By Deeb Eid, PharmD, RPh, PTCB Executive Resident | Feb 27, 2017
The Iowa Pharmacy Association (IPA) has been involved in an ongoing research initiative to pilot advanced roles for pharmacy technicians in the community setting. Recently Deeb Eid, PharmD, RPh, PTCB Executive Resident, interviewed Megan Myers, PharmD, New Practice Model Project Manager, and Kate Gainer, PharmD, Executive Vice President & CEO of the Iowa Pharmacy Association to hear about their experience with the pilot project and certified pharmacy technician role expansions in Iowa.
Photo: Megan Myers, PharmD, New Practice Model Project Manager, and Kate Gainer, PharmD, Executive Vice President & CEO, Iowa Pharmacy Association
How did the conversation begin about expanding pharmacy technician roles, and why did Iowa decide the time was right?
Megan/Kate: "The conversation was brought to IPA by independent pharmacy owners in the state. Pharmacists were discussing the barriers in community pharmacy practice that were inhibiting practice change. Why had no change occurred after raising standards for pharmacists’ training by moving to all doctorate of pharmacy curriculum, and pharmacy technician training through required national certification? The task force was formed to find a solution to the barriers that were preventing pharmacists from embracing their clinical role, namely high levels of dispensing activity leading to time constraints. The economic environment in 2008 was a contributing factor as many pharmacies in Iowa faced financial stress and/or closure."
What feedback have you received from pharmacists, students, and technicians that are involved in the project?
Megan/Kate: "In the beginning, there was excitement but also concern and hesitation that naturally comes with big changes. Once pharmacists and technicians embraced and settled into their new roles, the feedback was overwhelmingly positive. With the New Practice Model, the pharmacist oversees all activities and technicians can check products confidently knowing support is nearby if there is a question. Pharmacists are liable for all errors, but are confident knowing the research supports technicians being capable in this role. Technicians have commented that they feel empowered and that they have a more important role on the team. Pharmacists like being able to take time with a patient who needs more help, knowing they won’t slow down workflow to do it. Technicians like being able to continue to help patients who need refills with no issues or problems so that the pharmacist can spend time with patients who need the extra help. The New Practice Model’s purpose is to help prioritize time so that patients who need help don’t leave the pharmacy without it."
What were the most challenging barriers you faced with this project?
Megan/Kate: "The most challenging barrier was coordinating and organizing our efforts, so everyone involved knew the design, intent, and purpose of the New Practice Model. Reorganizing and redistributing staff roles and tasks was a challenge initially. The technicians doing the checking settled into their new roles successfully and quickly. Pharmacists had more difficulty with changing their mindset to be ready to provide patient care whenever the opportunity presented itself, to evolve and/or develop their services, and to create workflow processes for services. The time freed up from using certified technicians for product verification is as unpredictable as the nature of community pharmacy itself. The pharmacist may get 5 extra minutes, or 20, and needs to be prepared to make the most out of that time to provide patient care."
To others that might be looking to take similar steps, what are your top two recommendations on how to get started?
Megan/Kate: "First, pharmacy groups need to put aside competition and work together. Our success was largely due to working together as one profession, sharing ideas, and supporting one another. This included not just community pharmacies, but also our colleges of pharmacy, association, board of pharmacy, and the Collaborative Education Institute all working together to make this project possible. Second, a clear vision and honest self-reflection are needed. Where are you and where do you want to be? Sites need to have pharmacists who are actively providing services and need more time to get to the next level. If the pharmacists are not prepared to increase their role in patient care, delegating product verification won’t help achieve this goal of the New Practice Model."
What role do pharmacy technician training, education, and certification serve when a state decides to take action and expand roles?
Megan/Kate: "Having qualified technicians participating was the key to the success of this program. Technicians in our program had a minimum of 2,000 hours of work experience, were nationally certified, completed formal advanced training education, and passed an audit to participate as a product verification technician. Routine audits and monitoring are also part of the program."
The Iowa Pharmacy Association partnered with Drake University College of Pharmacy and Health Sciences, The Collaborative Education Institute, NACDS, the Community Pharmacy Foundation, McKesson, and Telligen on the initiative. The project highlights advancements and collaborations within the community pharmacy sector.