Pharmacy Directors Say Technicians are Valuable Investment
At North Mississippi Medical Center (NMMC) in Tupelo, the hiring and training of pharmacy technicians represents a big investment, and career development is an important tool for retaining these critical staff members.
“We don’t want to lose them to a phone job at the help desk,” said Patti Hawkins, director of hospital-based outpatient infusion and specialty pharmacy services.
That’s the sort of thing that happened years ago, before NMMC developed a 4-tier career ladder and convinced the human resources department to increase technicians’ pay to better match their training and responsibilities.
“We actually had to do something so our own system's departments weren’t recruiting people out from under us,” Hawkins said. “They were leaving to go to another department in the hospital that had an equivalent pay range but less responsibility and less-demanding work.”
Nowadays, she said, even entry-level pharmacy technicians are certified by the Pharmacy Technician Certification Board (PTCB) and undergo 2-3 months of structured on-the-job training and competency assessment. These technicians are responsible for traditional dispensing-related tasks performed under the supervision of a pharmacist.
Hawkins and Kristie Gholson, NMMC’s pharmacy director, said tasks performed by higher-level pharmacy technicians include i.v. product preparation, purchasing, clinical data analysis, pharmacy automation oversight, prior authorization review, claims coding, and reimbursement documentation.
“We have found that that pharmacy background is applicable in so many ... functions other than just dispensing,” Hawkins said. “Technicians have turned out to be, probably, the most qualified individuals that work in ... areas that pharmacy is having to expand into.”
Specialized training and a 4-tier career path for pharmacy technicians have also been long established at UW Health, the University of Wisconsin-Madison’s integrated health system.
About 60% of UW Health’s roughly 500 pharmacy staff members are pharmacy technicians or other support personnel, said pharmacy director Steven Rough.
UW Health operates an ASHP/Accreditation Council for Pharmacy Education-accredited pharmacy technician training program.
But Rough said the pharmacy department’s increasing presence in ambulatory care settings means that some staff who are trained and credentialed as pharmacy technicians aren’t really technicians in the traditional sense.
Instead, he said, they are medication-access coordinators, policy reviewers for the organization’s pharmacy benefit management program, and assistants to pharmacists who perform point-of-care testing in anticoagulation clinics, among many other roles.
“If the pharmacy department is involved in any area in ensuring that drug use is appropriate for patients, there is a role for technicians,” Rough said.
He said pharmacy technicians participate in transitional care by handling prior-authorization requests for patients scheduled to be discharged from the hospital and delivering discharge medications to the bedside.
Future projects at UW Health include a pharmacy residency project that will place pharmacists and pharmacy technicians into the health system’s primary care specialty clinics to manage complex cases.
Clinic-based technicians will be involved in a pilot project to test whether they can efficiently handle prescription renewals under the supervision of a pharmacist.
“Rather than having nurses do the prescription renewals, we think it can be more cost-effective for technicians to do it,” Rough said.
And he said he’s interested in using telepharmacy technology for the remote supervision of some pharmacy technicians.
ASHP’s 2016 national survey of pharmacy practice in hospitals found an increase in the use of pharmacy technicians in two areas classified as nontraditional: (1) supervisory roles and (2) medication reconciliation activities, with technicians working with patients to produce a medication list for review by a pharmacist.
PTCB Executive Director Everett B. McAllister said information technology and automation, procurement, controlled substance documentation, medication reconciliation, prior authorization, and transitional care are all areas where pharmacy technicians could play a larger role in the years ahead.
Nowadays, he said, technicians are increasingly involved in leadership and supervisory activities; one program, he said, has a single pharmacy technician supervising 60 others.
In general, he said health systems are appropriately assigning to technicians activities that were previously exclusively performed by pharmacists.
“Anything that frees the pharmacist to do more of a clinical role, I think, is a good thing,” McAllister said. "Even the idea of doing the ward inspections, going out and inspecting crash carts, making sure there are no expired drugs on the [ward]—those are jobs that technicians can do that pharmacists have been doing.”
At UW Health, one such task is obtaining a medication history before a planned admission. Rough said pharmacy technicians take medication histories in advance by phone for about 90% of patients and enter the information into the electronic medical records system.
“Five years ago, pharmacists did that,” he said. “Now, when the patient comes into the organization, they have a med history ... for the pharmacist and physician to work with and reconcile.”
Rough said UW Health’s accredited training program for pharmacy technicians is a cornerstone of the organization’s support for advanced pharmacy services. Technicians are on UW’s payroll during their training, and the organization pays for their PTCB certification.
UW Health developed its technician training program, in part, because there weren’t enough qualified technicians in the local area to fill the organization’s job positions, Rough said. And because it can be difficult to find enough technicians to support the organization’s growing needs, UW actively recruits prospective technicians from local high schools and boys and girls clubs.
“There’s not a lot of other positions where you can get your education and training on our dime," he said. "We’ve made ourselves an employer of choice in the community by investing in their skill development.”
And he’s confident the evolving national healthcare enterprise will lead to new opportunities for pharmacy technicians and pharmacists to improve patient care.
“We always have to find ways to be more efficient, be more safe, be more accurate. So, I don’t think the pharmacist and technician roles will ever plateau,” Rough said. “The sky’s the limit.”
[This news story appears in the May 15, 2017, issue of AJHP.]