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Innovating the Pharmacy Technician’s Role

New Paradigm Frees Up Pharmacists for Direct Patient Care

Dec 26, 2010

Illustrated by Matt Sweitzer ©2010 ASHP

AS PHARMACISTS EXPAND THEIR ROLES and carve out new niches in an era of health care reform, they are counting more and more on highly skilled pharmacy technicians to take on added responsibility.

Pharmacy technicians in practice sites around the country are performing tasks that were once considered solely the domain of pharmacists, such as dispensing medication, taking prescriptions over the phone, and managing error-reduction efforts. The result is tandem evolution: When pharmacy techs handle these duties, it frees pharmacists up to counsel patients and grow as key members of multidisciplinary health teams.

“Highly trained, skilled technicians are critical elements in a high-functioning pharmacy team,” said ASHP President Diane Ginsburg, M.S., R.Ph., FASHP. “If pharmacists are to achieve their highest calling—direct patient care—we must be able to rely on our technician workforce as our support system.”

In order for technicians to shoulder more responsibility, they will need more training and education. The push is on nationwide for standardization and accreditation.

“With the advancing role of pharmacists, we need technicians who are properly trained,” said Lisa S. Lifshin, R.Ph., director of program services and coordinator of technician program development in ASHP’s Accreditation Services Division. “Consumers are more in tune with their own safety, and they want someone who is trained to handle their medications safely.”

Portable, High-Level Skills

Heather Stremick, a student in the North Dakota State College of Science Pharmacy Technician Program in Wahpeton, checks the stock for a medication

The requirements for ASHP-accredited programs are stringent. Students must complete at least 600 hours of training and education that combine didactic components such as lectures and textbook learning, hands-on experience through lab work, and actual experiential rotations in real pharmacy environments.

The result of such an intensive mix of education is a thoroughly prepared pharmacy technician. This new type of worker has skills that are portable not just from environment to environment but also from region to region as more and more states ratchet up their standards and require pharmacy technicians to register with boards of pharmacy.

“We are a mobile society, and when techs train under accredited programs, there is an assurance that they have the same broad knowledge and training,” said Barbara Lacher, assistant program director and associate professor at the North Dakota State College of Science (NDSCS) Pharmacy Technician Program in Wahpeton. “They are not trained just to be a retail technician or a hospital technician. They have across-the-board training, and you know that anyone you hire out of an accredited program has had experience with things that nonaccredited programs might not offer, like vaccines, sterile products, IV preparation, and stress management.”

ASHP is not the only organization advocating for the professionalism of the pharmacy technician workforce. The National Association of Boards of Pharmacy, which has several technician training task forces, is advocating that technicians complete an education and training program that meets minimum standardized guidelines. It also recommends the use of a single accrediting agency
and a program that is developed by an established pharmacy organization.

Innovations in Pharmacy Tech Education

As the demand for highly trained pharmacy technicians grows, educators are using local resources creatively to offer comprehensive instruction to students. In Florida, Orange County Public Schools (OCPS) offers accredited pharmacy technician programs through technical schools such as Westside Tech in Orlando and Winter Park Techin Winter Park, where students range in age from 16 to about 40.

A pharmacy technician at Wishard Health Services, Indianapolis, utilizes the pharmacy’s electronic inventory.

“One of the toughest things [about setting up a program] was finding a way to educate full-time adult students and part-time high school students,” said Lori DeVeau-Diem, CPhT, a pharmacy technician instructor at Westside. “We had to juggle the schedule to ensure that the part-time students would get all of the necessary instruction and the full-time students wouldn’t have stretches of unoccupied time.”

The answer was to craft a modular program in which students can proceed at the pace that works best with their schedules and allows for one-on-one time with instructors as well as interaction with other students.

The heterogeneity of the student population benefits all involved, said John Diem, CPhT, director of pharmacy technician programs for OCPS. “Our students work extremely well together. The high school students challenge the adults academically, and the adults give them an example of professionalism and maturity,” he said. “It prepares them for working in the real world, where they’ll be working alongside people of all ages.”

At Southeastern Technical College, which has three campuses in southeastern Georgia, the pharmacy technician program stresses hands-on experience indifferent environments.

