Training Technicians for More Responsibility

June 5, 2019
Ken Krizner
Volume 163, Issue 6

Training programs reflect the changing practice of pharmacies.

Product-wise, they’re worlds apart. Yet a common bond exists between fast-food restaurants and pharmacies: Both are expected to place a premium on customer service. For that reason-as surprising as it might sound-when Eric Shoffner, BPharm, PD, and owner of iCare RX in Newport, AR, is seeking prospective new pharmacy technicians, he sees fast-food restaurants as fertile ground for his search.

“There is always someone in the restaurant running around like a chicken with its head cut off,” Shoffner says. “Those employees are doing more than anyone else. They’re the individuals I target. I ask them to consider a healthcare occupation.”

Not everyone jumps at the opportunity. Shoffner estimates that three or four out of ten fast-food employees he approaches show interest. But if employees show potential in the fast-food environment, they stand a better-than-good chance at succeeding as a pharmacy technician, he believes.

Once a person who shows potential is found, technician training is an absolute must. As pharmacies have evolved, so has technician training. With pharmacists doing more patient counseling than ever before, it is up to the technician to make sure the pharmacy itself is running efficiently and safely.

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“My pharmacy is clinically oriented, and our pharmacists are practitioners,” says Dennis Song, RPh, owner of Flower Mound Pharmacy in Flower Mound, TX. “I shift a lot of the day-to-day responsibilities to my technicians.”

Not only do technicians need to know the “soft skills” of customer service, they need to be proficient in data entry and possess clinical aptitude-the “hard skills” of the job, Song says. 

“Technicians need to be ‘technical’ because there is so much to work through in terms of prior authorizations, insurance rejections, and other issues,” he points out. “There is no manual, so a technician has to be able to think through these issues and come up with solutions. Critical-thinking and problem-solving skills are a must.”

The Need for Training

Training is growing in importance because there is expected to be an increase in the need for technicians. According to the Bureau of Labor Statistics, nearly 450,000 pharmacy technicians will be needed in the United States by 2026. Training also reflects the broader changes in pharmacy. As pharmacists provide more patients with more clinical services, such as medication therapy, immunizations, medication reconciliation, and health screenings, technicians will shoulder a larger burden of the workflow.

“Even as we move toward the pharmacy becoming more of a primary healthcare destination, the traditional tasks will still continue,” says Jeremy Sasser, pharmacy content strategist for National Healthcareer Association (NHA). “Pharmacy technicians fill that void while pharmacists carry out clinical duties.”

There are numerous educational and training programsfor pharmacy technicians throughout the country, offered by colleges and universities, high schools, technical and vocational schools, allied health programs, career institutes, and training centers, as well as some sponsored by corporations and health systems.

The expansion of the role of the technician prompted the Pharmacy Technician Certification Board (PTCB) to change its eligibility requirements for the Certified Pharmacy Technician (CPhT) Program and update its Pharmacy Technician Certification Exam (PTCE). Beginning in 2020, PTCB will offer two eligibility pathways for technicians submitting certification applications-completion of a PTCB-recognized education/training program or equivalent work experience.

“Technicians are an integral part of the pharmacy team,” says David R. Bright, PharmD, BCACP, immediate past president of PTCP’s Certification Council and associate professor in the Department of Pharmaceutical Sciences at Ferris State University’s College of Pharmacy in Big Rapids, MI. “We believe the time is right to recognize and support the level of preparation that has become more standard in the field to advance medication safety and patient care.”

Students who complete a PTCB-recognized education/training program will be eligible to apply for and earn their CPhT credential. PTCB’s work experience alternative is for technicians who have completed 500 work hours and can attest to fulfilling specified knowledge requirements.

Aside from new eligibility requirements, PTCB recently granted more than 500 Compounded Sterile Preparation Technician (CSPT) certifications, the organization’s first advanced certification program, which was launched in December 2017.

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“Sterile compounding requires advanced knowledge, close attention, and skill proficiency to ensure patient safety,” Bright stresses. “This credential allows a pharmacy technician to mark their accomplishment and expertise in sterile compounding in a consistent way across the profession.” 

Once technicians are trained and working in the pharmacy, continuing education (CE) is a necessity to keep current with medication safety, new classes of medications, workplace performance and other responsibilities, says Liza Chapman, PharmD, FAPhA, vice president of partnership development for PTCB. The organization requires technicians to take 20 hours of CE every two years to maintain national certification. One of the required hours is on medication safety and another hour is on pharmacy law. 

