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Course Administered By: J&D Educational Services, Inc
PO Box 130909
The Woodlands, Texas 77393-0909 Voice: 1-866-747-5545
Fax: 1-936-321-9295 www.jdeducation.com
“Is There More to this than Counting Pills?”
A Review Of the Practice of Pharmacy and Its Different Settings A Knowledge Based Course
By
Jeff Blackburn, C.Ph.T., MBA – Healthcare Administration ACPE No. 0096-9999-15-086-H04-T
Release Date: 08/31/2015 Expiration Date: 08/31/2018
Total number of pharmacy continuing education hours: 6 hours (0.6 CEU’s) Course Cost: $14.00 (to be paid at time of testing)
Average time to Complete: Approximately Six hours including testing Course Value: Six Contact Hours
Reading: 47 Pages
Final Exam: 40 Questions
Completion Requirements: Answer 70% of questions correctly, Evaluation
Council For Pharmaceutical Education (ACPE) as a provider of continuing
Pharmaceutical Education.
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October 17, 2015
PTCB RE-CERTIFICATION CHANGES
On February 27th The Pharmacy Technician Certification Board (PTCB) announced significant certification program changes. Some of the changes are concerning required CE or re-certification. A summary of those changes is on the following page. More information is available at the PTCB website (www.ptcb.org).
If you have questions or if we can be of any additional service, please give me a call at our toll free customer service number: 866-747-5545.
Thank you for choosing J&D for your CE requirements. Carl
IMPORTANT NOTE FROM PTCB
You Ask, We Answer
Your Question:"I am entering my CE hours online to recertify, but the total is wrong. Why?"
PTCB's Answer: If your CE hours do not seem to add up in your application to recertify, you may have selected incorrect 'types' for your CEs. Under 'CE Program Details' there are three CE types in the menu to choose from:
1) Seminars, Workshops, and Conferences: The vast majority of CE
hours are this type. Choose it for
online
CE courses and activities,
recorded presentations, or webinars,
as well as live
conferences,
seminars, workshops, or other educational programs that contain
primarily pharmacy-related subject matter. This is also the type for
home study courses. This includes all courses in this package.
iii by PTCB Staff | Feb 27, 2013
WASHINGTON, DC — The Pharmacy Technician Certification Board (PTCB) announces future changes to the PTCB Certification Program. The new changes will advance pharmacy technician qualifications by elevating PTCB’s standards for national certification and
recertification. During the next seven years, PTCB will phase in the changes, including mandatory background checks, accredited education requirements, and changes in acceptable continuing education (CE) programs for recertification.
“PTCB is elevating our certification requirements in order to meet the demands of the evolving healthcare system,” said PTCB Executive Director and CEO Everett B. McAllister, MPA, RPh. “We have made bold decisions on what will be required for candidates to become certified pharmacy technicians (CPhTs). Our Board of Governors is sharply focused on ensuring that the PTCB Program prepares CPhTs for the integral roles they play in supporting pharmacists in all practice settings.” PTCB’s requirements have remained largely unchanged since the
organization’s founding in 1995.
The PTCB Board of Governors decided that new candidates for PTCB certification will be required to complete criminal background checks, beginning in, or around, 2014. Many
employers already require background checks as a condition of employment, and PTCB plans to collaborate with stakeholders to synchronize with the existing systems.
As part of the 20 hours of CE required for recertification, individual CPhTs will
need to complete one hour of medication safety CE, effective in 2014, in addition
to the one hour of law CE already required. By 2015, PTCB will require all 20
recertification CE hours to be pharmacy technician-specific. Many existing CE
offerings already fit this definition. The allowable CE hours from college courses
will be reduced from 15 to 10 by 2016, and allowable in-service hours will be
phased out by 2018.
By 2020, PTCB will require candidates for initial PTCB certification to successfully complete an American Society of Health-System Pharmacists (ASHP)-accredited education program. ASHP-accredited programs include didactic course work and practical experience, thereby providing well-rounded training for technicians.
For additional information visit www.ptcb.org
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Changes to CE Monitoring That Will Affect Your CE Beginning May 1, 2012!
CPE Monitor is a national collaborative effort by the National Association of Boards of
Pharmacy (NABP) and the Accreditation Council for Pharmacy Education (ACPE) to provide an electronic system for state pharmacy boards and other licensing agencies to track and
authenticate CE units completed by pharmacist and pharmacy technicians. This will eliminate the need for the random audits now being done. Most state boards have committed to this program beginning year and many others have shown a strong interest. It is expected that all 50 states will soon become a part of this program due to the savings they will experience in time and money. As an ACPE approved provider of CE for Certified Pharmacy Technicians, J&D
Educational Services, in association with Texas Tech University School of Pharmacy, will be participating in this program.
How does this benefit me?
After you have registered to participate in this program J&D will electronically transmit the results for each course you successfully complete to CPE Monitor where they will be stored in a highly secure environment. This information will be available only to your appropriate licensing agency and to you. J&D will continue to maintain your records and issue you printed credits as we have always done.
What does it cost?
There is no cost to you to participate in this program. Don’t wait!
Technicians are strongly urged to obtain their NABP e-profile ID now to ensure their e-Profile is properly set up. If you choose not to enroll in e-profile you will continue to get your credits as before. However, beginning 5-1-2012 we will not be authorized to use ACPE logo or ACPE number on your statements of credit. Don’t Wait! It only takes a few minutes.
www.nabp.net/programs/cpe-monitor/
After you have reached the site choose “CPE Monitor Log in”
If you are registered at jdeducation.com, enter your e-Profile ID and your date of birth in your personal info.
Be sure to email your e-Profile ID and your date of birth to [email protected] using “e-profile ID” in the subject line. Please include your name and a contact phone number. Important Note: Your requirements for re-certification with your state board and PTCB have not changed. You will still be required to re-certify or re-register as you have always done.
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Please Read Carefully
Re-certification Procedures and Requirements
Re-certification procedures and requirements are determined by the Pharmacy Technician Certification Board (PTCB) and/or your state board and change from time to time. It is highly advisable that you review these procedures and requirements on a periodic basis. You may do this on line at the PTCB website (www.ptcb.org). If you are certified or registered with your state board of pharmacy or other agency, you should contact that agency for re-certification procedures and requirements.
J & D Educational Services, Inc. does not send the results of your CE to PTCB. PTCB requires that all certified pharmacy technicians complete the re-certification process and provide them with all requested information. J & D will provide you with a Statement of Credit for all courses you have successfully completed.