“My students do a lot of community service,” said Karen Davis, CPhT, pharmacy technology instructor at the Vidalia campus and former president of the Pharmacy Technician Educators Council. “They will work in patient assistant programs, do paperwork, conduct inventory, request medications, type labels, and more.”

Students in Southeastern’s program can rotate through different facilities as interns, where they learn how to be part of a multidisciplinary health team. “What students get in the classroom and lab should be reinforced at the work site,” said Davis. “By the time they have to take their tests for certification, they know how to do everything from data entry to IVs to total parenteral nutrition. The ASHP requirements are designed not for us to teach but for students to do.”

Looking Ahead

The future for pharmacy technicians is a bright one. The Bureau of Labor Statistics predicts that employment of pharmacy technicians will increase 31 percent by 2018 compared with 2008 figures, not only because pharmacists are expanding into more clinical roles, but also because prescription drug use will increase overall as the population ages.

The projected growth of programs is not just in hospital systems and traditional academia, said ASHP’s Lifshin. “We are getting a lot of calls from community and chain pharmacy representatives about how they can start an accredited program,” she said. “Health care is always a good avenue for schools to explore, and accreditation is their way of becoming more competitive. The voice of accreditation is a lot louder than it was just a few years ago.”

Davis sees pharmacy technician education evolving as the role of pharmacy technicians evolves. “Lick, stick, and pour jobs are all but gone,” said Davis. “Now that techs are working in triage, diabetes clinics, veterans’ programs, and so on, I think that eventually we will need national minimum standards. I can see the technician’s role expanding to the point where it will require an associate’s degree.”

Davis also predicts different levels of practice for pharmacy technicians and eventually specialization. “Pharmacists are asking for it,” she said. “They want technicians to be able to do things like take scrips over the phone. I can see someone calling us to request a technician for job placement and asking for a Level 1 pharmacy technician for one level of care, a Level 2 tech for more involved care, and so on.”

She added that pharmacy technicians and their educators should stay abreast of legislative changes within their states and continue to push for standardization and accreditation.

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  • http://Website Steve Pickette

    Elevating the level of the technician is a key part of a strategy to fully utilize the expertise of the pharmacist to improve patient outcomes. I applaud ASHP’s efforts in this area. We use certified technicians in most distributional work including checking product which allows our pharmacists to manage therapy.

  • http://Website Debbie Heckathorn

    Pharmacy technicians in my hospital are conducting patient interviews re: individual medication history. The data collected is analyzed by the pharmacist. Significant findings are shared with either the attending or consulting physician as appropriate. Our Med Exec Committee is pleased with our results to date.

    The pharmcy technicians also initate the contact with PCP of all scheduled admits to our facility to obtain current medication lists; and they work with the nursing care coordinators to prepare patint friendly discharge med instructions for our patients/families. All of this is part of our medication reconciliation process.

  • http://Website jeff Gibbons

    Lip service. All of it. The examples cited in this article might constitute a paltry 3% of the technician workforce. I have worked both chain and hospital pharmacy. Chain techs are still very much lick, stick and pour. 90% of the job. And the remaining % acting as register jockey, discount coupons and gift cards are what we handle. God help you if you have drive-up windows to cover as well. Also worked inpatient pharmacy at one of the more prestigious hospitals in the country, you know, the ones founded by the brothers long ago. No different. The job is refill, run and compound. The pharmacy mules. Dare not impose on the demi-god pharmacists. God forbid they get up to leave their chairs. As with chain, inpatient techs are the lowest paid workers in the hospital and maybe just above facilities workers. Attractive huh? That’s reality. I tried, as an older tech, to get into informatics and figuring I could specialize in that. Take some of the pressure off the PharmDs. Nope. Management decided only pharmacists could do that. Separation of duties. Techs are to blame as well. The certification, I have it, is really a window dressing. We need more BLS classes and the like but my hospital only reserves that type of training for doctors, nurses, pharmacists. Techs are pigeon-holed. And just look at the TV ads touting all the work available in the healthcare fields. Don’t bother unless you are a single female between 18-25, or single moms as well. But they will always be paid the minimum and meanwhile the educational requirements and CE continue to increase. A call for “nationwide standards.” At whose expense? Show me the money? Pharmacy technician is a “pass-thru” profession and always will be. For those on their way to becoming a pharmacist, doctor, nurse, etc. I doubt that paradigm will be broken in my working career.