It is confident that in the future most of the dispensing system is replaced by robot and computer. The robot can dispense capsule, tablet, and possible cream and solution. It can count tablets and capsules. Actually, it really happens in USA now. The advantage of using robot is to reduce the dispensing cost (up to 66%, according to some commercial websites), increase the accuracy, increase the speed, spare manpower for patient education, reduce wastage of drugs and improve the tractability of the item dispensed to each patient.

When a prescription is received, it is checked by a pharmacist and the data is entered into a computer linking to a robot. The computer can warn pharmacist about the potential drug interactions, contraindication, and the possibility of incorrect dosing. After that, the data is sent to the robot, and the robot starts to dispense. Finally, the pharmacist checks the dispensed items and issues them to patients.

Though most of the well-developed societies have the system of separation of prescribing and dispensing (SOPD), it is still not being practiced in Hong Kong. The main reason for this is due to the power of doctor. It is far more than that of pharmacist. The fight for SOPD started in the early 70’s by Pharmaceutical Society. The details can be obtained from Pharmaceutical Society.

Anyway, it is confident that SOPD will be established in Hong Kong since it is the fate of all the well-developed societies. The time is still unknown. It may be as long as 50years or as short as 10 years. What is confident is that the fight is long, must be longer than the occupation of Japanese in Hong Kong (counting from today).

The advantages of SOPD can be summarised as follows:

1. Patient can receive the right prescribed items. Now, the drugs are dispensed by female workers (the so-called nurses) in private clinics. They do not receive any formal training. Their academic level is only F.5 (may be only a bare pass for 5 subjects), and possibly F.3 or lower. Would you believe that they would have a high accuracy of dispensing drugs, of course not!! The role for them is just simply sorting out the drugs and collecting money from patients.
2. Patient can know more about what drugs they take in. Pharmacist is the best professional who can give the best patient counseling but not the female worker in private clinics. When you ask about drug information, she may only answer it one out of ten or she may only ask you to ask the doctor. The door of the doctor is closed all the time, leaving the patient.
3. Patient can obtain better healthcare service yet with a lower price. In general, private practitioner likes to charge patients a lot. But after SOPD, private doctor can only charge for the diagnosis fee but the drug fee.
4. Closer link between patients and the primary health information provider, pharmacist. After SOPD, patient would like to assess pharmacy more frequently. As pharmacy is open to all the customers and the customers can see and ask pharmacist more easily and directly as compared to doctor (always inside a room). This can help improve the health consciousness of people.
5. Doctor can write their prescription more freely without considering the storage of his drugs in clinics. Since a private clinic would normally contain lesser drugs as compared to a pharmacy, a private doctor could write his prescription more freely.
6. Pharmacist can fully utilise his knowledge. Under the current healthcare system, pharmacist can only use his knowledge in a limited aspect. But after SOPD, this would certainly improve.
7. The female worker in the clinic does not need to deal with drugs, so they can act more like a “nurse”.
8. Pharmaceutical dealers and manufacturers need to promote their products less frequently in private clinics. So, sparing more time and effort for pharmacies.
9. The role of conflict between pharmacist and doctor would become lesser and lesser. Therefore, they can respect each other.

This is a new concept developed by me (I think). This concept applies to outpatient pharmacy hospital. What is open pharmacy? It means that the pharmacy is open to patients such that the patient can pick up their items by themselves. After seeing doctor and obtaining prescription, patient can go to the pharmacy and have their drugs picked up by themselves. The number of tables/capsules and the volume of liquid medicines would be calculated by computer after scanning their gum label. After that they know how much they should pick up. This is particularly helpful in reducing the cost for dispensing. Moreover, this can help patients know more about the layout of pharmacy.

Chronically ill patients may only need to take their medicines repeatedly for number of years. So, it is particular useful for them. After the drugs are picked up, they can their drugs checked by pharmacists and proper patient counseling would be given where necessary.

But first, Hong Kong people general knowledge of drugs should be elevated a lot in order to have it successfully implemented.

I predict this would happen in 2040 in western countries and 2080 in Hong Kong.