Empowering Pharmacy Technicians:
Then, Now, and Next
I, Jill Spivey, disclose no vested interest or affiliation
with any corporate organization offering financial
support or grant monies for this continuing education
activity, or an affiliation with an organization whose
philosophy could potentially bias my presentation.
Jill Spivey
Manager of Partnership Development
Learning Objectives
• Describe the range and evolution of regulations in
the US pertaining to pharmacy technicians
• Describe the blueprint for the updated Pharmacy
Technician Certification Exam (PTCE) and understand
why standardized assessments are updated
periodically.
• Understand the roles of pharmacy organizations in
the evolution of the pharmacy technician role.
Pharmacy Today
• Pharmacy profession under pressure to change
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Medication Therapy Management
Affordable Care Act
Accountable Care Organizations
Medical Home model
Medicaid expansion
Collaborative practice
Provider status
© 2012 by the American Pharmacists Association. All rights reserved.
Agenda
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Setting the Stage: Pharmacy Today
Looking Back to Look Forward
Today’s Reality
The Path Ahead
Questions/Comments
Pharmacy Technicians Today
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Filling medication orders
Compounding IVs
Order entry
Medication shortages
Immunization assistance
Supply chain management
Informatics
Transitions of Care
Med Rec
Looking back to look forward
Flashback: 1969
• ASHP workshop defines professional versus
nonprofessional tasks for hospital pharmacy services and
recommends education/training for nonprofessional
personnel
• Rhode Island Hospital initiates a formal pharmacy
technician training program
• APhA conducts analysis of functions in providing
community and hospital pharmacy services and whether
pharmacists or pharmacy technicians should perform the
tasks
1970s: Policy Process
• 1971: APhA House of Delegates endorses the appropriate use
of supportive personnel as a positive step toward improving
quality and quantity of pharmacy services
• 1972: NABP calls for a review of pharmacist’s roles before
assigning “professional” functions to nonprofessionals
• 1973: NACDS supports greater use of pharmacy technicians
and favors on-the-job training programs
• 1974: NARD opposes use of pharmacy technicians of limited
training in the practice of pharmacy as a protection to the
public
1992: Scope of Pharmacy Practice Project
• Sponsored by AACP, APhA, ASHP, and NABP, the
Scope of Pharmacy project identified the functions
and responsibilities of pharmacists and pharmacy
technicians, along with the skills and knowledge
required to perform those responsibilities
• This project was considered to be the snapshot of
pharmacy practice at the time
© 2012 by the American Pharmacists Association. All rights reserved.
1981 & 1987: Exams
• 1981: Michigan Pharmacists Association initiates an
exam-based certification program for pharmacy
technicians
• 1983: ASHP begins accrediting technician training
programs
• 1987: Illinois Council of Hospital Pharmacists begins
to develop a pharmacy technician certification exam
1995: Formation of PTCB
• 1993: Announcement was made at the ASHP
Midyear Clinical Meeting in December 1993 that a
new organization would be formed to develop one
national exam for pharmacy technician certification
• ASHP, APhA, the Illinois Council of Health-System
Pharmacists (ICHP), and the Michigan Pharmacists
Association (MPA), creates the Pharmacy Technician
Certification Board (PTCB) as an independent body to
create and administer national voluntary certification
examinations. PTCB delivers the first exams in 1995.
2001: NABP Joins PTCB
PTCB expands its Board of Governors to include the
National Association of Boards of Pharmacy (NABP).
2005: Launch of the ExCPT Exam
In 2005, the Institute for the Certification of Pharmacy
Technicians (ICPT) launched another certification
program for pharmacy technicians.
As of 2010, it was in the hands of the National
Healthcareer Association (part of Ascend Learning), and
is now referred to as the Exam for the Certification of
Pharmacy Technicians (ExCPT).
2010: ASHP PPMI
In 2010, ASHP embarked on the Pharmacy Practice Model Initiative
(PPMI). The Pharmacy Practice Model Initiative recommended:
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Uniform national standards should apply to the education and training of
pharmacy technicians.
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To support optimal pharmacy practice models, pharmacy technicians must
be PTCB certified.
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By 2015, PTCB should require completion of an accredited training
program before an individual may take the PTCE.
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To support optimal pharmacy practice models, pharmacy technicians must
be licensed by State Boards of Pharmacy.
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All distributive functions that do not require clinical judgment should be
assigned to pharmacy technicians.
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Opportunities for pharmacy technician specialization should be
developed.
© 2012 by the American Pharmacists Association. All rights reserved.
2002: ASHP-Accredited Training
The number of ASHP-accredited technician training
programs reaches a total of 91 across 26 states.
2009: NABP Task Force
An NABP Task Force on Pharmacy Technician Education and
Training Programs issued several recommendations that were
subsequently accepted by NABP’s executive committee. Among
these recommendations were to encourage states to
• Clarify the terms licensure, registration, and certification,
• License or register pharmacy technicians,
• Accept PTCB certification,
• Report pharmacy technician disciplinary information to a
central clearinghouse,
• Require pharmacy technician education that meets
standardized guidelines, and
• By 2015, require pharmacy technicians to have completed an
accredited education and training program as a condition of
certification.
2011: C.R.E.S.T. Initiative
• C.R.E.S.T. Summit
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Consumer Awareness
Resources
Education
State Policy
Testing
• 2 National Surveys
• Recommendations similar to NABP and PPMI
C.R.E.S.T. Recommendations
Summit recommendations pertaining to the PTCB
Certification Program:
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Require a minimum period of practical experience.
Mandate criminal background checks.