It is highly recommended you keep a copy of the CE statement provided at the completion of each course. This is your proof that you completed the necessary requirements and have received credit for the course. Additional information is available on our website (www.jdeducation.com). LEGAL
The material contained in this book is owned and administered by J & D Educational Services, Inc. and is protected under U.S. and international copyright laws. The content of the continuing education courses provided within this book are developed by licensed and certified
professionals. All courses are approved by the Accreditation Council for Pharmaceutical Education (ACPE) and meet all requirements of the Pharmacy
Technician Certification Board (PTCB) as outlined for continuing education.
J & D EDUCATIONAL SERVICES, Inc ASSUMES NO RESPONSIBILITY OR LIABILITY AS A RESULT OF INACCURATE INFORMATION CONTAINED IN THESE COURSES. J & D EDUCATIONAL SERVICES, Inc. DOES NOT EDIT THE COURSES FOR CONTENT.
THE INFORMATION CONTAINED IN THESE COURSES IS SELECTED AND PREPARED BY VARIOUS AUTHORS. ALL RECOMMENDATIONS OR
SUGGESTIONS FOR THE USE OF DRUGS, DEVICES OR TECHNIQUES REFLECT THEIR OPINIONS. NO RESPONSIBILITY OR LIABILITY IN PROVIDING THIS INFORMATION IS ASSUMED BY J& D EDUCATIONAL SERVICES, Inc.
vi Frequently Asked Questions:
1) What if I fail the final exam?
To receive CE credit, the technician must work through the manual and self-assessment
questions and pass a final exam with a score of 70% or better. If you do not pass, we will return your graded exam and ask you to try again at no charge.
2) What date is placed on my certificate?
The date that your final exam arrives in our office. We can use the postmark date if it is legible. You may fax your completed answer sheet to us if necessary to meet your deadline. On line testing is available with instant results. Visit our website (www.jdeducation.com) for details.
3) How long should it take me to complete a course?
One contact hour (0.1 CEU) is offered for each 50 - 60 minutes of organized activity pertinent to pharmacy practice. A four contact hour course, for example, should take approximately four hours to complete.
4) Can I take the same course twice?
Please do not submit an exam for a course you have already successfully completed. Your board will not allow credit for a course you have submitted for a prior renewal.
5) Will you return my corrected answer sheet to me?
We return your corrected answer sheet to you because we know that reviewing your mistakes is part of the learning process. PTCB requires that you keep your statement of credit in your file for one year. Some states require that the statements be available for review at anytime during the renewal cycle.
6) Do you send a receipt?
We will send an itemized receipt with your order. 7) Do you send my results to PTCB?
We cannot send your results to PTCB. PTCB requires that each individual technician complete the re-certification process. We will provide you with Statements of Credit for each course you successfully complete.
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would like to make completing your course as pleasant as possible and will gladly assist you in any way we can. Please don’t hesitate to call if we can help.
First: Please locate the course and an answer sheet. All answer sheets are the same and can be used for any course. They are located in the back of your courses.
Second: The purpose of the final exam is to guide your reading to the most important points in the course. It is also proof to your Board that you have, in fact, read the material. In order to earn your statement of credit, please:
1) Read the material in the course.
2) On the exam itself, circle the correct one answer that most completely and fully answers the question.
3) Transfer your answers from the exam to the answer sheet. You may use a soft lead pencil or black pen and fill the appropriate space completely.
4) Mail only the completed answer sheet and the corresponding evaluation. The evaluation is required by ACPE before we can issue your statement of credit. You may fax your answer sheets and evaluations if you wish. If you wish your results to be faxed back, you must clearly state your request along with a return fax number. It is not necessary to mail your answer sheets if you use the fax.
5) As a precaution against loss, please make and keep a copy of the answer sheets on which you marked your answers until you receive your statement of credit.
6) Your original test will be graded and returned to you along with a statement of credit. PTCB requires that a copy of your statement of credit be retained by you for audit. J & D Educational Services does not keep copies of your answer sheets on file and cannot replace it if lost. We do keep a record of your grade and will furnish you with a copy of your statement of credit if requested.
Last: Please allow several days for your answer sheet to arrive at our office. It takes longer than you think – often up to four or five working days from the East Coast. Within two working days we will correct the answer sheet and hand it and your statement of credit to the mail carrier to return to you.
Thank you again for ordering your continuing education for J & D Educational Services. If you have any questions, don’t hesitate to call us toll free at 1-866-747-5545.
1 Intended Audience
The intended audience for this course is Certified Pharmacy Technicians. Assessment Strategy
Government/Regulatory Requirement – the Pharmacy Technician Certification Board requires that Certified Pharmacy Technicians complete 20 hours of continuing education that is specific to pharmacy technicians.
Current Gap
A recent draft of the Long-Range Vision for the Pharmacy Work Force by the ASHP’s Council on Education and Work-Force Development described the pharmacy technician of the future with the following role classifications: generalist working in inpatient, ambulatory, chronic, and home care; focused practitioners working in specialty settings; advanced practitioners collecting clinical data for pharmacist evaluation; and managerial roles. Each of these roles would require basic education and training in an accredited pharmacy technician training program. Each role would require national certification by the Pharmacy Technician Certification Board (PTCB) as soon as possible after completion of the educational program.
While the role of the pharmacist is becoming more and more about patient care and the void they are leaving behind is being filled more and more by pharmacy technicians. This void is not only functional and administrative work, but also advanced practitioner work that requires a certain amount of professional judgment about when to alert the supervising pharmacist.
As the career of the pharmacy technician moves into more advanced roles, it is important that they have an understanding of the different positions and practice settings that may be open to them both now and in the future. This course will review the different pharmacy practice settings as well as the different roles technicians currently hold and may in the future. OBJECTIVES
• Describe the pharmacy practice and the tasks and functions defined by the ASHP’s
Model Curriculum.
• Discuss the current and future advanced roles available to the certified pharmacy
technician.
• List and describe some of the community based pharmacy practice settings. • List and describe some of the institutional based pharmacy practice settings.
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Table of Contents I. Introduction
II. The Practice of Pharmacy
III. Pharmacy Technicians Functions and Tasks IV. The Future of the Pharmacy Technician V. Community Based Pharmacy Practice Settings VI. Institutional Based Pharmacy Practice Settings VII. Conclusion
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INTRODUCTION
A 2002 white paper on pharmacy technicians provided a comprehensive analysis of historical developments, drivers for change, work-force issues, and the education, training, certification, and regulation of pharmacy technicians. 1 The paper called for a profession-wide vision for pharmacy technicians, identified the key issues that needed to be addressed, and described the needed action.
