President’s Platform

ON THE IMPORTANCE OF TECHNICIANS

Applying Resources Wisely as Pharmacy Scope Expands

BY HEATHER CHRISTENSEN, Pharm.D., clinical pharmacy specialist, ambulatory care, Spectrum Health West Michigan; president, Michigan Pharmacists Association

All teams everywhere continue to be tasked with doing more with less. But are we being intentional to ensure that our work is optimized for the safety of our teams and our patients? Pharmacy operations in our community sector have long been seen as unsustainable, putting our patients and our teams at risk. This continues to be a focus for the Michigan Pharmacists Association (MPA), as shown by the work of our Director of Government Affairs Brian Sapita. Reimbursement reform is a fundamental need in pharmacy practice. There is a consensus among some that workplace concerns will only be addressed once reimbursement is corrected, as this will balance out the costs of doing business. This balance would then allow for redistribution of financial resources and allow for overlapping staff to accomplish the basic functions of dispensing medication safely.

However, there is so much more to the practice of pharmacy than dispensing medications and supplies, which further alters the demands of how work is and should be done. A major driver that impacted how pharmacy professionals work today emerged from the Affordable Care Act in 2010. This law codified language that pharmacists coordinate care through the provision of medication therapy management (MTM) or chronic care management (CCM). Organizations across the nation continue to build upon the expansion of pharmaceutical care that started in the 1980s, with advances such as provider status, vaccine administration at the local pharmacy, prescribing oral contraceptives and telepharmacy – resulting in more work, important work.

The market currently demonstrates there is a surplus of pharmacists trained to work without sufficient jobs to support them. Conversely, we see that the pharmacy professionals comprising most of the workforce have not had adequate attention or support for growth: our pharmacy technicians. The advancement of pharmacy practice through expanding the scope of pharmacy technicians can result in fear among pharmacists that such changes would negate the role of the pharmacist.1 This fear is not new. It has been documented as early as 1970, but it has yet to come to fruition. Among the various roles I have worked in as a pharmacist in the past 14 years, I know without a doubt my work would never have been accomplished without the support of pharmacy technicians, and only when I have appropriate support through technicians can I do my best work.

Other concerns about growing the scope of a pharmacy technician relate to standardized training of pharmacy support staff, particularly the inconsistency within each state on whether a technician is licensed, registered or certified. There is not even a consensus as to the level of training recommended for technicians. Michigan recognizes two competing boards through which technicians can be certified: the Pharmacy Technician Certification Board (PTCB) or the National Pharmacy Technician Association (NPTA). These boards attest a technician has passed an examination with the baseline knowledge to work within a pharmacy.

In reviewing literature about the different ways technician roles have evolved, I saw reference to multiple studies that demonstrate technicians are as accurate as pharmacists when performing various tasks. Expanded roles for a technician include technicians checking technicians on accuracy of filling, the administration of vaccines, performing Clinical Laboratory Improvement Amendment (CLIA) screens with point-of-care tests and gathering baseline data to start the process of medication therapy management. Technicians have also seen a larger role with the development of telepharmacies. They work to collect patient information for outreach, scheduling, or for MTM or CMM; they help with patient assistance applications, where cost is a burden to adherence to medication; and technicians can be found working in primary care, supporting the team by working through formulary management and prior authorizations for the many different insurance plans across the state.

All these evolutions in practice are seen only through the lens of our pharmacy teams. When looking to improve care, we need to consider the lens of our patients. There are many barriers to receiving care, starting with the fact that everyone is busy and employers do not always support time off for medication consultation or pointof-care testing. There are barriers to travel as distances and transportation impact a patient’s ability to get to where care is offered. This has continued to drive the development of convenient care clinics, telemedicine and the expansion of work for pharmacy teams.

Technicians and the support they provide must be included in discussions about infrastructure advancements as they make up such a large part of our workforce. As professionals at MPA, pharmacy technicians are highly underrepresented within our membership. The noble practice of pharmacy is everchanging. You are the profession; you are the future. It’s important for each of us to consider how we impact our practice and the direction it is going.

REFERENCES:

1. B.Taylor, B.Mehta, The Community Pharmacy Technician’s Role in the Changing Pharmacy Practice Space. Innov Pharm 2020; 11(2): 10.24926/iip.v11i2.3325.