Accept only pharmacy technician-targeted CE.
Require one of the 20 required CE hours to be
medication or patient safety.
• Require completion of an accredited education
program.
March 2012 survey reaffirmed the initial 2011 survey.
Tech Requirements
• There are no standard nationwide requirements to work
as a pharmacy technician
• Employers may require:
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Formal pharmacy technician education
Prior experience
National certification (Certified Technician -- CPhT) through PTCB or ExCPT
State registration
Continuing education
Today’s Reality
Career (U.S. Bureau of Labor Statistics, January 2014)
• 2012, Median Pay
• 2012, Number of Jobs
• Job Outlook, 2012 – 2022
$14.10 hr / $29,320 yr
355,300
20% increase
– Employment increase faster than average for all
occupations
• Formal Education Programs
– ~750 in the United States
– 258 accredited by American Society of Health-System Pharmacists (ASHP)
www.bls.gov/oes/current
State Regulations Vary Widely
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45 states regulate pharmacy technicians
18 states require national certification
5 states require and accept only the PTCE
17 states require a background check
18 states require CE
5 states have a pharmacy technician serving on the
state Board of Pharmacy
• 6 states do not regulate pharmacy technicians
• Many states have pending legislation or regulations
© 2012 by the American Pharmacists Association. All rights reserved.
Today: State Regulations
PTCE Assessment Process
Current Technician Requirements
• A high school diploma or equivalent
• Disclosure of all criminal history and adverse state
Board of Pharmacy actions
• A passing score on the PTCE or ExCPT
• Complete a training program or 1 year experience
(ExCPT only)
• 18 years of age or older (ExCPT only)
• Recertification every two years
Pharmacy Technician Certification Exam (PTCE) is:
• Widely recognized and trusted throughout the profession
• Based on the Scope of Pharmacy Practice Project
• Psychometrically sound
PTCE Job Analysis
Exam
Blueprint
Develop
Items
Assemble
Forms
Set Standard
Equate
Forms
Publish &
Administer
QA & Issue
Results
PTCE Updated Blueprint
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Generally every 5 years
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Required for national accreditation through the National Commission for
Certifying Agencies (NCCA)
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Identified entry level knowledge and skills
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Most recently, PTCB conducted a nationwide survey across all practice
settings with over 25,000 responses
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Detailed survey measures what pharmacy technicians do on a daily basis
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Delineated pharmacy technician tasks (and their importance) to protect
public health
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Critical for exam validity
Previous PTCE Blueprint
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Driven by results of 2011 job analysis
Reflects evolution of technician responsibilities
Increased specificity for knowledge domains
Revising the PTCE
– Blueprint and item mapping
– Gap analysis and new item development
– Standard Setting
Updated, Current PTCE Blueprint
Pharmacy
Information Systems
Usage and
Application, 10%
Participating in the
Administration and
Management
of Pharmacy
Practice, 12%
Maintaining
Medication and
Inventory Control
Systems, 22%
Job Analysis
Pharmacology for
Technicians, 13.75%
Pharmacy Billing and
Reimbursement,
8.75%
Pharmacy Inventory
Management, 8.75%
Assisting the
Pharmacist in
Serving Patients,
66%
Medication Order
Entry and Fill
Process, 17.5%
Pharmacy Quality
Assurance, 7.5%
© 2012 by the American Pharmacists Association. All rights reserved.
Pharmacy Law and
Regulations, 12.5%
Exam launched
November 1st
Sterile and
Non-sterile
Compounding,
8.75%
Medication Safety,
12.5%
Winds of Change
Moving Forward
Over the past several years, the pharmacy profession has
witnessed changes in. . .
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Regulatory Oversight
Job Market
Pharmacy Education
Pharmacy Practice Models
Technology
EHR/e-prescribing
Collaborative Process
Who or what is going to
forge the path ahead?
Collaboration Underway
Who?
• State pharmacy associations
• State boards of pharmacy
• National pharmacy associations
• Hospitals and community pharmacies
• Individual pharmacy technicians and pharmacists
Joint Commission of Pharmacy Practitioners (JCPP)
Vision Statement for 2015
Pharmacists will be the health care professionals responsible for providing
patient care that ensures optimal medication therapy outcomes.
What?
• Collaborative movement
• Desire to move the profession forward
PTCB Program Changes
New PTCB requirements to become initially certified:
• By 2020, PTCB candidates will be required to complete an
ASHP/ACPE-accredited education program
• Criminal background checks will be required in or around
2014
New PTCB requirements to become recertified:
• PTCB will require one of the 20 required CE hours to be in
patient safety, in addition to one already required in law
• PTCB will only accept pharmacy-technician-targeted CE
• The number of CE hours allowed from college courses will be
reduced and in-services will be reduced, then phased out
© 2012 by the American Pharmacists Association. All rights reserved.
Questions
1.
In what year did the APhA House of Delegates endorse the
appropriate use of supportive personnel as a positive step toward
improving quality and quantity of pharmacy services?
a)
b)
c)
d)
1982
1999
1971
2001
1.
True or False: All 50 states regulate pharmacy technicians.
2.
True or False: PTCB will require new CPhT candidates to complete
an ASHP/ACPE-accredited program in order to apply for the exam.
3.
Choose two states that created the first technician certification
exams:
a)
b)
c)
d)
Maryland
Michigan
California
Illinois
Summary
Questions?
Jill Spivey
Manager of Partnership Development
Pharmacy Technician Certification Board
Email: [email protected]
© 2012 by the American Pharmacists Association. All rights reserved.
Thank you
for your
participation!