ASHP Statement on the Roles of Pharmacy Technicians

ASHP recognizes that well-educated and highly skilled pharmacy technicians have important roles and responsibilities in the pharmacy profession and that a safe and effective medication-use process depends significantly on the skills, knowledge, and competence of those pharmacy technicians. To properly fill these roles, pharmacy technicians require standardized education, training, and competence assessment. ASHP advocates that states encourage this education, training, and assessment through the development and adoption of uniform state laws and regulations requiring licensure of pharmacy technicians. Pharmacy technicians practice in a variety of settings and have diverse roles and responsibilities, ranging from those suitable for technicians meeting minimum requirements for education, training, and experience to complex, advanced, or specialized roles that require additional education, training, and demonstration of competence. Because pharmacy technicians are the foundation of pharmacy’s distributive functions and are utilized in clinical functions where appropriate, pharmacy must strongly support the development of uniform education, training, registration, certification, and recertification of pharmacy technicians. Standardization will be required at all levels of pharmacy technician practice. The role of pharmacy technicians is a significant focus of the ASHP Pharmacy Practice Model Initiative (PPMI). The goal of the PPMI is “to significantly advance the health and well-being of patients by developing and disseminating a futuristic practice model that supports the most effective use of pharmacists as direct patient care providers.”1 ASHP strongly believes that advancing the roles of pharmacists will require changes in the way that pharmacy technicians are educated, trained, regulated, and incorporated into pharmacy practice, dependent on their capabilities. The consensus of the Pharmacy Practice Model Summit called for standardization in scope of practice, competencies, education and training, licensure, and certification of pharmacy technicians.2 One of the recommendations from the ASHP Ambulatory Care Conference and Summit recognized that to “promote efficiency and improve access to patient care, pharmacists who provide ambulatory care services should optimize the role of certified pharmacy technicians and other members of the healthcare team.”3 The purpose of this statement is to outline the evolving roles and responsibilities of pharmacy technicians, describe a model for educating and certifying pharmacy technicians, and propose a legal and regulatory structure that reflects the evolving nature of pharmacy technicians’ responsibilities. ASHP recognizes that pharmacy technicians have many different roles in a variety of healthcare settings, with varying levels of responsibility and complexity, from those suitable for technicians just entering the work force to advanced or specialized roles that require additional education, training, experience, and competence. The following are categories of competencies that pharmacy technicians must possess for entry to practice: Pharmacology for technicians Pharmacy law and regulations Compounding Low- or medium-risk level sterile compounding Nonsterile compounding Basic safe medication practices Pharmacy quality assurance Medication order entry and distribution Pharmacy inventory management Pharmacy billing and reimbursement Medication-use system technology Advanced pharmacy technicians who have additional education, training, and competencies may perform tasks that require more responsibility. Under the supervision of pharmacists and/or with the approval of state boards of pharmacy, advanced pharmacy technicians may be involved in, but not limited to, the following roles: Advanced medication systems, including “tech-check-tech” programs Purchasing or fiscal management Management or supervision of other pharmacy technicians Medication history assistance Medication therapy management assistance Quality improvement Immunization assistance Hazardous drug handling Patient assistance programs Pharmacy technician education and training Community outreach Drug utilization evaluation and/or adverse-drug-event monitoring Industry Informatics4 In today’s era of rapid evolution of healthcare, declining reimbursements, and increasing complexity of the healthcare market, pharmacy technicians will need to advance to a level of operations management that has not been previously required. Pharmacists and pharmacy technicians must work synergistically in targeted initiatives to provide patient care services, understanding their potential roles to maximize the utilization of resources.5 The integration of pharmacy technicians into pharmacy care teams has been demonstrated in database and interface management and in an analyst role, with the goal of achieving the highest level of care for patients.6 These roles include preparing and analyzing reports as well as benchmarking by educated and trained pharmacy technicians, who provide information to pharmacists ready for decision-making. These pharmacy technicians require standardized education to develop a sufficient knowledge of medications and the medication-use process, documentation systems, and databases. In management, pharmacy technicians are an untapped resource, though some are already performing leadership roles, such as operations manager, independently.7 These individuals are essential to pharmacy services, as they can provide leadership in supervisory roles and tasks,7,8 freeing pharmacists to devote their attention to other areas of patient care.9 ASHP believes there must be an emphasis within leadership teams to ensure the success of these technician leaders through the elimination of perceived technician practice barriers, enhancement of educational opportunities, and provision of increased mentoring sessions. ASHP recognizes the need for specialized certification of pharmacy technicians who perform activities involving greater degrees of complexity and risk. Any pharmacy technician in an area of pharmacy practice designated for specialty certification by the Pharmacy Technician Certification Board (PTCB) must have successfully