Evaluating and Elevating Specialty Pharmacists Through Certification

The development of the Certified Specialty Pharmacist provides the opportunity for specialty pharmacists to demonstrate their expertise through an evaluation of their skills.

Specialty pharmacy has reached a critical point. The need to qualify pharmacists while providing opportunities for them to grow within the profession has never been greater. Recently, the Specialty Pharmacy Certification Board (SPCB) responded to this need and tapped experts throughout the industry to help with the development of the Certified Specialty Pharmacist (CSP), a certification program providing verification of proficiency in all aspects of specialty pharmacy practice. Administered twice yearly, in April and October, the CSP exam was created using a nationally recognized certification program and examination development process, based on the American Educational Research Association/American Psychological Association/National Council on Measurement in Education Standards for Educational and Psychological Testing, providing an objective method for measuring the knowledge and abilities of specialty pharmacists.

The examination’s development process was comprehensive and lengthy (Figure 1). It was essential that the CSP represent the most progressive, forward-thinking aspects within specialty pharmacy today, resulting in a standardized, uniform tool for ensuring highly qualified and highly trained professionals. Three Walgreens team members, including the author, were among the initial group of pharmacists to earn the CSP credential from SPCB.

{Click to enlarge image}

Created by Experts from Across the Industry

One of the most critical elements to the development of the CSP exam was ensuring the inclusion of industry experts—those closely involved with specialty pharmacy, its trends, developments, challenges, and evolution, as well as ongoing advancements and the needs of patients. Including specialty pharmacists representing a wide range of experience and practice areas at each step of the exam’s development ensured that the examination included the most up-to-date concepts and the credibility necessary to be accepted as a true measurable tool by the greater industry. It was essential to bring these experts on board early in the development process—including the creation of the exam’s blueprint—as well as throughout item writing, evaluation, and determining scoring methods.

According to Nick Calla, RPh, CSP, vice president, industry relations, Community Specialty Pharmacy Network, and president, SPCB board of directors, “Involving practicing specialty pharmacists from across the country in the development of the CSP exam was essential to the validity and credibility of the exam. These experts were fully engaged at each stage of the development process, so that the exam fully reflected what specialty pharmacists do on a daily basis and the knowledge they must possess to perform their duties optimally.”

Testing for the Most Up-to-Date Skills and Knowledge

With industry growth comes technological and scientific progression, and it was imperative that the CSP exam assessed for expertise related to these advancements. In fact, early on, current specialty pharmacists were surveyed to determine what aspects of the job are essential, particularly as it relates to new technology and an increasingly demanding work environment. This was a particularly important component of the development process as it made certain that the CSP exam tested comprehensively for the essential knowledge required for the experienced specialty pharmacist.

The results from an initial job analysis survey of nearly 200 specialty pharmacists reinforced the exam’s content validity by identifying 1) the important tasks performed by today’s specialty pharmacist and 2) the requisite knowledge and skills necessary to perform the tasks safely and competently. The results of the job analysis survey became the foundation for all aspects of the exam’s item writing, item review, test assembly, and publication. And the input of specialty pharmacists in the field was critical to the ensuring that the right questions were being asked and the most central skills assessed.

A Thorough and Consistent Process

In addition to including highly trained specialty pharmacists while building the exam, it was important to make certain that the development process itself was consistent and thorough to guarantee a well-rounded, comprehensive tool. This can be especially noted in the exam’s item writing process, where nearly 30 subject matter experts—each of whom completed a training workshop in item development—constructed each individual item to address a specialty pharmacy task as given in the original content specification outline while covering the 4 practice domains identified by the test blueprint: intake, clinical management, fulfillment, and outcomes.

This ensured that the exam tested on real-world industry trends and practices, frontline technology, and the skills necessary to effectively perform specialty pharmacists’ job tasks. Following the item writing, an extensive review period followed, in which 12 subject matter experts verified the domain and task associated with each question, checked each item for clarity and accuracy, and made revisions according to review group consensus.

Well-Rounded Scoring

It wasn’t just necessary to define what exactly constituted a passing score for those taking the CSP. The exam developers had to determine how much a specialty pharmacist should know in order to do their job well and protect patients. To achieve this, an independent panel of several experienced specialty pharmacists was convened to review the exam’s final drafts. This group also participated in a standard-setting study, facilitated by exam development experts, to determine pass/fail criteria according to a rigorous 2-round process. This guaranteed that in order to pass the examination, pharmacists must demonstrate well-rounded, sufficient knowledge rather than simply receiving an arbitrary “passing” score.

“Including seasoned, highly trained specialty pharmacists in the finalization of the exam, including scoring criteria, was essential to its legitimacy and thoroughness. As this is the only certification exam currently offered within the specialty pharmacy industry, it was critically important that the final scoring be based in true knowledge and skills possessed by those taking the examination,” said SPCB board of directors president Nick Calla, RPh, CSP.

Results

To date, 43 specialty pharmacists have taken the examination and 74% have passed. Those who have taken the exam perceive that earning the CSP credential will afford them several inherent rewards, including increased business, a better resume, job advancement, knowledge validation, and differentiation/distinction from other pharmacists. Further, 82% of surveyed test takers said that they will encourage their colleagues to consider earning the CSP. “Job advancement” continues to be the leading reason for taking the exam.

