Topics The Pharmaceutical Manufacturers Association of Japan (PMAJ) held the "Forum on Pharmaceutical Consultation and Response".
The Pharmaceutical Manufacturers Association of Japan (PMAJ) Pharmaceutical Consultation and Response Study Group held a forum on February 8, 2020 at Nomura Conference Plaza Nihonbashi (Chuo-ku, Tokyo) under the theme of "Considering how information should be provided to patients - with a view to the next generation". The forum was attended by 137 participants, including pharmaceutical consultation counter representatives from member companies, the Pharmaceutical Affairs Information Center of the Pharmaceutical Association of Japan, the Tokyo Metropolitan Hospital Pharmaceutical Association, and pharmacists from insurance pharmacies.
The venue
First, the Pharmaceutical Manufacturers' Association of Japan (PMAJ) Pharmaceutical Consultation Study Group shared case studies of new approaches taken by each company to provide information to healthcare professionals. This was followed by special lectures by Mr. Nobuo Mochizuki of the Department of Pharmacy, National Cancer Center Hospital East, on "How hospital pharmacists should provide information to patients with a view to the next generation," and Mr. Hirokazu Horikoshi, Director of the Japan Pharmaceutical Association and pharmacist at Marusho Pharmacy, on "The role of insurance pharmacies in a comprehensive community care system. ～Mr. Hirokazu Horikoshi, Director of Japan Pharmaceutical Association and Marusho Pharmacy Pharmacist, gave a lecture titled "The Role of Insurance Pharmacies in the Community Comprehensive Care System: To the Community DI Office. In addition, Mr. Yasutaka Sachika of Amazon Web Services Japan gave an invited lecture on "Introduction of Advanced Case Studies Related to the Present and Future of Health Care". Finally, a panel discussion was held in the form of a question-and-answer session using smart phones and questionnaires, a first for this forum.
Opening Remarks
The opening remarks were made by Sadahito Itabashi, Chairperson of the Pharmaceutical Consultation and Response Study Group. Based on the response to the "Guidelines on Marketing Information Provision Activities for Prescription Drugs," which came into full effect in October 2019, and the analysis of the impact of the guidelines on pharmaceutical consultation, Chair Itabashi stated that amidst the changes in the system and environment regarding information provision, as seen in the revision of the Guidelines for Response to Pharmaceutical Consultation He stated that he would like to take this forum as an opportunity to think about how the Study Group, which aims to "promote appropriate drug use," "realize patient-participatory medicine," and "improve the credibility of pharmaceutical companies," can deepen mutual understanding with pharmacists and how it should conduct its activities in the future.
New examples of efforts by each company to provide information to healthcare professionals
Akira Kamijo, a member of the Pharmaceutical Consultation and Response Study Group, introduced new initiatives by each company.
First, he introduced the "AI chatbot," which can provide information 24 hours a day, 365 days a year. Chatbots are being introduced for products that are frequently inquired about or for which inquiries increase for a limited period of time, as well as to make it easier to reach information amid the volume of information available. Some of the companies that have implemented chatbots were found to be directing customers to a telephone contact if they could not obtain information that met their needs.
Next, "Remote MSL and Remote MI" was introduced as a channel to respond to inquiries from medical institutions in a timely manner. The features of remote provision of information via a web conferencing system included not only timely response, but also flexibility in scheduling, shortened time to response, the ability to conduct interviews from any location, and the ability to share literature, charts, and other information by utilizing screen sharing. The companies that participated in the pharmaceutical consultation study meeting In a preliminary survey of companies participating in the Pharmaceutical Consultation Response Study Group, approximately 60% of the companies had already introduced or were considering the use of remotes, and given that most of them were remote MRs, it was noted that the provision of information via remotes may be actively promoted in the future.
Third, he introduced the provision of FAQs through keyword searches on the Web. He introduced examples of renewal in response to the "Guidelines for Activities to Provide Information on the Sale of Ethical Drugs," such as the addition of a consent button not only for obtaining personal information but also for providing information on off-label use, and the input of the history of the question.