An increasing number of state boards of pharmacy, recognizing the integral role of pharmacy technicians, have revised practice regulations to allow a broadening of their responsibilities and regulation of pharmacy technicians has increased significantly over the past 15 years. In 1993, only 12 states regulated pharmacy technicians. At present, 39 states regulate pharmacy
technicians through licensure, certification, or registration. It is estimated that there are over 280,000 technicians regulated by state boards of pharmacy. The majority of states require some level of training or education that must be completed by a pharmacy technician; 29 of the 39 states that regulate pharmacy technicians have mandated training requirements. The majority of these training programs must be reviewed, or approved by the state board of pharmacy. As a part of their regulation of technicians, 14 boards of pharmacy have examination requirements that must be completed. An overview of the state regulation of pharmacy technicians is provided in NABP's annual Survey of Pharmacy Law.2
Pharmacy technicians work in a wide variety of practice settings, including community pharmacies, hospitals, the military, home health care, long-term care, prescription mail-order facilities, managed healthcare facilities, and educational/training programs. The role of a pharmacy technician has evolved to assist the pharmacist in almost all types of practice settings with completing the technical aspects of dispensing prescriptions such as computer entry, labeling, medication preparation, record keeping, insurance form completion, and maintenance of an appropriate supply of medications in the pharmacy. The pharmacy technician is
accountable to the supervising pharmacist who, in turn, is legally responsible—through state licensure—for the care and safety of patients served by the pharmacy. Pharmacy technicians are a critical part of the pharmacy work force, and the ever-increasing complexity of practice requires the increased utilization of qualified competent technical personnel.
The following synopsis of the practice is provided to give readers an understanding of the vital role that they play in the delivery of pharmacy services. We will first look the history of the pharmacy practice, then at the general tasks performed by pharmacy technicians and finally we will explore some of the different practice settings from a general perspective. Some of the practices described in this course do not give specific technician duties, but offer a “flavor” of the practice type, keeping in mind that technicians are vital to almost all forms of pharmacy practice.
1 White Paper on Pharmacy Technicians 2002: Needed Changes Can no Longer Wait Am J Health-Syst Pharm. 2003;60:37–51; www.ashp.org/s_ashp/docs/files/Tech_WhitePaper.pdf; Accessed 6/15/2009.
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The Practice of Pharmacy
The mission of the profession of pharmacy is to improve public health through ensuring safe, effective, and appropriate use of medications. Contemporary pharmacy practice reflects an evolving paradigm from one in which the pharmacist primarily supervises medication
distribution and counsels patients, to a more expanded and team-based clinical role providing patient-centered medication therapy management, health improvement, and disease prevention services.
The Model State Pharmacy Act and Model Rules of the National Association of Boards of Pharmacy (NABP) defines the practice of pharmacy as follows:
The “Practice of Pharmacy” means the interpretation, evaluation, and implementation of Medical Orders; the Dispensing of Prescription Drug Orders; participation in Drug and Device selection; Drug Administration; Drug Regimen Review; the Practice of Telepharmacy within and across state lines; Drug or Drug-related research; the provision of Patient Counseling; the provision of those acts or services necessary to provide Pharmacist Care in all areas of patient care, including Primary Care and Collaborative Pharmacy Practice; and the responsibility for Compounding and Labeling of Drugs and Devices (except Labeling by a Manufacturer, Repackager, or Distributor of Non-Prescription Drugs and commercially packaged Legend Drugs and Devices), proper and safe storage of Drugs and Devices, and maintenance of required records. The practice of
pharmacy also includes continually optimizing patient safety and quality of services through effective use of emerging technologies and competency-based training.3
Tasks and Functions of Pharmacy Technicians
In its Model Act, NABP defines pharmacy technicians as “personnel registered with the Board who may, under the supervision of the pharmacist, assist in the pharmacy and perform such functions as assisting in the dispensing process; processing of medical coverage claims; stocking of medications; cashiering but excluding drug regimen review; clinical conflict resolution; prescriber contact concerning prescription drug order clarification or therapy modification; patient counseling; dispensing process validation; prescription transfer; and receipt of new prescription drug orders. There has been recurring collaborative initiatives to analyze and document the work activities of pharmacy technicians. Some of these studies have been
accomplished at the same time as an evaluation of professional activities of pharmacists, e.g., the Scope of Pharmacy Practice Project (1992–1994) mentioned above.4, The most recent practice analysis for pharmacy technicians was completed in 2005. It identified new responsibilities performed by CPhTs, including the handling and processing of restricted, investigational, and chemotherapy drugs; working in mail-order pharmacy settings; and increased involvement in third-party payment. New knowledge areas identified in the practice analysis included
knowledge of error prevention strategies for data entry, cultural diversity, third-party payment, and pharmacy benefit management companies. The practice analysis indicated that CPhTs spend about 66 percent of their time assisting the pharmacist in serving patients, 22 percent maintaining medication and inventory control systems, and 12 percent participating in pharmacy practice
3 Model State Pharmacy Act and Model Rules of the National Boards of Pharmacy; National Association of boards of Pharmacy; www.nabp.net; August 2008; Accessed: December 30, 2014.
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management and administration. This distribution of the workday is similar across community, health-system, and other work settings. Community-based CPhTs are most frequently involved in assisting with outpatient prescription dispensing, purchasing and inventory control, and billing. For health-system CPhTs, assisting in inpatient medication dispensing, preparing intravenous admixtures, and prepackaging and repackaging are the primary responsibilities. CPhTs are taking on additional, more advanced responsibilities, including those more
traditionally performed by a pharmacist. In community settings, there has been growth in the extent to which pharmacy technicians are contacting prescribers for clarification of prescriptions and participating in quality assurance activities. Skilled technicians are now playing an important role in improving patient safety and medication-error strategies. Technician roles include
medication order entry, multiple-point checking, screening medication orders for dangerous medical abbreviations, physically separating look-alike medications and sound-alike medication names, and assisting the pharmacist in monitoring patient outcomes by collecting patient-specific data. Many CPhTs now have expanded supervisory responsibilities, including order-entry verification, preparation and packaging of medications produced by other technicians, and preparing prescription and medication orders for final approval by a pharmacist, as allowed by law. Additional practice management tasks include collecting productivity information, performing billing and accounting functions, performing or contributing to employee
evaluations, and participating in the establishment, implementation, and monitoring of policies and procedures.
