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Pharmaceuticals

Why dosage matters in menopause treatment

By Rizvan Faruk Batha MPharm, PGDip GPP, IPresc, MRPharmS, Superintendent Pharmacist of Specialist Pharmacy.

Bioidentical Hormone Restoration Therapy (BHRT) is an alternative option to traditional synthetic HRT, using bioidentical hormones to treat hormonal conditions in both men and women. BHRT is compounded medicine and put simply, means that the individualised ingredients are mixed together under the direction of a qualified prescriber’s prescription to meet the tailored needs of a patient.

For women going through menopause, compounding treatments are often prescribed later down the line, when a woman has been unable to settle on the appropriate dose of HRT with a General Practitioner, often experiencing severe side effects from either too much or too little HRT. In short, compounded menopause medication offers another route for those patients where the licensed preparation is not appropriate or hasn’t worked.

Patient-led care plays an important role in compounded menopause medicine because the patient is involved throughout the process; during the consultation with the prescribing practitioner, and with the pharmacist developing the customised dosage.

One of the biggest challenges faced by compounding pharmacies is the drugs being classified as unlicensed. For drugs to be licensed, it involves research and clinical trials to assess the efficacy, quality, and safety of the medicines, and because of this process, more often than not it is the recommended route to prescribe licensed medicines. That being said, prescribing unlicensed compounded menopause medicines may be necessary, especially when it comes to the patient’s specific need and interests and where licensed medicines have been unable to satisfactorily meet the needs of the patient or are unsuitable for them.

Utilising compounded menopause medicine as a method to enhance patient care could be beneficial for the many patients that need specific dosing or formulation requirements, but sadly more often than not we see delays to patient needs and treatment, as the rise of mass manufactured licensed medicines have grown in popularity. Compounding menopause medicine could offer huge potential for many, but prescribing practices have moved towards evidence-based medicines because of the responsibility imposed on prescribers for prescribing compounded therapies. Clinicians need to understand that even licensed products are not safe or effective for all patients particularly if the product is being used in a population that were not part of the original clinical trials for the drug.

It is important to know that compounding pharmacies and pharmacists in the UK are also regulated and licensed by the General Pharmaceutical Council (GPhC). The GPhC set standards for pharmacists and pharmacies to meet to remain on their register with the aim to protect the public and give them assurance that they will receive safe and effective care when using pharmacy services.

So even though compounded medicines are ‘unlicensed’, there is a lot of due diligence exercised by the pharmacists to ensure the products meet the safe and effective care criteria. This is generally demonstrated through the purchase of medical grade active and inactive pharmaceutical ingredients (with certificates of analysis and safety data sheets), trained staff, following and updating SOPs, audits, traceability of ingredients and products during recalls, as well as continuous learning and error reporting being supported in the pharmacy.

Ultimately, how compounded menopause medicine is viewed will depend on the knowledge and experience of the patients and professionals involved. Although the medicine is unlicensed it is important to understand that experienced clinicians and pharmacists involved in the process of making the decisions are regulated, and patients are consistently monitored during their response to the medicine. If compounded menopause medicine was integrated in the healthcare system, it could change and improve the quality of life of many patients suffering with debilitating menopause symptoms, and we hope as a pharmacy that in the future we will see a shift in how compounded medicine is viewed.

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Pharmaceuticals

Improving Patient Experience: How To Utilise an Interactive Whiteboard in Hospitals

Hospitals and healthcare facilities face a unique set of challenges every day. Patients comprise most of their daily visitors, and no two cases are alike. Yet it’s crucial that medical staff deliver a stellar patient experience for each individual they see.

Of course, long waiting times, confusing information, and other issues can get in the way of this. And when the patient experience suffers, the hospital’s reputation does as well. Bringing in technology such as interactive whiteboards offers a practical solution, and they’re easier to manage than ever.

How Patient Experience Affects Your Bottom Line

Even in facilities featuring top doctors and services, patients will walk out after just one negative interaction. This might include missed or cancelled appointments, faulty or inaccurate diagnoses, and surly customer service staff. Notice the one thing common with these examples? Often, a negative patient experience comes from a problem with communication—or a complete lack of it.

By nature, the medical practice is busy, and miscommunication can be hard to avoid. But it only takes one highly publicised negative experience to undermine a healthcare company’s reputation. Once word spreads about long wait times, cancelled appointments, unresponsive staff, and misunderstood diagnoses, your bottom line starts sinking.

