Empowering Pharmacy Technicians: Then, Now, and Next Jill Spivey Manager of Partnership Development 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. 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. Agenda Setting the Stage: Pharmacy Today Looking Back to Look Forward Today s Reality The Path Ahead Questions/Comments Pharmacy Today Pharmacy Technicians Today Pharmacy profession under pressure to change Medication Therapy Management Affordable Care Act Accountable Care Organizations Medical Home model Medicaid expansion Collaborative practice Provider status 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 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 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 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). 2002: ASHP-Accredited Training The number of ASHP-accredited technician training programs reaches a total of 91 across 26 states. 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). 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. 2010: ASHP PPMI In 2010, ASHP embarked on the Pharmacy Practice Model Initiative (PPMI). The Pharmacy Practice Model Initiative recommended: Uniform national standards should apply to the education and training of pharmacy technicians. To support optimal pharmacy practice models, pharmacy technicians must be PTCB certified. By 2015, PTCB should require completion of an accredited training program before an individual may take the PTCE. To support optimal pharmacy practice models, pharmacy technicians must be licensed by State Boards of Pharmacy. All distributive functions that do not require clinical judgment should be assigned to pharmacy technicians. Opportunities for pharmacy technician specialization should be developed. 2011: C.R.E.S.T. Initiative C.R.E.S.T. Summit 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: 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. Today s Reality Tech Requirements There are no standard nationwide requirements to work as a pharmacy technician Employers may require: Formal pharmacy technician education Prior experience National certification (Certified Technician -- CPhT) through PTCB or ExCPT State registration Continuing education Formal Education Programs ~750 in the United States 258 accredited by American Society of Health-System Pharmacists (ASHP) Career (U.S. Bureau of Labor Statistics, January 2014) 2012, Median Pay $14.10 hr / $29,320 yr 2012, Number of Jobs 355,300 Job Outlook, 2012 2022 20% increase Employment increase faster than average for all occupations www.bls.gov/oes/current State Regulations Vary Widely Today: State Regulations 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
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 PTCE Assessment Process Pharmacy Technician Certification Exam (PTCE) is: Widely recognized and trusted throughout the profession Based on the Scope of Pharmacy Practice Project Psychometrically sound Job Analysis Exam Blueprint Develop Items Assemble Forms Set Standard Equate Forms Publish & Administer QA & Issue Results PTCE Job Analysis PTCE Updated Blueprint Generally every 5 years Required for national accreditation through the National Commission for Certifying Agencies (NCCA) Identified entry level knowledge and skills Most recently, PTCB conducted a nationwide survey across all practice settings with over 25,000 responses Detailed survey measures what pharmacy technicians do on a daily basis Delineated pharmacy technician tasks (and their importance) to protect public health 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 Critical for exam validity Previous PTCE Blueprint Updated, Current PTCE Blueprint Participating in the Administration and Management of Pharmacy Practice, 12% Maintaining Medication and Inventory Control Systems, 22% Assisting the Pharmacist in Serving Patients, 66% Pharmacy Information Systems Usage and Application, 10% Pharmacy Billing and Reimbursement, 8.75% Pharmacy Inventory Management, 8.75% Medication Order Entry and Fill Process, 17.5% Exam launched November 1st Pharmacology for Technicians, 13.75% Pharmacy Law and Regulations, 12.5% Sterile and Non-sterile Compounding, 8.75% Pharmacy Quality Assurance, 7.5% Medication Safety, 12.5%
Winds of Change Over the past several years, the pharmacy profession has witnessed changes in... Regulatory Oversight Job Market Pharmacy Education Pharmacy Practice Models Technology EHR/e-prescribing Moving Forward Who or what is going to forge the path ahead? Collaborative Process 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 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) 1982 b) 1999 c) 1971 d) 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) Maryland b) Michigan c) California d) Illinois
Summary Questions? Jill Spivey Manager of Partnership Development Pharmacy Technician Certification Board Email: jspivey@ptcb.org Thank you for your participation!