There have been a number of significant positive developments affecting pharmacy technicians in the past ten to fifteen years including the establishment of certification boards, the
development of the Model Curriculum for pharmacy technician training5, an expansion in the number of accredited training programs, and greater regulatory recognition of pharmacy technicians in state pharmacy practice acts. Pharmacy technician education and training requirements vary among states and employers; there is, however, a trend toward more
formalized technician training, either through an academic training program or on the job. The Model Curriculum provides a starting point for identifying core competencies for pharmacy technicians and a framework for training pharmacy technicians for all practice settings and geographic locations.
The goal statements of the Model Curriculum are listed below.
1. Assist the pharmacist in collecting, organizing, and evaluating information for direct patient care, medication.
2. Receive and screen prescription/medication orders for completeness and authenticity. 3. Prepare medication for distribution.
4. Verify the measurements, preparation, and/or packaging of medication produced by other
5 American Society of Health-System Pharmacists. Model Curriculum for Pharmacy Technician Training2nd Edition. American Society of Health-System
Pharmacists;www.ashp.org/Import/MEMBERCENTER/Technicians/Training/ModelCurriculum.aspx. Bethesda, MD. 2001; Accessed February 13, 2009.
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5. Distribute Medications.
6. Assist the pharmacist in the administration of immunizations. 7. Assist the pharmacist in the identification of patients.
8. Initiate, verify, assist in the adjudication of and collect payment and/or initiate billing for pharmacy services and goods.
9. Purchase pharmaceuticals, devices, and supplies according to an established purchasing program.
10.Control the inventory of medications, equipment, and devices according to an established plan.
11.Assist the pharmacist in monitoring the practice site and/or service area for compliance with federal, state, and local laws; regulations; and professional standards.
12.Maintain pharmacy equipment and facilities.
13.Assist the pharmacist in preparing, storing, and distributing investigational medication products.
14.Assist the pharmacist in the monitoring of medication therapy.
15.Participate in the pharmacy department’s process for preventing medication misadventures.
16.Take personal responsibility for assisting the pharmacist in improving direct patient care. 17.Demonstrate ethical conduct in all job-related activities.
18.Maintain an image appropriate for the profession of pharmacy. 19.Resolve conflicts through negotiation.
20.Understand the principles for managing change.
21.Appreciate the need to adapt direct patient care to meet the needs of diversity.
22.Appreciate the benefits of active involvement in local, state, and national technician and other pharmacy organizations.
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24.Understand the importance of and resources for staying current with changes in pharmacy practice.
25.Communicate clearly when speaking or writing.
26.Maximize work efficiency through the use of technology.
27.Efficiently solve problems commonly encountered in one’s own work. 28.Display a caring attitude toward patients in all aspects of job responsibilities. 29.Maintain confidentiality of patient and proprietary business information. 30.Understand direct patient care delivery systems in multiple practice settings. 31.Efficiently manage one’s work whether preformed alone or as part of a team. 32.Function effectively as a member of the health care team.
33.Balance obligations to one’s self, relationships, and work in a way that minimizes stress. 34.Understand the use and side effects of prescription and nonprescription medications used
to treat common disease states.
35.Assist the pharmacist in assuring the quality of all pharmaceutical services. Several national pharmacy organizations have adopted policies calling for nationally
standardized education and training for pharmacy technicians. The development of guidelines and standards to regulate the qualifications of individuals who work as pharmacy technicians will ultimately reduce the variation in pharmacy technician qualifications and deployment across the country.
The Future of the Pharmacy Technician
Now that we have outlined the traditional tasks and functions of the pharmacy technician, it is time to discuss both future and current roles that are becoming available to pharmacy
technicians. Technicians will find positions available in a number of practice settings. As you continue to develop expertise in your profession, you should continue to be alert for
opportunities for advancement. Keep a log documenting all aspects of your education, training, certifications, and job responsibilities in preparation for any opportunity that arises. Continue to explore all related horizons to find that perfect position that will open the door to a fulfilling career.
This section discusses some of the professional duties technicians are performing now or may be performing in the future. The future is in your hands as you begin your journey toward the
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career goals that are of interest to you. Keep an open mind as you explore this exciting profession because the possibilities are endless.
Don’t be deterred if someone tells you that pharmacy technicians do not perform that role in a particular facility. Be prepared to demonstrate your abilities and desire to be a part of the team.
Pharmacy Technician Educator
A practice setting that employs many technicians may require a technician educator in the pharmacy setting to assist with orientation and training of new employees. If this position does not yet exist and you see a need for it in your practice setting, you can begin by offering to train new hires. Outline a formal procedure for this process and document your training activities. Request feedback from technicians you have trained and document this. Many technicians do not like to be bothered by training others and consider it a nuisance. If there is new equipment or new software brought into the practice setting, ask to be trained on it first and assist in the
training of others. If your site accepts students for clinical rotation, offer to be the preceptor, and set up a documented training plan. When you have amassed enough documentation for your training activities, approach the supervisor with your request for creation of a new position. Be prepared to promote yourself by discussing your knowledge, ability to convey that knowledge, the respect you have earned as a professional, your communication skills, and your desire to be of service.
Pharmacy Technician Supervisor
The role of a technician supervisor is different from that of an educator, although in some settings the positions may be combined. The technician supervisor usually has the ultimate responsibility for managing all the technicians employed in the facility. This would include recruiting, interviewing, screening, and hiring new employees. The supervisor must be totally familiar with the workflow so that adequate help can be scheduled and adjustments in personnel can be made quickly to accommodate work load. Technicians must be cross trained in all areas to facilitate workload changes. Although one or more technicians may be designated for
inventory control, it would ultimately be the responsibility of the supervisor to ensure competent inventory management. Technician attendance issues, poor work habits, and disagreements among employee would be addressed by the technician supervisor. Generally, this position would also involve a great deal of administrative paperwork responsibilities, and often some business management courses would be helpful. The technician supervisor usually reports to the pharmacy manager and must have a good working relationship with management. If this is a position of interest, acquire a copy of the job description and requirements for your facility and be certain that you meet all the requirements.
Pharmacy Warehouse Supervisor
A large hospital facility will require a pharmacy warehouse separate from the hospital warehouse facility so that medications can be more closely monitored. There may be an opportunity for a qualified technician to assume the role of pharmacy warehouse supervisor. This position would require good computer skills, proficiency in using the ordering system, and great organizational
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skills. A systematic approach to receiving orders, accurately stocking the shelves, and distributing medication to other areas is essential. Adequate procedures for the handling of controlled drugs will prevent the chaos that accompanies discrepancies. This person would be responsible for handling expired drugs and drug recalls.
Clinical Coordinator for Pharmacy Technician Program
Pharmacy technician education programs are becoming increasingly prevalent across the country and the need for more competent, educated technicians in the workforce is recognized.