So, how do healthcare organisations improve their communication systems and deliver a better patient experience? Usually, a communication problem requires a communication solution.

Use Technology To Improve Communication and the Patient Experience

To improve communication between your medical professionals and their patients, don’t reinvent the wheel. There are plenty of existing technologies that help bridge communication gaps and increase engagement levels.

For instance, use monitors to post regular updates in the waiting room and let patients know how long they’ll have to wait. Displaying the order in which patients are being treated offers transparency about how long doctors typically meet with their patients. This way, those in the waiting room know what to expect in terms of when they might be seen.

You can also lean on presentations or videos to help patients better understand their diagnosis and treatment plans. This can free up the doctor’s time and give patients another way to process information.

Among the more popular and easy-to-implement ways to improve communication are interactive whiteboards. Through touchscreen technology, these smart devices help make information more accessible for both patients and medical teams.

4 Ways To Use Interactive Whiteboards for Better Patient Experience

Why digital interactive whiteboards? Previous versions such as dry-erase boards and chalkboards were messy prototypes that relied solely on human handwriting. It takes time to write everything on the board. Plus, chalk and markers are both health and environmental hazards. (Besides, doctors have notoriously bad handwriting.)

Interactive whiteboards are a modern way to communicate with patients. You can use your fingers to write on these devices, and many programs will automatically transform handwriting into readable text. Even better, whiteboards can also serve as digital displays that play presentations, slideshows, videos, and images.

If you need to clarify a point, medical staff can annotate the whiteboard’s content directly. Finally, anything displayed on the interactive whiteboard can be saved into a file and printed. This allows both doctors and patients to keep records of their interactions for future reference.

Let’s review some of the other ways interactive whiteboards can improve the patient experience.

Hospital Branding

An interactive whiteboard in the registration area, waiting rooms, consultation areas, and patient rooms signals a healthcare facility’s commitment to communication. Waiting patients can quickly get updates about the current queue lines and estimated waiting times. In between, staff can display hospital information that can help raise brand awareness.

Whiteboards can also play interactive presentations that share the company’s mission, vision, and goals. Then, patients who want to know more can simply interact with the whiteboard to get additional information.

Personalized Care Planning

During consultations, healthcare professionals can easily share their initial findings and discuss the information with patients. Doctors can also use the interactive whiteboard to gather specific information from patients in order to come up with a more accurate diagnosis. Once a treatment is prescribed, patients can turn to the whiteboard to play videos or presentations that help them better understand the treatment process.

Patient Education

Interactive presentations that are catered to individual patients can help educate patients on the nature and treatment of their conditions. By clicking on the presentation via touchscreen controls, they can get more details of how treatment can reverse their condition. Patients can also view simulations of what can happen to them in the absence of treatment.

In addition, patients can use interactive whiteboards to gather more information about their healthcare facility, including its history, specialisations, and public staff data.

(Hospital) Unit-Specific Information

An interactive whiteboard in a hospital room can give doctors and nurses a quick summary of their patient’s current condition. At the same time, they can add changes or instructions so that attending staff can adjust accordingly. Confined patients or their companions can also access information from whiteboards that show updates on administrative matters such as billing, consumption summaries, and timetables.

For the Best Patient Experience, Interactive Whiteboards Need Reliable Device Managers

Interactive whiteboards can improve the patient experience by providing an always-ready communication medium. Because these smart devices are a substantial investment for any healthcare company, be sure to invest in a reliable device management solution to manage, maintain, and secure them.

The right device manager utilises remote cloud technology to provide over-the-air (OTA) updates to all connected devices. It can also control access levels by assigning authority to users based on need. What’s more, a well-designed device manager can secure devices by shutting down units that report unauthorised access.

Device managers can geolocate missing or stolen devices and start the retrieval process. Finally, admins can remotely wipe private data from the devices if there’s a threat of data theft.

As you can see, your choice of device management software can help you get the most out of your interactive whiteboards. Invest in a reliable device manager to maximise their performance for a more efficient medical staff and a better overall patient experience.

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Pharmaceuticals

Strong IP protection is vital to healthcare’s AI-encompassing future

Head of Innovation at InnoScot Health, Robert Rea analyses the challenges and opportunities of integrating artificial intelligence into the NHS

Artificial Intelligence (AI) offers huge possibilities for healthcare improvement, and many are already being realised – but it also presents complexities for innovators looking to protect their ideas.

