical as to whether web-based pharmacy could develop, it was important to consider several questions. For example, would health consumerism not increase in Europe and would governments not be keen to encourage electronic prescribing? Would wholesalers and pharmacy chains not be looking for new avenues of growth? And, most importantly, for pharmacy — did the local pharmacy have a more sustainable model than the web? With even smarter patients, the increased power of the web and the personal service of the small pharmacy, how could pharmacists become a more critical part of the landscape?
The need for effective regulation of the supply of pharmaceutical services over the internet was emphasised to the FIP council when Dr Tim Webster (executive director, American Society of Consultant Pharmacists) gave a special presentation at the council's meeting in Barcelona on September 5. He warned that the problem was likely to get worse before it got better. What was needed was consumer education and awareness about the risks involved in internet prescription activity.
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Tim Webster: worse before it gets better |
The American Medical Association had emphasised that websites offering prescriptions on the basis of a simple on-line "consultation" were not sufficient. Many such consultations merely involved filling in very brief details of the medical history and problem. Many websites also offered only a limited range of popular products, such as Prozac and Viagra.
Dr Webster said that he had recently been able to obtain a supply of Prozac without a prescription, without a consultation and without even knowing where the supplying "pharmacy" was. It had taken 10-13 minutes to place the order and the medicine had arrived the next day. The charge, including the cost of mailing, had been 30 per cent less than he would have paid at a normal discount pharmacy.
Dr Webster added that the National Association of Boards of Pharmacy (www.nabp.net) had introduced a "verified pharmacy practice site" programme to assure customers of the validity of pharmacy websites. Pharmacies that met the NABP's range of criteria were allowed to use a special logo on their websites.