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Specialized Roles for Pharmacy Technicians


April 2016 - Vol.13 No. 4 - Page #18

The 2010 Pharmacy Practice Model Initiative (PPMI) challenged health systems to maximize the quality and safety roles of the pharmacist in direct patient care.1 Specifically, PPMI recommendation E4e recognizes that expansion of pharmacy technician roles is essential to this process. Other key guidance documents—including the Pharmacy Technician Initiative (PTI),2 the American Society of Health-System Pharmacists (ASHP) 2015 Strategic Plan,3 and the Pharmacy Technician Certification Board (PTCB) CREST Summit Proceedings4—support this thesis.

The expansion of pharmacy technician roles must be performed in accordance with applicable laws and regulations and with the caveat that technicians perform only tasks that do not require the judgment of a pharmacist and do so under the supervision of a licensed pharmacist.1,5 Developing and expanding specialized technician roles facilitates and supports pharmacists in providing quality, safe patient care.

Cedars-Sinai Medical Center (CSMC), an 886-bed acute, tertiary care teaching hospital in Los Angeles, California, is a level 1 trauma center and comprehensive stroke center that supports patient care, research, teaching, and community service. Clinical programs range from primary care to the treatment and research of heart disease, cancer, brain disorders, and solid organ transplant. The pharmacy department provides decentralized clinical pharmacy services with support from the central, research, and outpatient pharmacy service areas. Pharmacists and pharmacy technicians are actively involved in transitions of care initiatives. CSMC has made it a priority to facilitate technicians performing to the top of their licenses and, thus, has developed multiple specialized roles for its technicians.

How It Works

The pharmacist and pharmacy technician work as a team to support optimal patient care outcomes. As pharmacist roles have expanded from traditional to non-traditional areas, so have the roles of technicians. Specialized technician support assists in expanding and maintaining a high level of pharmacy services.

The ideal candidate for a specialty technician role is one who has completed an ASHP-accredited training program, has successfully passed PTCB certification, and has previous pharmacy technician experience. Desirable attributes for all specialty pharmacy positions include:

  • A commitment to ongoing learning and education
  • Time management skills
  • The ability to prioritize tasks and responsibilities
  • Effective verbal and written communication skills
  • The ability to work as part of a team
  • Critical thinking and problem-solving skills
  • The ability to be a creative, innovative agent for change

Desirable skill sets include:

  • Adept at mathematical calculations
  • Proficient with trade and generic drug names
  • Strong computer skills, including word processing and spreadsheet
    management

Specialty technicians work closely alongside dedicated pharmacists in their areas. Below are roles for specialized pharmacy technicians at CSMC.

Automation Technician

The automation technician assists with all pharmacy automation systems, including automated dispensing cabinets, robots, carousels, and medication packaging equipment. Selected job functions include:

  • Maintaining and troubleshooting automation
  • Assisting in the configuration, functionality testing, and rollout of new devices
  • Monitoring inventory based on par levels
  • Ensuring integration between the pharmacy information system and
    automation
  • Ensuring that medications are bar coded and will scan accurately
  • Assisting with staff development and automation training
  • Assisting with the preparation of training guides/job aids for staff
  • Performing quality assurance audits to ascertain staff proficiency in
    automation use
  • Identifying opportunities to improve efficiency, quality, and safety
  • Assisting with maintenance of the medication formulary databases for
    automation
  • Assisting in the development of clinical rules/alerts for automation
  • Special projects

A successful candidate for this position possesses mechanical skills; strong computer skills in word processing, spreadsheet manipulation, and database management; and problem-solving capabilities.

Compliance Technician

The compliance technician works closely with the compliance pharmacist to ensure compliance to regulatory and legal standards. Selected job functions include:

  • Coordinating the medication recall process
  • Educating medical center staff and orienting new pharmacy staff on medication management compliance, safety principles, and regulatory compliance
  • Reviewing external literature, alerts, and Web sites for new standards, rules, alerts, and information
  • Involvement in hospital and departmental medication management audits utilizing tracer methodology
  • Performing scheduled and ad hoc audits for medication management,
    regulatory compliance, and best practice adherence
  • Maintaining the department’s regulatory Web page
  • Assisting in the maintenance of the staff competency database
  • Assisting with the monitoring of temperature-regulated devices
  • Special projects

A successful candidate for this position demonstrates a fundamental knowledge of hospital and departmental operations and how/where to access regulatory, legal, and best practice information. The compliance technician possesses strong computer skills, especially in the area of spreadsheet manipulation, and demonstrates analytical and problem-solving skills. Additionally, knowledge of automation is essential.

