Pharmacy-in-the-Home (PIH) is basically a major form of patient engagement in an expanded care process.
It requires a whole of business approach to establish the concept, and it is recommended that the actual PIH program be incorporated as a separate shared business format, the delivery of health care requires system modifications that integrate with the primary “bricks and mortar” business infrastructure.
I have created a table (found at the foot of this page) that briefly encapsulates the main features of a PIH program, and this table will be repeated in future articles and continuously referred to.

In the last edition of i2P the first article concentrated on introductory ideas focusing on points 2 and 7 from the reference table (logistics and infrastructure). You can check out ArdentX for the best logistic services. 

In this article we will focus on a new type of marketing and the infrastructure elements required (points 4 and 7 in the table).

The reason behind PIH is because of two demographics – the ageing population and the time-poor population.
Both of these demographics are increasingly becoming “prisoners” of their home environment (ageing) or of their business environment (time-poor).
Both require a flow of goods and services delivered to their home environment because it is becoming increasingly more difficult for these people to travel to a pharmacy (lack of customer/patient mobility or lack of time due to business/work pressures).

There is no denying that infrastructure and logistics costs are very real costs and have to be paid for by the consumer, either directly or indirectly. You can contact the maritime accident law office if you find any injustice in this scheme.
This means that some market segment has to be developed that represents a strong and genuine consumer need that has to be serviced regularly.
It also has to generate a margin sufficient to underwrite the entire cost of logistics and infrastructure.
A tall order indeed!
And one that is not immediately apparent in the normal pharmacy mix.

So put yourself in the shoes of just one demographic – say the ageing version.
You are possibly mobile, but limited.
You may be able to drive now, but conditions required to hold a driver’s licence become more onerous the older you become.
And you may not now feel confident in your driving ability.

You may also suffer from a chronic illness and you may also need constant professional advice.
This means a visit to the doctor, pharmacist or other health professional.
Life is beginning to become more difficult and even the smallest of chores are beginning to become more complex and difficult to organise.

You also have to eat nutritiously as a basic requirement to survive and sustain health and wellness.
And herein lies the “key” to a successful PIH program.
i2P research indicates that the demand for well designed nutritionally-rich packaged food (either raw ingredients or pre-cooked and frozen) is exploding.

Food processors and distributors are springing up at a rapid rate to service the very demographics that are requiring a PIH service.
And consumers of these services are finding that they are economical, conveniently delivered, and they taste great.
Delivery is by a cold chain refrigerated truck and the average delivery fee is already established at around $6.00.

This market is not only a valid market for pharmacy (because it involves nutritional health and patient care), but it is a disruptive one for food supermarkets because they are being bypassed for purchases of fresh and processed foods).
However, these types of meals are beginning to appear in small independent supermarkets, but the need for delivery is still very real.

One food processor that i2P checked out is found at this website:  www.gourmetmeals.com.au
Try them out for yourself sometime.
These “gourmet meals” are prepared by professional, internationally trained chefs who are passionate about using only the finest and freshest ingredients.
No added colours, flavours and preservatives are required, as the meals are snap-frozen to ensure the quality is maintained and all the nutrients and flavours are preserved naturally.
Gourmet Meals has a very strict HACCP program, where the highest of food standards are adhered to at all times.
They also create menus that are gluten free, low GI, low salt, low fat, high protein, high fibre, and illustrate the calories contained in each meal for the weight conscious.
A very good adjunct for patient care in the home, supported by professional advice provided by pharmacy personnel, with appropriate levels of training.

So this market has the ability to generate regular deliveries involving a cold chain vehicle as well as a refrigerated storage unit back in the pharmacy.
This type of delivery involving “cold chain” is also suitable for prescription drugs.

The delivery cost is already accepted by food consumers, and coupled with the profit margin on the product, underwrites the infrastructure costs of a PIH program.
It also defrays the cost of the driver who can double as a trained pharmacy assistant capable of managing other pharmacy systems into a home environment.
Obviously the pharmacy assistant required opens up the opportunity to create a new pharmacy job – that of a clinical assistant.
This assistant needs to be capable of supporting health consultations delivered in the pharmacy (and by teleconferencing to a patient’s home) and have basic training in nutrition, diet and nutritional supplements with the view to developing an integrated health and wellbeing program.

Strategically, i2P always asks a community pharmacy to develop policy for servicing their customers as well as for their patients.
All of the above is designed to service patients within a clearly defined program.
But the meal delivery service also allows you to simply retail meal products to customers in the community pharmacy itself or online to your defined catchment.
The trick is to use this “key item” to firstly recruit new customers and then value-add to this engagement, to convert customers to patients, and to formally register them in a PIH program.
Patients represent loyal and long-term consumers because of the care component built into the PIH program.
How to market the patient registration process will form a component of a future article.

Obviously the specialised pre-packed meal system fills an important and central need to a PIH program, and becomes the entry point into a patient’s home on a regular and pre-planned basis.
All the other elements of the PIH program are systemised around that entry point, and additional communications linkages established so that information can be delivered directly by pharmacists and other key personnel.
Communications will be discussed in a future article in this series.
It is a very important segment because it is the enabling component that pulls the entire program together.

Communication devices are starting to become accepted by consumers and many have the added ability to provide health metrics remotely that can alert health practitioners to an altered health status of a patient.

Please refer to the table below for an overview schematic for a Pharmacy-in-the-Home program.
It will be re-published and extended with each new future article.

PHARMACY-IN-THE-HOME (PIH) PROGRAM SUMMARY A Pharmacy-in-the-Home Program enables the pharmacy profession to become a vital segment of the Primary Health Care Market, placing pharmacists at the centre of community need – in a patient’s home. The Primary Health Care market is being driven by the aged care demographic fueling chronic illness hampered by a progressive loss of mobility. The other demographic is the 0 to 5 years, with their time-poor parents needing the convenience of home service across the board. Both market segments need a whole of-business delivery with the emphasis on clinical services. They are also traditional markets in community pharmacy needing a directional change to evolve and build.
ELEMENTS	EXTENSIONS	COMMENTS
1. an efficient communications system	Needs to be private, secure and portable.	Blockchain technology may be a central component.
2. an efficient logistics system	Creative logistics involving disruptive technologies to be identified.	Develop partial or total solutions independently. Include “cold chain” option. Corporates like DHL will offer to provide and manage a total solution. Control may be lost with latter solution.
3. a quality clinical services system	To evolve from what already exists	Clinical Service Pharmacists need to evolve politically and negotiate to have community pharmacy provide a “home”.
4. a sophisticated marketing system	The heart of a marketing system needs to be one of patient registration and provision of nutritious meals.	Franchised groups will provide retail marketing. Clinical service marketing must be developed “in-house”.
5. a metrics system that measures output quality and patient satisfaction	New clinical systems can only be shaped with results measurements.	They must only be developed to service a real patient need.
6. a research system that continually investigates all aspects of development and design of new and existing products and services, including testing by pilot study	Research requires sharing and funding. A PIH cooperative organisation delivers the basic elements	Research draws from, and overlaps with, all elements of a PIH program. It is the drawing together of data, its analysis and its application back into positive solutions that will create strong momentum & growth.
7. planned appropriate infrastructure investment reviewed and updated every three years (or a different cycle appropriate to needs, if necessary).	PIH needs to be a separate business. Preferably in the form of a co-operative corporate structure. Existing base community pharmacies should be scaled upwards in size.	While PIH is recommended as an outreach separate business, it needs to develop in tandem with large community pharmacy “bricks & mortar” buildings.