completed the appropriate certifications before practicing in that specialty area. ASHP further recommends that any pharmacy technician in an area of pharmacy practice designated for other specialty or advanced certification have successfully completed the appropriate certifications before practicing in that specialty area. PTCB plans careful evaluation and recognition of emerging specialties as practice and patient needs evolve. National standards for the education and training of pharmacy technicians exist10; however, they have not been widely adopted. Technicians attain the necessary knowledge base in a variety of ways, ranging from on-the-job training to online or publication-based training, employer-based structured didactic learning, and formalized study with programs that may or may not have proper professional accreditation status. To obtain the pharmacy technician work force of the future, pharmacy must attract the highest-quality candidates. To attract the best possible candidates, ASHP advocates that pharmacy technician education ultimately require a minimum of an associate’s degree from an accredited source. ASHP also supports testing candidates in reading, oral and written English communication, and math upon entry into a technician program to establish a minimum baseline of performance. ASHP recognizes that differing roles for pharmacy technicians will require advanced education and training beyond that of an entry-level technician. Education and training requirements must reflect the responsibilities that technicians will have in their daily activities. Ongoing competence assessment must be a component of advanced or specialized technician roles. In addition to meeting the requirements to become PTCB certified, pharmacy technicians also must undergo site-specific training to the specific roles and responsibilities that they will perform. When a new role is introduced, additional training specific to that new position must be completed. Quality measures must be employed to assess the accuracy of the pharmacy technician’s performance. ASHP advocates that all pharmacy technicians, from entry-level to specialty-trained technicians, complete a pharmacy technician training program accredited by ASHP and the Accreditation Council for Pharmacy Education (ACPE) through the Pharmacy Technician Accreditation Commission as a requirement for earning PTCB certification. Further, ASHP advocates that pharmacy technicians be PTCB certified and maintain their certification through mandated continuing education and recertification. In addition, changes to the PTCB certification process over the coming years will elevate PTCB’s standards for national certification and recertification, including a requirement for completion of an ASHP-/ACPE-accredited education program by 2020 and modifications to the continuing-education requirements for recertification.11 Currently, only a handful of states require pharmacy technician licensure, several states do not require either licensure or registration, and the majority require registration of pharmacy technicians. ASHP advocates the development and adoption of uniform state laws and regulations regarding pharmacy technicians. ASHP strongly advocates that those laws and regulations eventually require that pharmacy technicians be licensed by state boards of pharmacy to grant technicians permission to engage in the full scope of responsibilities authorized by the state. ASHP advocates that pharmacy technicians must be certified by PTCB as a prerequisite to licensure by their state board of pharmacy. The National Association of Boards of Pharmacy and ASHP advocate that pharmacy technicians become certified by PTCB before being licensed or registered by state boards of pharmacy.12 ASHP advocates that (1) licensure of technicians must not permit the independent, unsupervised practice of pharmacy technicians, (2) all pharmacy functions must be performed under the supervision of a licensed pharmacist, and (3) licensed pharmacists and technicians must be held mutually accountable for the quality of pharmacy services provided. ASHP supports the advancement of pharmacy technician roles and responsibilities to aid pharmacists in providing optimal patient care. In order to be effective in these roles and responsibilities, it is imperative that pharmacy technicians have standardized education, training, certification, and licensing requirements. The authors have declared no potential conflicts of interest. Approved by the ASHP Board of Directors on September 18, 2015, and by the ASHP House of Delegates on November 20, 2015. Developed through the ASHP Section of Inpatient Care Practitioners Advisory Group on Advancing Pharmacy Practice with Technicians. ASHP gratefully acknowledges the following organizations and individuals for reviewing these guidelines (review does not imply endorsement): American Association of Colleges of Pharmacy; American Pharmacists Association; Canadian Society of Hospital Pharmacists; Idaho Society of Health-System Pharmacists; New Hampshire Society of Health-System Pharmacists; Pharmacy Technician Certification Board; Pharmacy Technician Educators Council; Thomas S. Achey, Pharm.D.; Tolulope Akinbo, Pharm.D., M.P.H.; Sandra Andrews, CPhT, BLS; John Armitstead, M.S., FASHP; Nicole Avant, Pharm.D.; Ann Barnes, Pharm.D.; Megan Brafford, Pharm.D., BCOP; Dominick A. Caselnova III, M.H.A.; Angela T. Cassano, Pharm.D., BCPS, FASHP; John S. Clark, Pharm.D., M.S., BCPS, FASHP; Gwyn Collier, CPhT, MCPhT, M.B.A.; Debra Cowan, Pharm.D., FASHP; Travis B. Dick, Pharm.D., M.B.A., BCPS; Lonnye Finneman; Rena Gosser, Pharm.D.; Jacquelyn Grahm, B.S., CPhT; Kathleen M. Gura, Pharm.D., BCNSP, FASHP, FPPAG, FASPEN; Tracy Hagemann, Pharm.D., FCCP, FPPAG; John B. Hertig, Pharm.D., M.S., CPPS; Stephen K. Hetey, M.S., FASHP; Stan Kent, M.S.; Susan Kleppin; James Lee, Pharm.D., BCACP; Janet Liles, CPHT, MSHS; Brandon Nemecek; Judy Neville; Stephanie C. Peshek, Pharm.D., M.B.A., M.S., FASHP; Barbara Petroff, M.S., FASHP; James Ponto, M.S., FASHP; Timothy Reilly, Pharm.D., BCPS, CGP, FASCP; Kelly Sennett, Pharm.D.; Jamie S. Sinclair, M.S., FASHP; Paul Wittmer, M.B.A.; and Roger Woolf, Pharm.D.

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