Advanced Pharmacy Technician Roles: A Discussion with Program Director Stephanie O’Bryan
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“Because there’s a national shortage of technicians right now, anywhere you go, you’re going to have a job, whether you’re looking at small towns or big towns. I get calls every week from pharmacies asking for students. Our students are coming out already having jobs.”
Stephanie O’Bryan, Pharmacy Technician Program Director at Central Oregon Community College
It has been a busy few years in the pharmaceutical world. Starting in 2019 there were drug shortages, the continued fight against the opioid epidemic, and rising drug prices continued to be major issues within the pharmacy community. Advocacy organizations like the American Society of Health-System Pharmacists (ASHP) were pushing Congress to address the impacts of these issues as they continue to play out before our eyes.
With the rise of Covid-19 in 2020, pharmacists were called upon to remain flexible and continue to serve their communities despite an ever-changing landscape. Retail pharmacists helped implement comprehensive prescription delivery services, establishing Covid-19 testing centers in their establishments, and ultimately administering the long-awaited Covid-19 vaccine.
Some pharmacies also implemented telehealth services to provide virtual consults. Many of these changes are here to stay as the world adjusts to this new way of life.
While there is still much to be worked out in confronting these difficult issues in coming years, there have also been a number of interesting new trends emerging within the industry such as the use of drones to deliver drugs to healthcare facilities and people’s homes; the rapid increase in the number of products available containing cannabidiol (CBD); and the emerging effort to prevent burnout caused by excessive workload and administrative burden amongst healthcare professionals, including pharmacists.
In conjunction with these emerging movements, there is a growing need for pharmaceutical services and employees, largely fueled by increased demand for prescription medications. The role of a pharmacy technician is expected to grow especially quickly. According to the Bureau of Labor Statistics (BLS 2021), the U.S. is expected to see 15,200 new pharmacy technician jobs created nationally between 2019 and 2029, which is a growth of 4 percent.
Recognizing Pharmacy Technicians During American Pharmacists Month
Each year the month of October is set aside as American Pharmacists Month (APhM). This month-long celebration is organized by American Pharmacists Association (APhA) and is a time to recognize the role pharmacists have in healthcare. The theme for 2021 is “Essential Providers, Accessible Care,” which is highlighting the role pharmacists, pharmacy technicians, and other pharmacy staff have had in caring for the public during the Covid-19 pandemic.
There are several ways to get involved with and celebrate American Pharmacists Month. The APhM website has a wealth of social media assets that can be used to bring awareness to this special month. Any online posts are encouraged to use the hashtags #PharmacistsMonth, #APhM2021, and #PharmacistsCare to help people find information relevant to this month.
Within APhM there are other important dates. The 12th of October is Women Pharmacist Day (#womenpharmacistday) and the National Pharmacy Technician Day (#rxtechday). These days are excellent opportunities to recognize the work done by women or pharmacy technicians during a month that celebrates all pharmacy work. Managers should ensure to share stories about these two groups on their special days and thank them with a card, catered lunch, press release, social media post, or another creative way.
The Role of Pharmacy Technicians
While we usually think of pharmacy technicians as working in the pharmacies at drug stores, they can also occupy positions in hospitals, manufacturing, disease state management, and mail order and insurance claims. Pharmacy technicians play an important role in pharmacy operations, distinct from the role of a pharmacist.
Technicians are usually the first person you interact with when you walk up to a pharmacy counter. They are responsible for administrative tasks, including tracking inventory, running the cash register, filing paperwork, and processing insurance claims, as well as counting, pouring, weighing, measuring, and assembling medicines for prescriptions.
The pharmacist’s tasks, by contrast, include conducting health screenings, giving vaccines, reviewing and approving prescriptions that technicians have assembled, and giving general advice about health and wellness to patients.
We talked to the leader of one of the top pharmacy technician programs in Oregon to get some insight into the state of the industry and what students can expect from a career as a pharmacy tech.
Meet the Expert: COCC Pharmacy Technician Program Director Stephanie O’Bryan
Stephanie O’Bryan is the director of the pharmacy technician program at Central Oregon Community College (COCC) in Bend, which is accredited by the American Society of Health-System Pharmacists (ACHP). She graduated from that very program back in 2013 and began working at COCC as a lab assistant for Shannon Waller, the program director at the time. O’Bryan worked there for two years, and eventually became a part-time instructor at the college and began helping to design lesson plans for the curriculum. In 2019, she was promoted to the position of director of the program.
COCC’s three-term program prepares students for employment in different areas of the pharmacy industry, including retail, chemotherapy, nuclear medicine, home health, manufacturing, and others.
O’Bryan said that the projected increase in the need for pharmacy technicians is no exaggeration. “Because there’s a national shortage of technicians right now, anywhere you go, you’re going to have a job, whether you’re looking at small towns or big towns,” O’Bryan said. “I get calls every week from pharmacies asking for students. Our students are coming out already having jobs.”
Beyond the potential employment opportunities, there are some other changes to the role of pharmacy technician underway that make it an interesting time to join the field.
The Evolution of the Pharmacy Technician
While pharmacy technicians are usually associated with seeing to the administrative tasks within pharmacies, O’Bryan says that the role of a pharmacy technician is “absolutely evolving,” and told us a few specific areas in which technicians—who are traditionally in the back seat—are being given the reins.
In 2016, a group of pharmacy technicians legally administered immunizations for the first time in the U.S. at Albertsons and Safeway pharmacies in Idaho. “This was really huge for pharmacy technicians,” O’Bryan said, as this task is traditionally reserved for pharmacists.