The final presentation was an introduction of "PhindMI" (Ethical Drug FAQ Search Service), which enables cross-search of FAQ information provided by various pharmaceutical companies through a web portal site. Currently, only six companies are participating in PhindMI, but they introduced their strategies for future expansion, enrichment and standardization of FAQs, and raising awareness of the service.
Each company has launched a variety of initiatives, but these initiatives are also expected to be useful for medical professionals, as they will reduce the time until they can access the information they need, allowing them to spend more time on interpersonal tasks, and for pharmaceutical companies, as they can focus on more specialized inquiries and are also useful for business continuity planning (BCP). He concluded by saying that the system can contribute to the enhancement of medical care and the promotion of patient-centered medicine.
How hospital pharmacists provide information to patients with a view to the next generation
Dr. Nobuo Mochizuki of the Department of Pharmacy, National Cancer Center Hospital East gave a lecture on the activities he is promoting.
The first was an introduction of a multi-center shared QA database (PharMAINe) utilizing AI (Watson), which he said would make it possible to standardize answers regardless of facility, years of work experience, etc., leading to lower education costs and assurance of answer quality. At present, approximately 4,000 QAs have been registered or are in the process of being registered at the National Cancer Center, approximately 600 at the National Center for Global Health and Medicine, and approximately 2,500 at the National Cardiovascular Center. He also mentioned the merit of diversity in the original data by having multiple facilities share this database. He also emphasized the benefit of increased time for in-person work by being able to quickly reach the information one wants to know.
Next, he introduced the provision of information to patients via the website. He shared that the Pharmacy Department's website receives a large number of hits, and that they are trying to create the website with the target audience in mind.
Finally, he discussed the planned introduction of AI in the telephone consultation service for patients (Outpatient Chemotherapy Hotline). The system will include voice recognition, keyword extraction, suggestion of additional questions to patients (e.g., what is your fever?), urgency prediction, and triage. He also mentioned that an AI-based system is under construction to predict urgency and suggest triage.
In summary, he concluded that it is important to prepare various information dissemination tools according to the needs of the recipients, and that in the situation of information overload, a higher level of expertise is now required to provide information.
The role of insurance pharmacies in community comprehensive care systems - to the community DI office
Mr. Hirokazu Horikoshi, Director of the Japan Pharmaceutical Association and pharmacist at Marusho Pharmacy, gave a lecture on the activities he is promoting with the Pharmaceutical Association and the city's hospitals.
He introduced the efforts of the General Incorporated Association of Tennoji Ward Pharmacists (Tennoji Ward, Osaka City), focusing on simplification of inquiry for questioning. The Tennoji Ward Pharmacists' Association is unique in that it has many hospital pharmacists as well as insurance pharmacy pharmacists as members, and the agreement prepared by the Tennoji Ward Council for the Promotion of Drug-Pharmacy Partnership is exchanged between hospitals and insurance pharmacies. The Tennoji Ward Hospital and Health Insurance Pharmacies have signed an agreement to simplify the inquiry of questions through Protocol Based Pharmacotherapy Management (PBPM). The district's PBPM is characterized not by a "pharmacy association ⇔ hospital" relationship, but by a "individual pharmacy - five local hospitals" PBPM agreement, and the initiative was published as an original article in the March 2018 issue of the Journal of the Japanese Pharmacists Association. As a result of this initiative, many hospital physicians have evaluated it as beneficial to patients, the insurance pharmacy side has felt a reduction in workload due to fewer question-and-answer inquiries, and patients have experienced a reduction in waiting time and cost burden, resulting in a "three-way benefit" for all physicians, pharmacists, and patients.
In summary, he stated that insurance pharmacies of the future should play the role of a "community DI office" that connects the information held by pharmaceutical companies with medical professionals, because as community formularies, etc., progress, they will be required not only to provide appropriate drugs to patients, but also to provide appropriate medical information to medical professionals. He concluded by saying that although the Pharmaceutical Affairs Law has been revised and pharmacist services are about to undergo a major shift from "object-to-person" to "person-to-person," the reality is that insurance pharmacies handle pharmaceuticals (products), so rather than "object-to-person," it is important to focus on "both object and person".
Introduction of advanced case studies related to the present and future of health care
Mr. Yasutaka Sachika of Amazon Web Services Japan gave a presentation on overseas cases where the latest technologies are providing new patient experiences.