In addition to the CPhT and CSPT accreditations, PTCB recently announced the addition of five assessment-based certificate programs for advanced technician roles, and an Advanced Certified Pharmacy Technician (CPhT-Adv) credential. 

The five certificate programs under development are Technician Product Verification (Tech-Check-Tech), Medication History, Controlled Substance Diversion Prevention, Billing and Reimbursement, and Hazardous Drug Management. Candidates seeking to be a CPhT-Adv will be required to have earned at least four of the new certificates to be eligible.

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Growing Responsibilities

PTCB’s program changes are based on data collected via a job task analysis survey of more than 40,000 respondents, as well as comments from technician employers, educators, state and national pharmacy associations, and state boards of pharmacy. 

The changes stemmed from input received at the 2017 Stakeholders Consensus Conference. That conference was instrumental because the American Society of Health-System Pharmacists (ASHP) and the Accreditation Council for Pharmacy Education (ACPE) revised their national standards for pharmacy technician education and training. 

The standards became effective for new programs at the beginning of 2019. Existing accredited pharmacy technician programs will be required to incorporate the new standards by Jan. 1, 2020.

The revised standards place additional emphasis on the educational outcomes expected of students and the methods used by training programs to assess competency. Competencies are defined to differentiate entry-level and advanced-level training, structural and process-related elements needed for program quality, and evidence-based outcome measures.

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The number of standards has increased from six to 15. Each standard highlights the key elements that must be met to demonstrate compliance. The key elements model those in pharmacist education and training programs and emphasize collaboration with pharmacists and other healthcare personnel.

The reassessment was prompted by several factors, including changes in state laws that allow for expanded technician roles, responsibilities, and authority, says Lisa Lifshin, BSPharm, director of program service for ASHP. 

“The preparation of medications is more extensive than ever before,” she notes. “There are more high-risk and dangerous medications to prepare–more than just a few years ago. Plus, new drugs are introduced all the time. The more technicians can be educated, the better.”

NHA’s new training product, PharmaSeer, exceeds ASHP’s revised standards. Sasser describes the product as a comprehensive approach to teaching individuals everything they need to know to practice as a technician. NHA markets its product primarily to employers and academic institutions such as community colleges and vocational programs. 

“We’re trying to take into account the marriage between didactic training and applying what is learned to hands-on tasks that go on behind the counter,” Sasser says. “We want to provide technicians with a baseline knowledge, so they can have confidence in the skills needed for the role.”

The Modern Pharmacy

At a time when margins are tight, many pharmacies are transforming themselves into patient-centrered enterprises, where the pharmacist interacts with customers on a regular basis, almost assuming the role of primary care physician. 

In this environment, pharmacists remove themselves from the daily grind of filling prescriptions and fulfilling administrative tasks. Those responsibilities fall on the shoulders of a well-trained technician staff. 

At Flower Mound Pharmacy, pharmacists cannot enter data, adjudicate and fill prescriptions electronically, count, or manage inventory. “I don’t want my pharmacists to perform [those responsibilities],” Song maintains. “Pharmacists are there to address specific patient needs.

“To be patient-centric, it is critical that pharmacists have confidence in the ability of their technicians,” he stresses. “The modern pharmacy must operate with competent and forward-thinking technicians, especially when quality measures, outcomes, and value-based medicine are taken into consideration.”

iCare RX’s Shoffner says at one time, the role of the technician was simply to watch the pharmacist do the work. Today, pharmacists perform their responsibilities  and technicians do everything else.

With a population that continues to age and life expectancies continue to increase, the number of medications prescribed will continue to grow, and with it, more comorbidities. More high-quality counseling will be necessary to help patients avoid adverse outcomes.

“Pharmacists will be more involved as a provider, delivering more information to the patient,” ASHP’s Lifshin says. “We’ll continue to see technicians taking more responsibilities so pharmacists can provide that type of patient care.”

As a former community pharmacist, PTCB’s Chapman stresses she could not have met the demands of everyday work without the assistance of trained technicians.

“They’re an absolute necessity in all facets of the profession,” she points out. “As pharmacists, we can’t do what we do every day without technicians.”

Which is why technician training and education is so vital for public health, job stability, professional advancement and consistency throughout the industry.

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