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By Todd Huseby
In an era where health care is becoming increasingly patient-centric, pharmacy chains stand at the forefront of a significant shift. The introduction of generative AI (GenAI) marks a new epoch of innovation, promising to redefine the landscape of pharmacy services. This technology is not just a tool for efficiency; it is the harbinger of a personalized future, where every patient interaction is tailored, every treatment is individualized, and every service is a step towards a more intimate health care experience. As we delve deeper into this transformative era, it’s essential to understand and embrace the potential of GenAI in revolutionizing patient care, ensuring that those who invest are well informed and poised to reap substantial benefits.
To fully grasp this potential, it is crucial to recognize what GenAI is and how it differs from traditional AI. Said succinctly, GenAI is the technology that enables machines to generate new content by learning from existing data. By contrast, regular old Artificial Intelligence (“Discriminative AI”) focuses on data patterns and uses those statistics to predict, without the creative element of content generation. In pharmacy services, GenAI intersects at the point of automating and personalizing patient care, streamlining operations, and enhancing decision-making processes. Recent statistics show a remarkable improvement in GenAI accuracy. Stanford’s “AI Index Report 2024” highlights the MedQA benchmark: In 2023, GPT-4 Medprompt, a medical AI prompting technique developed by Microsoft, “reached an accuracy rate of 90.2%, marking a 22.5 percentage point increase from the highest score in 2022. Since the benchmark’s introduction in 2019, AI performance on MedQA has nearly tripled.” Acknowledged, that’s not 100% yet, and hallucinations still occur. But as new narrow-purpose models are trained, we should anticipate super-human accuracy, quality and relevance in health care sector models in the coming years.
These advancements in GenAI are set to transform pharmacy operations, driving unprecedented efficiency and accuracy. Payors and pharmacy management teams surely are already counting on this. By automating routine tasks such as data entry, data review, more and better clinical reviews, and inventory management, pharmacies can significantly reduce the margin for human error and, importantly, free up pharmacists to focus on more critical, patient-centered activities. This shift not only streamlines workflow but also translates to considerable cost savings and increased productivity. For instance, it seems likely that automation will eliminate several tasks’ manual effort altogether and improve cycle time by more than 80%, leading to a more efficient use of resources and a better allocation of staff time. In the competitive landscape of health care, these improvements in operational efficiency are not just beneficial; they are essential for pharmacies aiming to thrive in an increasingly digital world.
Beyond operational efficiency, GenAI holds immense potential for enhancing personalized patient care. Personalized care, after all, is about understanding each patient’s unique needs and tailoring services accordingly. GenAI plays a pivotal role in this paradigm shift, offering unprecedented opportunities to enhance the patient experience. Building from available patient data, GenAI can provide customized medication recommendations, predict personalized health trends, and anticipate real-time individual patient needs before they arise. This level of personalization not only fosters a deeper patient-pharmacist relationship but also improves health outcomes by ensuring that care is relevant, timely and effective. In essence, GenAI acts as a catalyst for a more intimate and impactful health care journey, one that is truly patient-centric at its core.
Let’s consider a few pharmacy use cases that illustrate the transformative potential of GenAI:
• Straight-Through Processing of Data Entry and Data Review: GenAI using well-trained models can significantly enhance the accuracy and efficiency of processing prescriptions (eRxs). Transcription is straightforward, and the technology could perform multi-layered quality checks to verify data with negligible human intervention. Furthermore, GenAI can review clinical situations using the prescription, patient’s profile and all available relevant medical information, ultimately raising the standard of care.
• Third Party Insurance Engagement: Financial care is not health care. Learning from millions or billions of denied and successful claims, GenAI can be trained to understand the nuances of insurance adjudication (even by plan, by condition). Imagine fully automating pharmacy-payor communications to prevent or resolve adjudications, reducing the effort all parties spend on financial care to repurpose for health care.
• Personalized Patient Engagement: The use of GenAI in creating personalized patient engagement is groundbreaking. You’ve seen it: GenAI generates text, video, sound tailored to directed preferences. GenAI excels at personalized scripting, which can engage patients with personally compelling hooks, in their preferred language and communication channels … increasing the odds of behavior change and healthy outcomes.
These use cases not only demonstrate the practical applications of GenAI in pharmacy operations but also highlight its role in advancing patient care to new levels of personalization.
Personalized patient care can make a huge impact on U.S. health care, starting with senior pharmacy patients. The integration of GenAI into various devices is a game changer, especially for this demographic. For years we have chatted about the pros and cons of smart medication dispensers or alerts; with GenAI such tools could not only remind patients when to take pills but also make inquiries, collect additional information and offer personalized advice on managing side effects. Many octogenarians I spend time with use wearable health monitors (nice job, Apple Watch!) to track vital signs. No surprise that these wearables can alert both patients and caregivers to any concerning changes, facilitating early intervention. And, of course, devices like Alexa will get smarter, more integrated and more helpful too. These innovations, augmented with GenAI, will make health care (including drug therapies) more proactive, personalized and patient-friendly, enhancing the quality of life for seniors.
Given the transformative potential, now is a critical juncture for pharmacy chains to invest in GenAI. The technology has not only matured to a point where it can provide significant competitive advantages, but will continue to improve over the time horizon that new systems are built or bought. Investing in GenAI is not merely about keeping pace with competitors; it’s about strategically positioning your chain for the future. The value of GenAI lies in its ability to adapt to and predict changes in patients’ health care needs, ensuring that your services are visible and remain relevant for patient needs. By investing in this technology now, executive teams are not just future-proofing operations, but are setting new standards in patient care — positioning their pharmacies to be more relevant and more interoperable.
For U.S. pharmacy chains, the imperative to lead with GenAI is clear. It’s a strategic move that aligns with the future of health care — a future where technology and care are seamlessly integrated to deliver personalized patient experiences. Sure, there will be challenges and road blocks, and there will continue to be enormous ethical considerations. Yet it is unmistakable that as we look ahead, today’s visionaries who embrace GenAI will shape the health care landscape of tomorrow.
Todd Huseby leads the pharmacy sector team for Kearney, a global management consulting firm. The author would like to thank Microsoft Copilot and OpenAI ChatGPT for their help with this article.
