Primary Pharmacy Care Services Clinical Pharmacy Technician

Hospital/Site Name: University of Utah Health Healthcare System

Advanced Role Title: Primary Pharmacy Care Services Clinical Pharmacy Technician

ASHP Practice Advancement Initiative (PAI): This case study is a resource that supports the goals of PAI and the critical roles pharmacy technicians have in patient care. Important characteristics of current and evolving advanced technician practice models include training through an ASHP/ACPE- accredited training program, PTCB certification, and registration with a Board of Pharmacy.

Primary Intended Outcome(s):

1. Increase the ambulatory care pharmacist’s direct patient care bandwidth and capabilities 
2. Serve as bridge between the institution’s primary care clinic and the on-site pharmacy
3. Increase patient satisfaction in clinical pharmacy services by acting as patients’ primary point of contact to the clinical pharmacist team
4. Improve provider/prescriber efficiency and enhance patient care through assistance with medication access and logistic issues, provided to all providers/prescribers within the clinic
5. Improve visibility of clinical pharmacy services to patients and providers within the clinic

Site Description:

University of Utah Health (also known as U of U Health) is the Mountain West’s only academic health care system, combining patient care, the latest medical research and teaching to provide a leading-edge care team approach in a caring and personal setting. The system provides care for Utah’s and residents of five surrounding states in a referral area encompassing more than 10% of the continental United States. U of U Health is composed of 5 hospitals and 12 community clinics. Ten of those clinics make up our Primary Pharmacy Care Service (PPCS) team¹. Each clinic is composed of at least one clinical pharmacist, and a clinical pharmacy technician, with some teams also having pharmacy students and residents. One of our team’s main goals is medication management through a collaborative practice agreement. 

Advanced Role Description:

University of Utah Health Pharmacy Primary Care Services (PPCS) consists of clinical pharmacists and technicians working collaboratively with providers to manage chronic diseases at primary care clinics throughout the health system. PPCS technicians assist clinical pharmacists with administrative and patient care duties; utilizing their unique training to help the primary healthcare team navigate medication-related barriers to care. Typical daily tasks include scheduling patient appointments, managing referrals from providers, obtaining medication histories, running test claims, and assisting with affordability solutions. PPCS technicians also follow-up with patients to obtain blood sugar and blood pressure readings for the pharmacist to assess.

How to Start:

Prior to implementation of PPCS technicians, community pharmacy technicians did part-time work within the University of Utah Health primary care clinics as a support role to our pharmacists. It became necessary to create the formal role of the clinical pharmacy technicians as a cost effective option to increase the pharmacist’s efficiency. The pharmacist’s work processes were reviewed and technical functions identified that could be assigned to a trained pharmacy technician under the direction of the pharmacist.

Regulatory and/or Legal Requirements:

1. Presence of pharmacist on site
2. Active Pharmacy technician license from the Utah Division of Occupational and Professional Licensing
3. Privacy, regulatory and security training 

Revenue & Expense Parameters (abbreviated financials as applicable):

Mandatory costs include salary and benefits for the clinical pharmacy technicians. Workstations need to be equipped with computers, phones, printers, and software access and office supplies. There is no revenue currently associated with the clinical pharmacy technician role.

Training and/or education requirements:

• Licensed pharmacy technician in Utah
• Extensive team-based training approach based on shadowing existing technicians
• Training and development materials are reviewed and updated semiannually for the role
• Excellent communication and interpersonal skills
• Ability to prioritize workload and triage patient calls
• Strongly developed analytical and problem-solving skills
• University of Utah Health has a system-level technician career ladder with three levels (i.e. Technician I, II, III) most technicians hired on to this position started at level II 
• Advancement is based on experience, excellent behavioral and problem-solving skills

Outcome Measures:

Example. Include measures that worked and measures that didn’t work.

1. Increased patient reach and improved follow-up through technician-patient phone calls.
2. Improved collaboration between pharmacy services and providers through close proximity and coordination of hand-offs.
3. Improved medication access and patient satisfaction through medication affordability checks.
4. Decreased administrative burden on pharmacists to allow for more focus on clinical functions.

Lessons Learned:

1. Align rapidly growing clinical services with the organizational priorities for support at all levels of the organization.
2. Ensure all team members clearly understand their role in developing and advancing clinical care opportunities.
3. Develop policies and procedures that promote a consistent service to patients, providers and other practitioners.
4. Consider additional roles that fall into the professional scope of the clinical technician
5. Items currently being addressed:

1. Technician workflow with regards to the task load 

Standardization between clinics

1. Obtaining reimbursement from insurance companies for services provided by clinical pharmacy team 

References:

1. About Us, University of Utah Hospitals and Clinics