Education can be a very rewarding pathway to a fulfilling career as a professional. A logical next step up the career ladder for a technician educator would be a position as a clinical coordinator for a formal education program. Classroom instruction about extemporaneous compounding and handling sterile products may be the responsibility of the clinical coordinator. Supervising laboratory experiences to prepare students for actual experiential time in a pharmacy setting is an important responsibility of the clinical coordinator. Maintaining an inventory of laboratory supplies and placing equipment and supply orders would also be duties of the coordinator. Teaching other classes in the curriculum might be included in the job description, depending on the expertise and credentials of the technician.
The coordinator also serves as a liaison with experiential practice sites and cultivates a
relationship with possible preceptors, assisting in their understanding of the important role they play in the education and training of the student. The coordinator meets with the students for discussions about their goals and decides on the practice settings that would be the most
productive for the training of each individual student. A booklet is prepared for each student and each clinical rotation. The competencies required of the student will vary depending on whether the setting is inpatient or outpatient. Contained in the booklet will be daily logs to document hours worked by the student and a brief description by the student of the work day. Each student should also fill out an evaluation of the site and the preceptor. For the preceptor there will be a checklist of competencies to be mastered by the student during the rotation, and an evaluation form for the affective behaviors observed in the student.
The clinical coordinator will make regular visits to each site on a predetermined schedule and meet briefly with the preceptor and the student to assess the learning and deal with any concerns. Any serious concerns should be directed to the program director for assessment and resolution. Often the clinical coordinator will also facilitate preparation for job interviews, assist in resume writing, and help the technician supervisor place students for employment after they complete the educational program. This position requires great organizational skills, outstanding clinical skills, and ability to teach effectively, and good communication skills to develop effective relationships with experiential sites.
Director of Pharmacy Technician Program
The director of a formal education program is ultimately responsible for the quality and viability of the program. Program directors often have an associate’s or bachelor’s degree, and in some cases may have a master’s degree and/or may be a pharmacist. In some cases the program director is responsible for developing and implementing every aspect of the program, but often
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some of the core courses are already in place and provide a foundation for pharmacy technician-specific courses.
Investigational Drug Pharmacy Technician
Some large hospitals systems are very involved in investigational drug studies and have a department devoted to record-keeping and dispensing of investigational drugs. Skilled
technicians are vital to this important aspect of the pharmacy profession. Each study drug has hundreds of protocols outlining everything from the specifications for the patients admitted to the study to the way the drug is labeled and dispensed to patients. The technician is responsible for documenting the many protocols used to validate the study. Confidentiality and accurate documentation are important because the pharmacy personnel may be the only ones who know which patients are taking the actual drug and which are taking placebos in the case of a double-blind study. An ability to read and understand the protocols enables the technician to set up the proper documentation for the various phases of the studies. Exact records of medications must be kept, and any medication not used by a patient must be retrieved because it is not an FDA approved drug. All of these tasks are performed under the supervision of a pharmacist, but the technician has great responsibilities in a rewarding and professional setting.
Refill Triage Pharmacy Technician
In a busy physician’s office, the phone rings incessantly and the fax machine continually prints requests from pharmacies for refill authorizations. The office personnel are busy taking care of patients and their immediate needs. A pharmacy technician can be invaluable, especially in a multi-physician office, to organize and triage the requests so that patients can receive their medications in a timely manner. The technician documents all the information from the phone request, along with the call back number and the pharmacy name. The patient charts are then retrieved and the refill request is checked against the documentation in the chart. The technician should learn the established protocols for refill authorization for patients and note when the patient was last seen in the office. The prescription refills to be called into the pharmacies should be written up on the appropriate form. A similar procedure is followed for requests that are faxed to the office. The prepared forms are placed along with the patient chart in the appropriate place for the prescribers to sign off on the refills. The authorizations can then be faxed back to the pharmacy and the designated person can return the calls for the phoned-in requests. The charts can then be filed. To be qualified for this position, a technician must have good organizational skills, be fluent in medical terminology and experienced in reading patient charts, and able to communicate well with the prescribers and work cooperatively with the other office personnel. A strong background in pharmacology, emphasizing brand and generic names and drug uses, will help the technician check the chart for similar drugs that have been
prescribed and others that may have been discontinued. If a fast-paced physician’s office appeals to you as a possible place to work, prepare yourself educationally, decide whether your personality type fits with this type of work, and contact some physicians and let them know what you are capable of doing for them.
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The Joint Commission Accrediting Healthcare Organizations (JCAHO) has mandated that all patient medications go through a verification process each time the patient is moved from one facility to another or from one unit to another. The medication reconciliation process is designed to prevent duplication of medication ordered by different physicians or by the same physician at different times.
When a patient first enters a healthcare facility, an accurate listing of all medications the patient is currently taking is compiled with information from the patient or a caregiver. This list is compared with the physician admission orders to check for any duplications or discrepancies. The professional judgment of the technician is invaluable at this step and aids in the decision to alert the pharmacist about a medication concern. Discrepancies are then evaluated by a
pharmacy using knowledge-based professional judgment to decide whether a medication adjustment is within the pharmacist’s scope and standards of practice, or whether a consultation with the physician is required to resolve the issue. Any changes in the physician’s orders are documented, and the reconciliation form should become a part of the patient’s chart. This form should follow the patients each time they are moved to another unit in the facility and continue with them if they are transferred to another facility or discharged to home.
Each of these steps should be documented according to a previously designed set of protocols established by the institution involved. The institution should have an official reconciliation form to be utilized and guidelines for the qualifications of the staff members allowed to participate in this process. A staff education process should be put into place for all staff
involved in this process. In some institutions, this process may be performed by the nursing staff or by pharmacists. This is a process that requires a considerable commitment of time to be effective. An educated pharmacy technician has more knowledge about pharmacology and a better understanding of the medication process, especially concerning brand and generic drug names, drug classes, adverse effects, and interactions, than the nursing staff. A competent pharmacy technician understands the scope of practice and standards of practice, and how they relate to the professional judgment of a technician. A competent, educated and certified pharmacy technician is trained to exercise professional judgment of a technician to alert the pharmacist to any discrepancies that require evaluation by the pharmacist. If this position interest you, prepare yourself by excelling in your educational requirements, demonstrating your skills as a staff technician, building a sense of trust with the pharmacists, and consistently proving your professionalism. Then you must make a formal request to train for this position.