Investigational Drug Technician

The investigational drug technician’s responsibilities include assisting the investigational drug pharmacists in preparing, controlling, distributing, and accounting for medications provided to patients in clinical research trials. Additional selected job functions include:

  • Managing investigational drug and supply inventories and tracking expiration dates
  • Collaborating and cooperating with other members of the study team, including study monitors and coordinators
  • Monitoring for protocol compliance
  • Assisting with database management to support research efforts with
    inventory control, billing, and workload statistics
  • Coordinating initial and subsequent sponsor visits
  • Ensuring compliance with regulations, policies, and study protocols
  • Organizing protocol binders and research-related files
  • Assisting with preparation of job aids for orienting and training health care personnel on protocol specifics

A successful candidate for this position must be accurate, detail-oriented, able to multitask, and capable of maintaining a clean, organized work environment. The technician must be certified to prepare sterile compounds per the department’s policies and procedures for sterile product preparation, and must be able to navigate and utilize the pharmacy information system.

Patient Assistance Technician

The patient assistance technician performs a critical patient care function: investigating and identifying opportunities for patient assistance, copay assistance, or drug replacement for patients on high-cost therapies or for those who need financial assistance to obtain vital, often life-saving, medications. Selected job functions include:

  • Identifying patients who would benefit from a patient assistance program
  • Helping patients apply for medication assistance, copay, or drug replacement resources
  • Working closely with physicians, nurses, pharmacists, and financial personnel throughout the patient assistance process
  • Tracking enrolled participants and patient appointments, and ensuring adequate medication supply at the time of appointment
  • Ordering replacement medication in a timely manner
  • Monitoring payments received from programs

A successful candidate for this position possesses excellent written and verbal communication skills. The technician must be familiar with ICD-10 codes and be able to locate information related to medications, regimens, and FDA approval status. This position requires excellent interpersonal skills, including compassion, empathy, and sensitivity. Organization, follow-through, and an ability to manipulate spreadsheets also are essential attributes for this job. An understanding of insurance and billing is helpful.

Specialty Medication Technician

The specialty medication technician is responsible for the preparation, distribution, and control of oral and injectable specialty medications provided to specific clinic patients. Selected job functions include:

  • Obtaining accurate and complete home medication regimens from patients
  • Contacting patients prior to the refill date to verify medication compliance and inquire about possible side effects
  • Assisting in the prior authorization process and managing the status of submitted requests
  • Identifying and assisting patients with accessing patient assistance, copay assistance, or drug replacement programs
  • Maintaining an adequate inventory of identified specialty drugs
  • Ensuring prescriptions are properly prepared and packaged for shipment when needed
  • Assisting with insurance reconciliation

A successful candidate for this position possesses good communication skills, is able to solve problems, and can effectively utilize inpatient and outpatient pharmacy information systems. Comfort with continuous learning is necessary to remain current with rapid developments in the specialty medication market.

Medication Reconciliation Technician

The medication reconciliation technician assists the pharmacist with patient medication reconciliation functions to assure medication safety and provide a smooth continuum of care by decreasing any potential drug-related problems due to incomplete or inaccurate information. Selected job functions include:

  • Obtaining a prior-to-admission (PTA) medication list from a variety of sources, including the patient, family, caregivers, outpatient pharmacies, physician offices, dialysis centers, and skilled nursing facilities (SNFs), for pharmacist review and reconciliation
  • Compiling discharge medication lists and the corresponding SNF admission lists for pharmacist review and reconciliation
  • Communicating effectively with patients, families, caregivers, and other health care providers in the performance of their duties
  • Utilizing technology to obtain and communicate medication information, document activities, and process prescriptions

A successful candidate for this position possesses a strong retail pharmacy background, is proficient in trade/generic names, and is familiar with the therapeutic classes of drugs. The technician should exhibit customer service skills that demonstrate sensitivity to the needs of each patient. Also, the ability to navigate the electronic medical record and an understanding of the formulary status of medications are desirable attributes.

