Clinical Pharmacy Services Bring Expanded Roles to the Pharmacy TEAM!

by, Christine Cline-Dahlman, BFA, CPhT-ADV

We are pharmacy!

Pharmacy claims the title of Medication Experts.

Medications will always need to be “dispensed”.

Wait – does this mean that the ONLY task pharmacy technicians can ever do is Count by 5?  We in community pharmacy will always be involved in the dispensing of medication.  BUT – Gone are the days where “Counting by 5” is the priority task!

As professional practice codes expand for Pharmacists, there is a sequential expansion for the practice roles for other Pharmacy Team members, especially Pharmacy Technicians. 

Does this mean that Techs will be doing more work for the same pay?  For many technicians, the term “expanded” means that they will be asked to do additional work in addition to dispensing but not see an increase in their wages.

I would like to dispel that notion. 

Our profession uses the term “expanded” to reference the increased permission for us to actively participate in the patient’s care, rather than serving in a passive role.  This permission is called “practice code”.

What could this new role look like?  Let’s review how our role is changing.

Workflow Changes that Techs are Seeing

We now see eScripts arrive at our pharmacy with the information immediately populated into the pharmacy management software.  No typing, verifying patient info, or noting duplicate drug therapy for existing patients – Our task list has been shortened.

We see the growth of automated packaging systems in our pharmacy.  A dynamic med-sync program for maintenance meds can schedule fills in this equipment.  A new script is reviewed for therapeutic approval and billing is completed without our input.  Messages to “Fill” are sent to the packaging machine.  A tech rarely counts by 5 anymore – Another reduction in our task list.

We know “mail-order” is taking scripts away from chain and mass merchandiser pharmacy pickup.  Mail-order scripts are filled in high-speed, high-capacity central fill facilities where a pharmacy technician is often a computer technology expert.  These scripts are not reaching our pharmacy – An additional reduction in our task list.

We hear that Amazon-like locker systems will let patients pick up their meds on their schedule.  Billing and Co-Pay are done with digital pay solutions.  Will we ever see patients again? Techs are not needed to ring up Co-Pays – The reduction to our task list keeps coming. 

We hear that Artificial Intelligence will control many of the tasks in the script-fill process.  Just what is left for Techs to do in the dispensing process?

These changes ARE the New Opportunity! 

Techs are being allowed to move into clinical patient care services.  Will you accept this professional invitation or will you run away?  Everyone wants to know what it looks like first.  We don’t know – Exactly.  We do know these are trailblazing times and you could be on the leading edge for your future.

Our pharmacists have a mindset that is referred to as “Clinical”.  It is now time for technicians to develop their Clinical Mindset.  This is the viewpoint that is needed for your professional future – in every task that you complete. 

Clinical services in community pharmacy usually reference immunizations, point-of-care testing, remote therapeutic monitoring for blood glucose, blood monitoring, and cardiovascular measures, disease state management, and patient education.  Medication Synchronization started as a schedule for refills but has grown to be an active resource to stay in touch with the patient, collect info on the adherence and efficacy of their medication, and identify potential barriers to medication access.  These are tasks that Techs have recently grown into, they will be the type of tasks that lead to our continued professional growth. 

When a pharmacist in a community pharmacy monitors a patient, the path has been that the med was filled properly, the patient picks up the meds mostly on time, no apparent drug interaction or duplicate therapy exists, the patient is not complaining, so all is good.  This pattern has changed.

In recent years, a variety of reports show that a patient still prefers the local connection for their medications. They visit their pharmacy about 3 times per month, and their doctor 1 – 2 times per year, the accountability for the well-being of the patient through medication has now come to the pharmacy team.  The process for accountability is a new opportunity for technicians to become active partners with the pharmacist for the clinical care of the patient. 

Medical care has long included a SOAP note for a patient’s record – office visits, lab results, medications prescribed, therapeutic outcomes, patient demographic, etc.  Today a pharmacy uses a template for a patient record called an eCare Plan.  The components are based on the 5 steps listed in the Joint Commissions Patient Care Process that were approved in 2014. 

The eCare Plan is developed by the pharmacy team but it is a blend of the patient’s pharmacy and medical information.  Technicians are now moving into the tasks of collecting and documenting patient information for the plan to be built.  This connectivity between pharmacy and medical is called interoperability.  These tools fuel the development of Collaborative Practice with the pharmacist/pharmacy and the doctor/medical office.

Prepare for Your New Roles

1. Develop your Mindset – Be a Partner WITH your Pharmacist and grow your Clinical Mindset.  Get to know what it means to have the patient as your priority, not the task.
2. Expand your skill set beyond dispensing  – There appear to be 2 paths developing for technicians – The Patient Care Path or the Business Operations Path.  Which path do you prefer?  The direct patient care or the operations side of patient care.
3. Catch the Wave at the right moment!  When you continue to learn, both accredited and non-accredited learning, you become prepared to accept the new roles that are currently being created.

1. Practice, Practice, Practice Every Day!  Look forward to the unknown you may encounter every day.  Use these encounters as learning tools to develop your skill set.