Tech Duties Increase in Health Systems

The landscape of pharmacy technician careers has changed dramatically over the past several years. In health-system pharmacy, as the recognition and utility of pharmacists’ capabilities expands beyond distributive functions, techs’ duties continue to increase. Their abilities and new duties help limit the time that a pharmacist spends completing tasks that are not direct patient care or do not require a pharmacist’s clinical judgement. With their expanding role, the potential for more techs to advance in their careers is high.

Here at the Boise VA Medical Center, we are working to expand our clinical tech role to take over many nonclinical responsibilities, allowing pharmacists to focus on activities at the top of their scope. Our clinical tech takes on several roles throughout the health system, including being a delegate for prescription drug monitoring programs (PDMPs) for primary-care teams, developing a Tech-Check-Tech program in the inpatient setting, and becoming part of a multi-disciplinary mental health care team for intensively managed patients.

One example of a clinical tech role in a health system is a PDMP delegate for ambulatory care providers, including pharmacists. The dashboard for clinical pain patients at our facility is a resource that tracks high-dose, long-term opioid therapy and PDMP search history documentation. This allows the tech, who acts as the delegate for a pharmacist or provider, to make inquiries within the PDMP system and chart the results in patients’ electronic medical records (EMRs). In this era of a critical opioid epidemic, having a tech stay ahead on these PDMP inquiries allows the primary-care provider to detect or track potentially risky behavior, such as an abnormal pattern of opioid abuse or doctor shopping. This relieves the administrative workload of the facility’s pharmacists and providers, allowing them to focus on patients’ clinical needs. For the tech, becoming a PDMP delegate requires gaining the trust of those who will depend on the results of these inquiries, as well as being reliable and responsive and learning skills of concise and effective charting in the EMR system.

Being integrated into a multidisciplinary team as a tech also increases the likelihood of advancement and job satisfaction. The newest task that has been delegated to the clinical tech within our facility is assembling Mediset pill organizers for the intensively case-managed patients requiring mental health assistance within the Boise VA. The tech is responsible for accurately filling the Mediset, maintaining active refills in the patient’s EMR, and making changes as directed by the pharmacist. In addition, the tech serves as a patient advocate by noting patterns of medication use and ensuring those observations are incorporated into future considerations by providers. After an initial trial period of a few weeks, this new service has produced great results for this vulnerable patient population. The tech has relayed many intervention opportunities to the mental health team, such as noticing that a patient had left a medication in the pill box for several weeks in a row and discussing whether a switch would be appropriate, optimizing half versus whole tablets for patients, and getting refills ready prior to patient arrival. By cutting out many administrative duties previously handled by the mental health clinical pharmacy specialist (CPS), such as chasing down refills, the CPS now has more time to work on a new clinic for clozapine monitoring and other direct patient care activities. This process has also required that the tech build trust with the health care team. Initially, this trust was built through Mediset auditing and pharmacist review, with the goal of allowing the clinical tech to be independent for nonclinical judgement activities.

Finally, our tech has been spearheading the implementation of the Tech-Check-Tech program within the inpatient pharmacy. This program has been slowly integrated all over the country in many hospital settings, and there is much evidence that a tech’s accuracy in performing a final dispensing check is highly comparable to a pharmacist’s. A program such as this will pay dividends moving forward, as 1 tech leader can train others, allowing a visible career development pathway while increasing the efficiency of the whole pharmacy workflow.

CONCLUSION

The tech career field is expanding rapidly across many pharmacy settings within the health system. Advancing in and transforming our health care systems means adapting to the changes and expansions of roles for pharmacists and techs alike. Many administrative functions that pharmacists perform simply require initiative and on-site training to be a proactive team member. Therefore, with the appropriate training, techs are more than qualified to complete these tasks, which will allow time to focus on more clinical care and advance- ment opportunities for techs.

Kathleen O'Dell, CPhT, is a clinical inpatient pharmacy technician at Boise VA Medical Center in Idaho.Lindsay Kaster, PharmD, BCOP, is a clinical oncology pharmacist at Boise VA Medical Center.Maribel Rincon is a PharmD candidate at Idaho State University College of Pharmacy in Pocatello.

REFERENCES

Adams AJ, Martin SJ, Stolpe SF. "Tech-check-tech": a review the evidence on its safety and benefits. Am J Health Syst Pharm. 2011;68(19):1824-1833. doi:10.2146/ajhp110022.