We’ve seen NHS Scotland and its triple helix partners across industry and academia increasingly leveraging AI with the aim of continuously improving patient care while streamlining operations for smarter, more efficient working practices.

Projects already underway include  the use of AI to help detect lung cancer, assess mammograms and skin lesions, and be used to predict or monitor health conditions, to name just a few examples.

Such applications hold the potential to nothing less than revolutionise diagnosis, treatment, and management of patients.

Thanks to a bank of high-quality data-led insights and forward-thinking, innovation-ready staff, NHS Scotland and its partners are well-placed to take a lead on taking advantage of the benefits of AI transformation.

Those benefits should absolutely be explored fully for improved patient outcomes and predictive potentialities. However, in applying the vast possibilities of AI to Scotland’s healthcare system, we also must be cognisant of broader implications; and the recent legal debate over whether AI can be named as an inventor has generated much interest.

It is an area we at InnoScot Health have been closely following – ensuring protection of the intellectual property (IP) inherent in new ideas that involve AI can be complex, particularly depending on how much of the idea sprang from the AI itself.

Patents are used to protect novel aspects of inventions, stopping others from duplicating them – that much is clear cut – but in December, the UK Supreme Court made headlines when it upheld earlier decisions which rejected a bid to allow AI to be named as an inventor in a patent application.

In 2019, US technologist Dr Stephen Thaler had sought to have his AI recognised as the inventor of a food container and a flashing light beacon after claiming the software was sentient and conscious, but the intellectual property office (IPO) rejected this, saying only a person could be named as an inventor.

The decision was backed by both the High Court and Court of Appeal after they supported the view that only ‘persons’ could hold patent rights.

Dr Thaler was not deterred though, and in December, five Supreme Court judges dismissed a bid to reverse those decisions, concluding similarly that “an inventor must be a person” and that AI could not secure patent rights.

One of the judges Lord Kitchin, said the AI was “a machine with no legal personality” and that Dr Thaler had “no independent right to obtain a patent in respect of any such technical advance”.

The judgement, commentators noted nevertheless, did not specifically deal with the issue of whether the AI did in fact invent the food container and light.

While the IPO welcomed the judgement and the clarification it offered – labelling the dispute a “test case, rather than one which is motivated by any pressing need in the real world” – it added interestingly that the government will “keep this area of law under review to ensure that the UK patent system supports AI innovation and the use of AI in the UK”.

So, would the outcome have been different if the AI had come up with the invention, but Dr Thaler had been identified as the inventor and owner of the patent? That remains unclear, though what is certainly clear is that a lot of organisations would find themselves in a predicament going forward if they were not able to own the patent from AI software-led inventions.

It serves to underline the complexities that now stem from AI use and how its growing prominence and advancement could force law changes in future.

Patents are not the only area of intellectual property protection that are being tested by AI – copyright too is being reassessed in light of fresh developments in the likes of AI-generated works.

Does the copyright from the works belong to the original programmer of the AI, for instance, or does it belong to the user who is instructing it to perform the task?

In future, will companies who use autonomous AI have to declare that their employees were the inventors despite them having little to do with the actual creation?

The IPO recently stated that it acknowledges “there are legitimate questions” around how intellectual property looks on AI creations and decides who owns them.

It believes that any future changes would need to be considered on an international level, not just within the UK.

All Scottish healthcare leaders have been very clear on the deployment of AI – that it should supplement human expertise rather than replace it – and there’s no doubting how effective it appears to be in, for example, enabling review and translation of mammograms with high accuracy alongside clinicians’ experience and insight.

Used well, AI can become an important safeguard in such processes while making them faster and more efficient.

For AI innovators working in healthcare though, the securing of patents and copyrights may become increasingly complex.

Under UK patent law, the NHS, as employer, will usually own the intellectual property created by healthcare professionals in the course of their employment or specifically assigned duties.

Comprehensive AI policies must therefore adapt to encompass both current challenges in delivering its benefits in healthcare settings, while precluding issues from likely future advances.

With a robust, horizon scanning policy in place, AI-related innovation can flourish but with the peace of mind which comes through IP protection.  

Protecting the IP rights of the NHS represents one of the cornerstones of InnoScot Health’s service offering and why the organisation was initially set up.