Quality Assurance Technician
Medication safety has become a major benchmark for pharmacies everywhere. The technician who is involved with the day-to-day functions performed in the pharmacy is in the best position to observe system problems that may be contributing to medication errors. A quality assurance technician should be familiar with all the established protocols for procedures performed in the pharmacy. These protocols should be evaluated regularly and adapted as needed. The technician in this role should be constantly alert for potential problems that may cause a medication error or a breach of aseptic technique. Documentation of any errors that have occurred and the plan to prevent the error from recurring, along with special training session to reinforce skills and education sessions to refresh the memory, would be parts of the role.
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COMMUNITY BASED CARE Community Pharmacy Practice
Community pharmacy is the practice setting that the public primarily envisions when pharmacy practice is discussed. The provision of medication for ambulatory patients is the primary responsibility of community pharmacy practitioners and the volume will increase as a result of an aging population and the trend toward managing more acute conditions and acute
exacerbations of chronic conditions in the ambulatory environment. The complexity and sophistication of the medications used in the ambulatory setting, coupled with the increasing number of ambulatory patients, suggests that pharmacists in community pharmacies will become an even more essential access point for acquisition of healthcare services. This trend will
continue despite the fact that an increasing number of patients receive their medications and medication information from an institutional or health system-affiliated pharmacy or a pharmacy that is located within an organized primary care medical practice.
Community pharmacy is a diverse, dynamic and constantly changing practice environment. First and foremost, community pharmacy is a practice environment that requires good people skills and excellent communication, because the pharmacy personnel deal with patients on a daily basis. Most people visit the community pharmacy more than any other health care setting. Pharmacy technicians play a vital role in this practice setting by assisting the pharmacist in preparing prescriptions, collecting information from patients, and performing several other important functions (many discussed in the goal statements of the Model Curriculum outlined earlier).
The number of prescriptions being filled has increased dramatically over the last few years and is only expected to keep rising. One of the reasons for this rise is the aging of the population. People are living longer and as people age, their medication requirements increase. In addition to the aging population, advances in medicine have led to the ability of physicians to treat more disease states in an outpatient setting. These factors, along with the fact that more and more prescription drugs become available each year and more and more patients have access to prescription insurance has allowed for more prescription to be processed in the community pharmacy practice.
Because of the rapid growth in the number of prescriptions each year, the community pharmacy environment needs to be open to change and ready to adapt to the challenges of the increased need. One constant change is the role of technology in the processing of prescriptions. Almost all community pharmacies utilize computers to some degree in the prescription filling process. Besides keeping a computerized patient profile, computers in the pharmacy can be used to screen phone calls, accept refill orders, scan prescriptions to prevent errors, and computers are being used to count the units of medication, fill the container, and label the vial or bottle. Computers are also used to alert the pharmacist to drug interactions and transmit insurance information to a patient’s insurance company. Many pharmacies utilize e-prescribing technology, where a
prescription can be generated at the prescriber’s office and electronically transmitted directly into the processing computer at the local pharmacy, eliminating the need to enter information off a paper prescription.
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With prescription volume increasing and the shortage of pharmacist worsening, the role of the pharmacy technician has increased in the community pharmacy practice. Pharmacist are
expanding their role as patient care providers and incorporating more patient-care activities into their daily practice. With the increasing complexity of drug regimens, pharmacists need to be spending more time with the patients, counseling and educating them on their disease states and medication therapy. With these increased tasks, technicians perform many of the technical functions in support of the pharmacist. By allowing pharmacist to spend more time with the patients, receiving care and information, the technician can help them get the most benefit from their therapy.
Independent Pharmacies
Independent pharmacies consist of one to four stores owned and operated by an individual pharmacist or group of individuals. They vary greatly in size, volume of prescription, and services. A benefit of working for an independent pharmacy is that a technician will usually have direct access to the owner or main decision maker. Also, independent pharmacies are more likely to specialize in one area of pharmacy, such as surgical supplies or home infusion therapy. These specialty areas can offer exciting and diverse opportunities for pharmacy technicians. The technician’s responsibilities vary according to the type of pharmacy and the services offered. In a full-service pharmacy the technician may be required to function in all departments of the store depending on the size of the store, the number of employees, and the prescription volume of the pharmacy. Inventory control is an important duty that technicians routinely perform. It is vitally important that an adequate stock of medications be available in the pharmacy so that patients can receive their treatment in a timely manner. There are various ways to control inventory, but most pharmacies use a computerized method. Prioritizing phone calls helps the pharmacist concentrate on patient-care concerns by directing calls that do not truly require the pharmacist’s attention to other employees or having the technician respond to questions when possible. Technicians may take refill phone orders from patients. A new prescription from a doctor must be transferred to the pharmacist. A refill order from the doctor may be accepted by the technician if there is no change in the medication strength or directions.
Receiving and verifying prescriptions requires the expertise of a competent technician.
Chain Pharmacies
Chain pharmacies also vary in size, volume, and services and can be differentiated one from another based on the setting in which they are housed. Chain drugstores are the most common, and although these stores sell mostly traditional drugstore merchandise, many of them carry a large variety of products. Chain drugstores can be regional, where they only operate stores in one geographic area, or national, with stores spread out all over the country.
Chain pharmacies generally have standard operating procedures that apply to all pharmacies in the system. On-the-job training, technician responsibilities, and general employee regulations are usually described during an orientation period and are often documented in a policy and procedure book and/or employee handbook. Many of the retail technician’s responsibilities will
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be the same as, or similar to, those expected of a technician in an independently owned retail pharmacy. Large chain pharmacies will often have a higher prescription volume and may have many more employees. There may be several pharmacists and many technicians depending on the location and size of the pharmacy. Some of these pharmacies may be open 24 hours and technicians may always work the same shift or take turns rotating through the morning, evening, and overnight shifts. Communication among the technicians and the pharmacists is vitally important to ensure the smooth operation of the pharmacy department. There may be one or more lead technicians to assist in training and scheduling, but everyone must work together in a professional manner to ensure excellent pharmaceutical care for patients.
In addition to chain drugstores, chain pharmacies can be located in supermarkets, and again, be regional or national in scope. The primary goal of these retail outlets is to generate sales of their traditional product lines, primarily groceries and related items.
Other types of stores that sometime house chain pharmacies are mass merchandisers like Target, Costco, and Kmart. These retail outlets’ primary goals are generating traditional retail sales and not pharmacy business. Mass merchants have entered the pharmacy market in a more serious fashion, primarily to attract new types of customers to their stores and grow the sales of their traditional products. Many have entered this market with the pharmacy department being a “loss leader,” meaning they are willing to lose money in this department because losses are more than offset by sales to these customers in other departments.
