Today’s healthcare industry is a race between technology, policy, and support, with the endpoint for all of them being a more patient-centered approach. Technological advancements have made precision medicine possible, resulting in an explosion of data and inquiries healthcare informatics is still trying to keep up with. All these rapid developments spur policy-makers to periodically step in with (sometimes challenging) revisions.
While technological and legislative progress deserve to be celebrated, many healthcare stakeholders sometimes overlook the negative impact of increased work demands and stricter regulations on their staff. Pharmacies, especially, feel the brunt of technology-led spikes in workload. This is where untapped support personnel – Pharmacy Technicians – can come in to finish the race.
Moving Forward with More Responsibility
Pharmacies feel the brunt of the push and pull between technology and policy. The adoption of e-Prescribing through EHRs and Computerized Provider Order Entry (CPOE) systems is a prime example of how technology can lessen the burden of routine tasks on pharmacists. While this new found efficiency streamlined clinician workflows and reduced ADEs, the estimated 30% increase in drug order volume and a minimum 10% increase in picked-up prescriptions presented a new challenge for pharmacies.1,2
When pharmacists are overwhelmed with order processing and medication reconciliation tasks, the clinical and counseling aspects of their patient encounters are compromised. So, while today’s emerging generation of pharmacists are eager to expand roles and care services, many of the technical and administrative tasks that still fall under their purview take away from time that should be spent on pharmacist-led medication counseling. For these tasks, pharmacists rely on technicians.
While pharmacy technicians’ daily tasks vary according to setting, some areas and states have begun entrusting them with bigger responsibilities that save valuable time for both the pharmacist and patient. The American Society of Health-System Pharmacies (ASHP) features several case studies that found a distinct increase in productivity and profitability when technicians’ roles were advanced. Here are some evidenced examples:5
1. Obtaining medication and allergy history6
A hospital in Ohio employs board-certified Emergency Department Pharmacy Technicians (EDPTs) to conduct medication history interviews prior to admission. They can also do more intensive history-taking by contacting retail pharmacies, prescribing physicians, and nursing facilities.
Although Ohio state regulations still require a nurse or pharmacist to review an EDPT-obtained history, the study reported improved nursing satisfaction and quality of gathered information for pharmacists. Staffing levels were minimally affected by the redistribution of duties and hours.
2. Discharge prescription services7
A 550-bed academic medical center in Milwaukee entrusts pharmacy technicians with anticipating and completing discharge prescription services. These include clarifying insurance questions and resolving issues ahead of discharge, facilitating timely in-patient medication delivery, and promoting the hospital’s outpatient and mail-order prescription services.
The study revealed an overall cost avoidance associated with medication errors worth over $1.1 million. Nearly half of technician-led interventions prevented medication errors, and outpatient pharmacies experienced a 300% increase in discharge prescription capture rate. Additionally, 60% of patients that interacted with a pharmacy technician chose to fill and pick-up their prescriptions from an outpatient pharmacy.
Diane Halvorson, a Certified Pharmacy Technician (CPhT) and long-time member of the North Dakota State Board of pharmacy shares that most technicians desire a pharmacist-technician relationship that resembles the doctor-nurse relationship, where each role works complimentarily to each other to improve patient outcomes. If pharmacists’ roles are expanding, pharmacy technicians as support personnel should be prepared and trusted to grow alongside their teammate.3
Moving Forward with Standardized Support
The bedrock of any expanded role in healthcare is education and licensing or certification, as this establishes baseline knowledge, skill, and judgement. However, across the 53 US boards of pharmacy registered with the National Boards of Pharmacy (NABP), only 12 states offer pharmacy technician licensing, and 34 offer registration. Additionally, only 21 states mandate certification.3
“But as pharmacists look to move . . . into consultation rooms with patients, the need for safe drug preparation is not lessened. Enabling another health care professional with the appropriate set of skills and competencies to ensure the maintenance of a safe and effective drug preparation and distribution system seems the logical evolution of the practice.”
– Sam Lanctin, BScPharm, MBA, registrar of the New Brunswick College of Pharmacists
To address the need for standardized regulations and qualifications, The Pharmacy Technician Certification Board (PTCB) charged itself in 2013 with developing and implementing an Accredited Education Requirement for Pharmacy Technicians. Although the plan was set to 2020, PTCB members found it necessary to suspend it, as “additional deliberation and research are needed to address stakeholder input, develop supporting policy, and conduct further study of technician roles.”4
Today’s rapidly evolving medication-use systems and regulations emphasize the need for prepared role expansion among pharmacy support personnel. A pharmacy equipped with a user-friendly system that provides comprehensive drug information, interaction checkers, and dosing tools along with patient education resources is better prepared to safely increase the responsibilities of its pharmacist support staff and allow time to nurture patient relations, improve medication adherence, and improve job satisfaction.
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Resources:
- Porterfield, Amber et al. “Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting” Perspectives in health information management 11,Spring 1g. 1 Apr. 2014
- Paavola, Alia. “The Answer to Cutting Cost While Expanding Your Pharmacy’s Services? Remote Pharmacy Models, Says This Cardinal Health Leader.” Becker’s Hospital Review, 2 Oct. 2018, http://www.beckershospitalreview.com/supply-chain/the-answer-to-cutting-cost-while-expanding-your-pharmacy-s-services-remote-pharmacy-models-says-this-cardinal-health-leader.html.
- “Evolving Pharmacy Technician Roles Open New Doors, Pose Regulatory Challenges.” National Association of Boards of Pharmacy, Apr. 2017, pharmacy/wp-content/uploads/2016/07/Innovations_April_2017_Final.pdf.
- Humphrey, Laura. “PTCB Suspends Implementation of Accredited Education Requirement Originally Planned for 2020.” Pharmacy Technician Certification Board (PTCB), 23 Jan. 2017, ptcb.org/about-ptcb/news-room/news-landing/2017/01/23/ptcb-suspends-implementation-of-accredited-education-requirement-originally-planned-for-2020#.W-tSEpNKiUk.
- Barker, Alex. “9 New Ways Pharmacy Technician Roles Are Changing.” Pharmacy Times, 2 June 2015, https://www.pharmacytimes.com/contributor/alex-barker-pharmd/2015/06/9-new-ways-pharmacy-technician-roles-are-changing.
- Michaels RD and Meisel SB. Program using pharmacy technicians to obtain medication histories. Am J Health Syst Pharm. 2003; 60(19):1982-86.
- Smith, E, Fleming, R, Karpinski, T, et al. Project PRIMED (Pharmacist Reconciliation and Medication Education at Discharge). ASHP Best Practices Award in Health-System Pharmacy, 2011.