We assist NHS Scotland in managing this IP, to ensure a return on investment for the health service. Any revenue generated from commercialising ideas and innovations from healthcare professionals is shared with the originator and the health board through a bespoke NHS inventor award scheme as detailed in individual employee contracts and health board IP policies.

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Lifestyle

Ushering in a more personalised healthcare system

Subhro Malik, Senior Vice President & Head Life Science, Infosys

Millions of users across England are using the NHS App to quickly access various digital services such as scheduling doctor appointments, checking their records, referring to repeat prescriptions etc. The UK government wants to extend the app’s usage with ambitious plans to enrich its features over the next couple of years, and eventually accelerate the digital revolution in healthcare. By March 2024, the government hopes to have at least 75% of the adult population relying on the app for a wide array of healthcare services.

These ambitions clearly indicate the growing acceptance of technology as an enabler of healthcare on a massive scale. In the modern context, public healthcare needs to be patient-centric, holistic, anytime and anywhere, and stakeholders are increasingly depending on technology to deliver at scale. Digital interventions can truly transform the way healthcare services are delivered and bring these in line with end-user expectations.

Technologies such as the Internet of things, artificial intelligence, big data analytics, blockchain, and wearables can enable remote monitoring, exchange, and capture of relevant patient information. Studies show that healthcare providers harnessing such technologies and digital solutions are better placed to improve patient outcomes. The use of data enables more accurate diagnoses, better decision-making, self-management, and personalization of care. Medical device companies are also adding value by embedding digital assistants and apps into their products to enable a more personalised user experience.

For example, patients ailing from cardiovascular diseases, diabetes mellitus, chronic pain, or spinal disorders are required to strictly following prescribed medication, exercise, and nutrition regimens to manage their condition. It calls for a high degree of health and nutrition literacy and support in tracking and monitoring regimens, while remaining mindful of ambiguities and consequences. Patients already grappling with chronic conditions often feel overwhelmed by the complexities involved. They tend to lean heavily on professional supervision and interventions, expecting support on-demand.

In such situations, digital health platforms can become their lifelines. By seamlessly integrating real-time data from medical devices, wearables, mobile apps as well as other digital devices, these platforms enable clinicians to remotely monitor each patient’s progress. Digital health platforms also aggregate and analyse data to produce insights tailored to help each patient. They focus on enabling self-management of chronic conditions, and forming positive habits, thus helping them work towards a better quality of life.

A host of digital tools such as virtual coaches and digital diaries are available today that make patient-centred care, a reality. Patients with chronic pain can record, monitor, and access their pain data, closely trace patterns. These insights that can inform and push them towards choosing a better diet, exercise routine, and lifestyle.

Patients want more accessibility to their healthcare provider and may require support anytime. However, this support can be hard to come by, especially at odd hours. On the other hand, one of the biggest advantages of virtual tools is that support is available anytime, anywhere. This makes them an ideal solution for patients with chronic pain to avail on-demand support. In the absence of a consistent in-person supervisor, they can use a virtual coach who remotely monitors and guides them through their medication and exercise regimens that are integral to pain management. They are also able to log their pain patterns, moods, sleep data, and activities and understand whether their coping strategies are effective or need improvement.

Undoubtedly, digital platforms are valuable in the management of patient care with their strong alignment to each patient’s expectation and needs of personalised care. They can play a key role in enabling easy access to reliable information, on-demand support, user-friendly navigation etc. There are challenges, however, that could derail the radical changes, which technology can bring to healthcare systems. For instance, research suggests that patients feel a natural reticence in sharing highly personal/confidential health data on an app or online tool. Patient sensitivities over data privacy and security breaches can override the advantages of any feature or functionality these apps promise.

After all, the success of personalised digital health systems depends on the extent to which patients can trust the healthcare provider with regards to: “Is my confidential data in safe hands? And is my care provider using the most relevant insights to deliver the care I need when it matters the most to me? Health care providers and medical device manufacturers investing in digital solutions need to address these concerns and plug systemic vulnerabilities, on priority. Some of the measures that have proved to be effective include implementing physical and digital access controls, electronic audit trails, and risk analyses. Of course, giving the patient the choice to share their personal information voluntarily and the choice to opt out is important too.

Ensuring the data safety and empowering patients with knowledge and choice will be key in shaping the future of digital healthcare.

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