The first was an introduction of a case study of information collection available to consumers/patients. Reliability must be ensured when consumers/patients obtain healthcare information from the Internet and other sources. The American Heart Association (AHA, which provides training on cardiopulmonary resuscitation, etc. via chatbot) and the National Health Service (NHS, which provides information on health care by asking the smart speaker Alexa ), and the UK's National Health Service (NHS, which reads out information provided by the NHS when you ask questions about health care to the smart speaker Alexa).
Next, he introduced health consultations in the UK. Babylon Health's so-called "AI Doctor" provides services such as AI chatbot conversations with users, video calls with medical professionals, and appointments for outpatient consultations, all via a web remote system. He stated that the NHS in the UK has also adopted this service as a service of its own ministry and is developing a national policy to optimize access to medical care.
Finally, regarding medication management, he introduced the benefits of digitizing medication logs for inhalers as a case study. He emphasized that analysis of the accumulated log data will not only improve medication adherence, but also enable prediction of acute exacerbations, recommendation of correct medical consultation behavior, and personalized intervention for each patient.
In summary, he concluded that the evolution of "health tech" (a coined term for healthcare + technology) is essential not only to improve the value of patient care, but also to optimize the healthcare infrastructure.
Q&A Session
In this year's forum, instead of taking questions from the audience at each lecture, a new survey system called "UMU" using smartphones was used. The session was moderated by Committee Chair Itabashi and Committee Member Tadashi Umeda, and featured speakers Mochizuki and Horikoshi, as well as Naoko Sato, Chairperson of the Pharmaceutical Information Study Group of the Pharmaceutical Manufacturers' Association of Japan, and Norihiko Kushido, Chairperson of the same Group for the Development of Information Provision. The discussion was held with a sense of unity among the participants by collecting participants' questionnaires and questions to the speakers in real time.
One of the questions asked to the entire audience using the UMU was "What do you consider to be effective channels for providing information to patients in the next generation? was the first question. The results showed that (1) chatbots, (2) the Internet, and (3) applications accounted for about 75% of the total, indicating the participants' expectations for new channels.
The survey also asked, "What are the most frequently asked questions from patients to the company's pharmaceutical consultation service?" The panelists discussed the results of the question "What are the most frequently asked questions from patients to the Company's Pharmaceutical Consultation Service? The panelists shared their concerns that corporate pharmaceutical consultation would damage the relationship of trust between patients and healthcare providers if there is a discrepancy between the questions asked about (1) and (2) and what is communicated to the patient by the healthcare provider, and that the response should be mainly based on the information in the package inserts. Although there are differences in the provision of information to patients depending on their position (medical professionals or companies), the panelists discussed how to make patients more positive about treatment, how to give advice to patients so that they can discuss their concerns with their physicians, and how to make patients feel satisfied that they consulted a corporate pharmaceutical consultation service. The entire audience shared that these issues will be the subject of future discussions.
At the end of the session, the audience was asked if, based on the content of today's lecture, they would like to consider new initiatives or accelerate their current efforts to provide information to patients with a view to the next generation. The session ended on a high note.
Q&A Session
Closing Remarks
Tokuo Tanaka, Executive Director of the Pharmaceutical Manufacturers Association of Japan (PMAJ), began by expressing his appreciation for the record number of participants, the long and enthusiastic discussions among them, and the attendance of pharmacists and other interested parties. He also stated that the collection of Q&A using the smartphone system (technology) made the forum a different type of all-participant forum, and that he felt that the evolution of technology is truly changing our lives and livelihoods, and that the PhindMI, which started in October 2019, will also be more convenient for users due to the number of participating companies He also stated that he expects the increase in the number of companies participating in PhindMI, which will be launched in October 2019, to improve convenience for users and optimize the pharmaceutical consultation operations of companies. Even with the evolution of technology, the pharmaceutical consultation department remains the only point of contact for patients. He closed the forum by emphasizing that the gratitude of patients for calling and consulting with the pharmaceutical consultation department will surely lead to contributions to healthcare.
(Pharmaceutical Consultation Response Study Group: Toshiyuki Toyoda, Hiroyoshi Terashima, Masashi Katayama )