Surgical Supply/Durable Medical Equipment (DME)
The third most prevalent form of home health care is home equipment management services, also referred to as home medical equipment (HME) services or durable medical equipment (DME)
services. Home equipment management services can be defined as the selection, delivery, setup, and maintenance of equipment and the education of the patient in the use of the equipment – all performed in the patient’s place of residence.
Some community pharmacies provide surgical supplies to patients in their community. This would include durable medical equipment such as knee braces, neck collars, hospital beds, canes, walkers, commodes, and other products. A pharmacy specializing in durable medical equipment will have a pharmacist and specialty trained staff to assist patients in choosing the best products, fitting patients for products like braces and other orthotic supplies, and obtaining proper
reimbursement from insurance providers for these services. Long-Term Care
Community pharmacies can also provide medications to long-term care facilities in addition to providing prescription processing services to the community. Some long-term care facilities, like nursing homes, have their own pharmacies in the building, but many, because of their size or budget, may not. In these cases the facilities use pharmacies that generally prepare the orders on a daily basis for the inpatients and deliver the medications to the facility. This type of setting combines both inpatient and outpatient services into one environment.
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Long-term care pharmacies sometimes service nursing homes in a state or regional area. They employ drivers or delivery persons to distribute the medications daily to the homes that have contracted with them for services. Pharmacy technicians are a vital link in the timely provision of these services. Orders from the homes are usually faxed to the pharmacy in the morning. Generally they are in the form of inpatient medication orders. There may be a pool of data entry technicians who type the medication orders into the computer to produce labels for the
medications. These technicians must be well versed in interpreting medication orders and accurately entering them in the computer.
Long-term care pharmacies also carry many nursing-home supplies, including IV tubing, catheters, colostomy supplies, and other convalescent needs. Technicians must familiarize themselves with all of the ancillary supplies to ensure that the correct items will be sent. Periodically during the day, the data entry department will run all the labels entered in a given time period. At this point, one or more pharmacists will check the labels produced against the original medication orders received. The labels will be verified by the pharmacist or returned to data entry for any corrections needed.
Once the labels are verified, they are passed on to the filing technicians, who begin to fill them in a manner appropriate for the facility being served. Many facilities utilize a system in which a 30-day supply of each medication is sealed in a blister pack (often called a “bingo card”). Each individual dose of medication can be punched out of its compartment and administered to the patient. The technician is responsible for placing the medications into the pockets in the card, heat-sealing the card, and placing the correct label on the card. This process may also be accomplished by automation if it is available. High-volume products are often sealed in cards ahead of time and placed in a storage area for easy retrieval when needed. These products are required to meet all the regulations for repackaging of drugs.
Repackaged products must have correct expiration dates, lot numbers, and brand or generic name, and be entered into a logbook and verified by a pharmacist.
When the medication orders are filled, they are placed in a central checking area to be verified by the pharmacist. For any compounds ordered, the labels go to the compounding area, where a technician is assigned to process them. The compounding process is supervised by a pharmacist. IV medications will be processed by the IV technician and checked by the pharmacist. Homes with a pediatric population may need medications packaged as unit dose oral liquids. Controlled drugs are usually kept in a controlled room with a pharmacist and one or more technicians assigned to work in the room. Controlled drugs sent to nursing homes are packaged in secure containers to prevent drug diversion. At a prearranged time all medications must be filled, checked by the pharmacist, and packed for delivery to each individual home. The technician may be the person who packs the delivery boxes and checks to determine that all ordered items are in the box. The homes usually contract with the pharmacy for all items ordered daily to be received by the end of the day, so it is important that no item be left out. If a nursing-home patient missies a dose of medication because it is unavailable, that would be considered a medication error from the home.
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Depending on the size of the pharmacy, inventory control may be the responsibility of one or several technicians. Often there is a lead technician or technician supervisor responsible for interviewing, hiring, scheduling, and general technician supervision. Many nursing homes use a medication cart system involving the exchange of medication carts every seven days or some other prearranged schedule. In this case, there may be an “exchange technician” who delivers the filled medication carts to the nursing home and returns the empty carts.
Medication carts are filled by technicians using unit dose medications. Many medications are available in unit dose packaging, but if an ordered medication is not available in a unit dose, the technician will package the correct quantity either manually or using a unit dose packaging machine.
Long-term care pharmacies often serve hundreds of nursing homes and fill thousands of order each day. The technicians’ knowledge of medications, convalescent supplies, and the policies and procedures of the facility is crucial for ensuring the smooth operation of the pharmacy and the provision of good pharmaceutical care to the many patients they serve. A position in a long-term care pharmacy can provide a fulfilling opportunity to work in a fast-paced setting where there are many opportunities for advancement learning.
Home Infusion
Similar to long-term care provision, some pharmacies provide home care organization with parenteral medications. These products are prepared in the community pharmacy and then delivered or shipped to the patient’s home, where a skilled nurse will administer the medication. The role of the technician is more varied and more progressive in home infusion therapy than almost any type of pharmacy. It can be both challenging and provide the opportunity for job changes or advancement. Pharmacy technicians have knowledge and skills that can adapt to other job functions and responsibilities in home infusion pharmacy practice.
The traditional and key role of the technician in home infusion therapy is in the preparation of sterile products under the supervision of a pharmacist. Some states have more stringent
requirements for technicians supervision by a pharmacist in outpatient and home settings (e.g., a pharmacist must be physically present within eyesight of the technician at all times) than in a hospital pharmacy. In some expanded health systems, there may be a retail or outpatient pharmacy, institutional pharmacy or hospital pharmacy, and clinic or satellite pharmacies in addition to the home infusion pharmacy, making the technician’s role more varied and possibly including duties and responsibilities in these other areas as well. Other roles for pharmacy technicians in home infusion therapy include:
• Equipment management technician • Patient service representative • Purchasing agent or manager • Warehouse supervisor • Billing clerk/case manager
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Home infusion pharmacies are increasing in number with the spiraling cost of inpatient services and the limits on inpatient coverage by insurance companies. Terminally ill patients also often choose to remain in the home, given the availability of hospice services. A technician’s
responsibilities often include packing IV medications and medical supplies for shipping or transport to the patient’s home. However, the primary responsibility will be accurate IV admixture using the strictest aseptic technique in a cleanroom. Broth test should be performed periodically6, IV bags sent into a patients home may be kept for several days to a week before use, so any break in aseptic technique that could allow the growth of organism would be critical for an already compromised patient. Home infusion pharmacies offer many opportunities for advancement into administrative roles for qualified technicians desiring this type of position. Educational requirements for home infusion technicians would be the same as for inpatient hospital technicians, with a strong emphasis on sterile products.