Controlled Substance Surveillance Technician

The controlled substance surveillance technician assists the pharmacist with collecting, collating, maintaining, and auditing records of controlled substance utilization within the organization. This information is related to the procurement, dispensing, distribution, and administration of controlled substances. Selected job functions include:

  • Maintaining controlled substance records and audits in an orderly, retrievable manner
  • Preparing and distributing reports related to controlled substance utilization
  • Serving as a member of the interdisciplinary monitoring team

A successful candidate for this position must be detail-oriented, demonstrate problem-solving skills, and have excellent written and verbal communication skills. The ability to extract and analyze data and reach a valid conclusion is essential for this position.

Advancing to a Specialty Technician Position

Pharmacy technicians at CSMC have the opportunity to advance through a voluntary, progressive career ladder (levels I, II, and III) that supports learning and the development of new knowledge and skills. Newly hired technicians begin at level I, although technicians who have the experience, expertise, and skill set necessary to successfully fill a specialty position may be hired directly into specialty positions. Promotions to levels II and III are based on specific criteria, and requirements for each level must be satisfied annually to maintain status.

Specialty technician positions are level III positions. In addition to meeting the requirements for levels I and II, level III technicians are recognized for excellent job performance, their ability to work in a variety of areas and assist with multiple department projects and initiatives, and are considered trusted information resources by their peers and the department. Compensation is commensurate with the technician’s level on the career ladder.

Conclusion

Developing advanced roles for pharmacy technicians frees pharmacists to focus on clinical pursuits and improves patient care. Moreover, encouraging technician career advancement improves job satisfaction for technicians. Uniformly, technicians in specialty roles demonstrate pride in their work, enjoy the challenges of their unique positions, and appreciate the ability to assist patients, other health care providers, and the public.

References

  1. 1. Zellmer WA, ed. Pharmacy Practice Model Initiative. Proceedings of the Pharmacy Practice Model Summit: An invitational consensus conference conducted by ASHP and the ASHP Research and Education Foundation, November 7-9, 2010, Dallas, Texas. http://www.ashp.org/doclibrary/ppmi/ppmi-summit-proceedings.aspx. Accessed 11/30/2015.
  2. 2. American Society of Health-System Pharmacists Web site. Pharmacy Technician Initiative. http://www.ashp.org/menu/PracticePolicy/ResourceCenters/Pharmacy-Technicians/Accreditation-Initiatives/Pharmacy-Technician-Initiative. Accessed 11/30/2015.
  3. 3. American Society of Health-System Pharmacy Web site. 2015 ASHP Strategic Plan. http://www.ashp.org/DocLibrary/AboutUs/2015-ASHP-Strategic-Plan.pdf. Accessed 11/30/2015.
  4. 4. Pharmacy Technician Certification Board Web site. C.R.E.S.T. Proceedings. https://www.ptcb.org/docs/about-ptcb/ptcb-2011-c-r-e-s-t-summit-proceedings.pdf?sfvrsn=0. Accessed
    11/30/2015.
  5. 5. Myers CE. Opportunities and challenges related to pharmacy technicians in supporting optimal pharmacy practice models in health systems. Am J Health Syst Pharm. 2011;68(12):1128-1136.

Diana Laubenstein, PharmD, is a pharmacy manager at Cedars-Sinai Medical Center in Los Angeles. She is a graduate of the University of the Pacific. Diana’s professional interests include pharmacy operations in the central pharmacy, OR, and in procedural and diagnostic areas.

The author would like to acknowledge the contributions of the following individuals in the development of this article: chief pharmacy officer Rita Shane, PharmD, FASHP, FCSHP; pharmacy technician supervisor Margarita Fedorova; and specialty pharmacy technicians Ashenfi Abebe, Anitha Bheemanpally, Seth Campos, Frank Diaz, Peter-Dat Do, Eliot Han, Debra Holm, Jonathan Polintan, Mykhael Stynnett, Jakerris Williams, and Parveen Zaman.

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