Through the development of the CSP examination, a research-based definition detailing the function of specialty pharmacists and the specific tasks associated with the specialty pharmacist’s role (Online Figure 2) was also born—providing the first and only a standardized definition of the specialty pharmacist role.

Figure 2: Definition of Specialty Pharmacy

Specialty Pharmacist: “Pharmacist whose practice model deals exclusively with medications and pharmaceuticals that are high in cost, require special handling, are subject to limited or restricted distribution, require ongoing assessment, treat rare diseases, or require active monitoring of side effects; with an increased emphasis on patient management, medication adherence, collaboration with other members of the health care team, an ability to use metrics to drive optimization of patient care, and an ability to assist the patient to access additional supportive resources.”

Benefits Throughout the Industry

Industry certification provides several intrinsic benefits to all stakeholders within specialty pharmacy. To the individual pharmacist, it provides the opportunity to hone current skills and prove to employers a dedication to their patients and to the greater industry. To those who employ specialty pharmacists, certification offers an objective method for proving proficiency and processes for developing and securing talent within the industry. Industry wide, certification helps create standards to enhance quality and outside industry perceptions. Perhaps most importantly, when it comes to patients, certification establishes new benchmarks that elevate care and safety, reinforcing assurance as to where the specialty pharmacy industry currently stands and where it is headed.

Certification programs are a significant indicator to employers, manufacturers, patients, health care providers, and the general public that a specialty pharmacist is an expert in handling complex pharmaceuticals and has demonstrated advanced proficiency in specialty pharmacy management duties in a variety of practice settings. As the industry advances and the space of high-cost, highly managed drugs evolves, it is essential that specialty pharmacists have the opportunity to demonstrate their expertise and that the industry, in turn, possesses a method for evaluating these skills and benchmarks to determine what is required to keep patients protected and businesses moving forward. By ensuring that the CSP examination was designed by true subject matter experts in the field and is thorough and consistent with the duties required of today’s specialty pharmacists, while testing for the most current knowledge within the industry today, we can be assured that we possess a truly useful tool that will further earn the specialty pharmacy more credibility and continue to generate exceptional employees.

Next Steps

SPCB plans to apply for CSP program accreditation through the National Commission for Certifying Agencies this year with the goal of achieving accreditation in 2015. Earning accreditation, considered the “gold standard” for certification programs, will demonstrate that the development of this certification program is consistent with best practices and will further validate the examination development process.

Those pharmacists who have their BSPharm or PharmD and have completed 30 hours of specialty pharmacy continuing education within the previous 2 years, as well as 3000 hours of specialty pharmacy practice within the previous 3 years, among other requirements, are eligible to apply. The SPCB board of directors recently announced a scholarship program for pharmacists seeking CSP certification. More information on scholarship availability and the application process for test dates is available at www.spcboard.org. Applications for the upcoming October examination administration will be accepted through September 15, 2014. SPT

About the Author

As vice president, specialty pharmacy development at Walgreens, Ray Tancredi, RPh, MBA, CSP, oversees a team responsible for all specialty pharmacy trade functions, including specialty pharmacy product access and relationships, managing manufacturer hub services and referrals, contract negotiation, implementation, contract compliance, pharma programs and services, data analysis and reporting, request for proposal support, coordination of clinical patient services, new drug in-services, and education. Additionally, Ray oversees the management of strategic manufacturer accounts in an effort to maximize contracts and provide exceptional customer service.Ray joined Walgreens Specialty Pharmacy in December 2008 as director of trade account management. His responsibilities included management of strategic manufacturer accounts in an effort to maximize contracts and provide exceptional customer service.Prior to working for Walgreens, Ray worked for McKesson from 2000 to 2008. Ray managed implementation of specialty pharmacy programs for managed care organizations. He was promoted to director or clinical marketing, and was responsible for development of clinical programs and strategies for targeted therapeutic categories. His role included marketing collaboration for development of marketing materials to target physicians, patients, payers, and manufacturers in support of clinical programs. Ray also had responsibilities for the McKesson Specialty Health Network, a network of chain retail pharmacies where McKesson supports specialty pharmacy capabilities.Ray began his career in Philadelphia in 1983, where he owned and operated retail pharmacies along with his father and brother. The pharmacies were bought by Rite Aid Corporation in 1996. Ray left retail pharmacy and joined Aetna U.S. Healthcare as an area assistant director of pharmacy. In this position he was responsible for the development and administration of pharmacy programs for the mid-Atlantic region. After a promotion to regional pharmacy director, Ray became responsible for regional and national pharmacy program launches, and managed a staff of clinical pharmacists.Ray has a Bachelor of Science in Pharmacy from Temple University and is a registered pharmacist. He also holds a Master of Business Administration in management from Eastern University. He gained extensive educational experience teaching pharmacology to dental hygiene students at Manor College from 1997 to 2002 and developed the pharmacology syllabus and college handbook summary. Ray is vice president of the Specialty Pharmacy Certification Board.