Specialty Compounding Services
Because every patient has different needs, customized, compounded medications are a vital part of quality medical care. The basis of the profession of pharmacy has always been the patient– physician–pharmacist relationship. Through this relationship, patient needs are determined by a physician, who chooses a treatment regimen that may include a compounded medication. Physicians prescribe compounded medications for many reasons including the following situations:
• When needed medications are discontinued by or generally unavailable from
pharmaceutical companies, often because the medications are no longer profitable to manufacture,
• When the patient is allergic to certain preservatives, dyes, or binders in off-the-shelf medications,
• When treatment requires tailored dosage strengths for patients with unique needs (e.g., infants),
• When a pharmacist can combine several medications the patient is taking to increase compliance,
• When the patient cannot ingest the medication in its commercially available form and a pharmacist can prepare the medication in cream, liquid, or other, more easily used form, • When medications require flavor additives to make them more palatable for some
patients, most often children.
For those people with unique health needs that cannot be met by commercially available manufactured prescription medicines, compounded medications prescribed or ordered by
physicians can be prepared safely by trained compounding pharmacists. Compounding is in even greater demand for treating animals because of their greater diversity in size and therapeutic needs and the relatively narrow selection, flavors, and dosages of medicines that are
manufactured by pharmaceutical companies.
6 A test to assess operators ability to maintain the sterility of materials during the preparation of aseptically prepared injectable dose forms, in order to ensure that minimal bioburden is introduced. http://www.civas.co.uk/universalbroth/Universal-Operator-Broth-Test-Version9-Dec2005.pdf
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Many pharmacists have unique knowledge and skills in pharmaceutical compounding, having studied chemical compatibilities and been trained to prepare alternate dosage forms.
Accreditation standards for professional degree programs in pharmacy require instruction in compounding pharmaceutical ingredients and so all pharmacists have foundational knowledge and skills in this area. Some pharmacists, however, have elected to focus their practice in this area and have additional experience, education, and training.
In 2004, the Pharmacy Compounding Accreditation Board (PCAB) was established by eight national pharmacy organizations. This was an important development impacting the practice of pharmacy compounding because it established a national standard of best practices for
compounding pharmacies. PCAB accreditation is a voluntary process focused on maximizing the quality of pharmacy compounding and reducing risk of patient harm. PCAB accreditation has been recognized by the American Medical Association and the American Pharmacists
Association as a way to identify compounding pharmacies that meet high quality standards. Many community and/or compounding pharmacies across the country specialize in compounding pharmaceutical products that are not readily available in a particular dosage form or in the dose necessary for the patient. Compounded pharmaceutical products can take the form of oral suspensions or solutions, intravenous admixtures, capsules, topical preparations, or even the unusual, like lollipops. Compounding services are an important part of many community
pharmacy services. They are especially useful in special patient populations such as children and veterinary practices. Many times children will suffer from illnesses that can be treated only with adult medications. In these cases, the medications may only be available as a tablet or capsule or only in a dosage that would far exceed what would be recommended for a child. The medication needs to be diluted into a child-appropriate dose and possibly into a dosage form that can be taken by a child who cannot swallow tablets or capsules. In these situations, the pharmacist would prepare a solution or suspension by grinding the available tablets into a powder, adding an appropriate amount of water or other diluents, and then flavoring the preparation to make to palatable. This is just one example of how pharmacist use compounding services to improve the care offered to patients.
Veterinary practices also use compounding services on a routine basis. Many veterinarians use human medications to treat their animals. The doses or dosage forms they need are not
commercially available. They will then go to a community pharmacy that specializes in compounding veterinary products and use their services to get what they need.
A pharmacy technician offers many types of services to the compounding pharmacist. A technician may be involved in almost any step in the process, from gathering necessary ingredients to be incorporated, to mixing the products together under the supervision of the pharmacist. Some of the skills necessary to participate in compounding services are meticulous attention to detail, knowing how to properly use equipment necessary to weigh and measure wet and dry ingredients, and knowledge of the metric and apothecary system for weights and
measures (extemporaneous compounding). Although extemporaneous compounding may be part of a technician’s duties in any of the practice settings, it is extremely important in a practice that specializes in compounding medications.
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Although basic compounding skills should be part of every technician’s education and training, additional compounding techniques can be learned by receiving on-the-job training or
completing a compounding certificate program.
Mail-Service Pharmacy
Some patients receive their medications—especially refills for medications used for chronic medical conditions—from mail-service pharmacies, which are used by some health plans, prescription benefit management companies (PBMs), large pharmacy chains, and Internet pharmacy providers to reduce costs associated with the supply of medications and provide the convenience of home delivery of medications. Patients typically order their medications via telephone, fax, e-mail, or the Internet. Once a prescription order is transmitted to the mail-service pharmacy, patients usually receive their prescription within a week to ten days. Large numbers of pharmacists and pharmacy technicians are employed at mail-service pharmacies, but many of the processes use high-volume automated dispensing technologies. Some mail-service pharmacies provide medication management services for individual or population-based patients.
The lack of one-on-one contact with a pharmacist and the delay in receiving medication are the main reasons people do not use mail-order pharmacies.
Mail-order pharmacies are becoming more prevalent because many insurance companies are mandating the use of mail-order for maintenance drugs, and some patients appreciate the
convenience of receiving their medications through the mail. It is especially helpful for patients who live in rural areas and are unable to drive to a pharmacy.
Technician positions are delineated into the various functions required to process prescriptions in a mail-order practice. Often there is a complete department of technicians responsible for
answering phones and either transferring the call to a pharmacist or, if it is a refill order,
recording the order and sending it to data entry to begin processing. The data-entry technicians receive the mail, the refill orders that have been called into the order line, and the new
prescriptions that have been called in to the pharmacists. The prescriptions are evaluated for completeness and if there are any concerns about content, dose or legibility, the prescription in question is sent to the phone area where a pharmacist completes the evaluation process and calls the prescriber for clarification if necessary. The phone-clarification area is staffed by
pharmacists and technicians. The technicians call prescribers for refill authorization and missing prescriber identification, and a pharmacist is available if other medication verification is
necessary.
When the prescription information is complete and accurate, the data-entry technicians process them and produce labels and paper work for each prescription. The technicians who prepare the label for the medications continue the prescription processing and send the completed
prescriptions and paper work to a pharmacist for a final check and transfer to the packaging and shipping area. This process must be completed in a timely manner so that patients can receive their medications promptly. To ensure an efficient process, technicians also perform inventory control, handle insurance processing, and help to stock and maintain the automated machines involved in the dispensing. All technicians work under the direct supervision of pharmacists;