The Idaho Board of Pharmacy granted a waiver to Washington State University (WSU) to complete a study, which involved 30 pharmacy technicians in a vaccine administration training program. The results were very positive; all 29 pharmacy technicians that took the home study assessment passed with at least 70 percent competency on the first attempt. Participants also reported increased confidence with immunization skills. From December 2016 to May 2017, following the training, the technicians administered 953 immunizations with zero adverse events reported.
The regulations around whether or not pharmacy technicians are allowed to administer immunizations or vaccines used to be determined at the state level. In August 2020, the Department of Human Services updated the Public Readiness and Emergency Preparedness (PREP) Act, allowing pharmacy technicians to administer immunizations in all US states as long as they met specific requirements. These include completing a training program, having CPR training, and completing at least two hours of immunization-related continuing pharmacy education hours.
Some states may have additional requirements, so pharmacy technicians should check with their local board to ensure they meet all the requirements.
Another example in which O’Bryan mentions technicians’ increasing responsibility is the process of compounding, which is the creation of a drug to meet the specific needs of a patient when the commercially available drug does not do so. For instance, a patient may be allergic to an ingredient contained within the commercially available drug, like corn, gluten, or lactose, which can be compounded into a tablet or pill without that ingredient.
Compounding can also be used, based upon a doctor’s prescription, to change drugs into different forms (ointments, creams, lip balm, lollipops, shampoos, etc.) to fit a patient’s unique needs.
Pharmacy techs are now even being able to compound chemotherapy. “Back in the day, there would be no way they’d even consider a technician touching chemotherapy because it’s such a hazardous drug,” O’Bryan said, “but now at the hospital center at the cancer center in Bend, they have the technicians making all of the [chemo] IVs.”
Pharmacy techs are also increasingly tasked with medication reconciliation—the process of creating the most accurate list possible of all medications a patient is on to ensure that the patient is provided with the correct medications during their stay at a hospital.
“Basically, when a patient comes into the emergency room and they are getting admitted to the hospital, technicians are being given this responsibility because we are familiar with the drugs themselves,” O’Bryan said. This is a task that is traditionally covered by nurses.
“They contact the pharmacies that patients go to in order to confirm that these are all the medications that they’re on prior to them being admitted to the hospital, just to make sure there are no contraindications of medications because sometimes those medications have the possibility of interacting,” O’Bryan explained.
“It started out with one person…now they have a whole team of medication reconciliation technicians that work all around the clock making sure that all of these patients are getting checked in correctly.”
Tiers of Technicians
One final trend that O’Bryan mentioned is the potential development of different tiers of pharmacy technicians, such as lead pharmacy technician, supervisor, and “step one, two, or three [technicians],” O’Bryan said. “Once you work your way up in the tech role, then hypothetically, you’ll be able to ‘check’ for the pharmacist, which will take a lot of extra training.”
Checking the medication order accuracy is an integral—and time-consuming—aspect of the pharmacist’s job, which can be delegated to technicians. Studies have shown that technicians are generally just as good as pharmacists at this task; however, this practice is only allowed in a handful of states.
“They’re letting technicians do more of the work to allow for the pharmacists to be more clinical,” O’Bryan said. “We’re being able to do more and more things every day.”
The Changing Requirements to Become a Pharmacy Tech
In 2019, the only requirement to become a pharmacy technician in many states was to have a high school diploma or equivalent and pass the Pharmacy Technician Certification Exam (PTCE). This changed, however, due to updates to requirements from the Accreditation Council for Pharmacy Education that went into effect on January 1, 2020.
The ASHP and the ACPE are the only nationally recognized, non-governmental organizations that programmatically accredit pharmacy education and training programs in the U.S. Many states require completion of any ASHP/ACPE-accredited pharmacy technician education and training program, as well as national certification and registration or licensure in the state to practice as a pharmacy technician. A goal is for all states to ultimately require these criteria for practicing as a pharmacy tech.
“As pharmacists’ responsibilities are increasing, the opportunities for more advanced roles of the pharmacy technician are available as well,” said Lisa Lifshin, senior director, technician program accreditation and residency services at ASHP. “Standardized training is essential to provide a backbone for training and education for technicians, as well as employer desirability to hire individuals who have had education and training, instead of having to train pharmacy technicians onsite and provide full on-the-job training.”
Completion of an ASHP/ACPE-accredited (or candidate-status) program will allow a graduate to sit for the PTCB exam. A directory of eligible programs is available on ASHP’s website. Individuals interested in pursuing a career as pharmacy technicians should make sure the programs they are considering are ASHP/ACPE-accredited.
O’Bryan thinks that the changes to increase requirements to become a pharmacy technician are all for the best. “It’s a step in the right direction, making it required. Some people are good at taking tests, but not as good at doing the hands-on work,” she said.
The changes to the standards certainly make sense, considering the increasing responsibilities now being placed in the hands of pharmacy technicians, like administering IVs and compounding drugs. However, raising the standards to require more schooling won’t help increase entry into pharmacy technician roles, which raises concerns about the current shortage of pharmacy technicians that is expected to increase more in coming years.
While this supply-demand imbalance may be troubling for employers, it’s good news for prospective students, who can expect salaries to continue to increase and ease securing a job upon graduation.
“It’s definitely an up-and-coming field, and it’s exciting to see where it’s growing, ” O’Bryan said. “It’s a super rewarding job and seeing patients being able to be discharged from the hospital or not having to take a certain medication anymore is such a rewarding feeling.”