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State Roundup: Alex Adams Discusses Idaho's Proposed Rules To Expand Technician Roles

by PTCB | Nov 21, 2016

Proposed rule changes in Idaho would expand certified pharmacy technician roles in several areas, including prescription transfers, accuracy checks, and immunizations. Pharmacy technician roles have been under discussion in the Idaho Board of Pharmacy all year. PTCB Executive Resident Deeb Eid, PharmD, RPh, talked with Alex Adams, PharmD, MPH, Executive Director of the Idaho Board, to learn more about technician role expansion in Idaho.

Photo:
Deeb Eid, PharmD, RPh, Executive Resident, PTCB (left), and Alex J. Adams, PharmD, MPH, Executive Director, Idaho Board of Pharmacy

Why did Idaho decide to consider expanding technician roles?
Alex: “For years, Idaho has required registration and certification of the pharmacy technician workforce. As of 2016, 84% of Idaho technicians are either certified or on a pathway to become certified, up from just 39% in 2011. In addition, Idaho’s certified technician workforce is becoming more experienced. Today, 45% of Idaho’s certified technicians have 3 or more years of practice experience. Despite increases in registration and certification, rules relating to roles and responsibilities of technicians have remained generally unchanged for 40 years. Other states have allowed technicians to perform certain non-discretionary technical services and we wanted to reassess our restrictions. If pharmacist time is spent on tasks that can be safely delegated to technicians, patients are deprived of the clinical expertise pharmacists bring to the health care team. It is critical for states to optimize the role of appropriately-trained technicians to protect patient safety and health.”

What roles and responsibilities would the proposed rules allow for technicians?
Alex:
“Other states have allowed certified technicians to receive verbal prescriptions, transfer prescriptions, perform tech-check-check on uncomplicated refills after a pharmacist drug utilization review, and perform remote data entry. We reviewed the outcomes in states that have allowed these activities for years, and the evidence is pretty clear that these tasks can be delegated to free up pharmacists for more patient care roles. We have discussed including the technical task of administering a vaccine as an allowable role of certified technicians with advanced training. Literature suggests this task can be safely and appropriately delegated. Some of our technicians previously performed this task in medical offices while serving as medical assistants. Training programs are emerging that intend to prepare technicians for advanced roles like vaccine administration.”

What feedback has the Idaho Board received from pharmacists and technicians?
Alex:
“We found that pharmacists are generally supportive of expanded technician roles, as long as the technician has the requisite training to perform the duty. Pharmacists report variability in technician qualifications, and thus it is critical to ensure the assignment of function ultimately rests with the supervising pharmacist even when the technician has completed a task-specific training. Pharmacists naturally have many questions about expanded technician roles and their own liability, and they were pleased to learn that liability insurers typically have not found expanded roles to increase risk in the states that have allowed them for years. Pharmacy technicians reflected excitement about the opportunity to take on new roles for which they receive advanced training. Some saw this as an opportunity to create a technician career ladder that helps recruit top talent.”

What are your top three recommendations for states considering similar actions?
Alex:
“First, start with registration and certification. Until these steps are in place, it will likely be difficult for stakeholders to embrace more advanced technician roles. Second, follow the evidence. There are many states that have allowed advanced roles for decades, and learning from their experience is beneficial. Keeping a focus on the evidence can ensure the Board is making decisions based on the public interest and patient safety. Third, engage stakeholders early in the process. The Idaho Board held a series of listening sessions with pharmacists, technicians, and the public before putting pen to paper on the proposed rules. These sessions were critical to developing a rules package.

How important are pharmacy technician training, education, and certification?
Alex:
“Our Board was able to have these discussions because registration and certification were previously required in the state. These steps elevate the pharmacy technician profession, and provide pharmacists with a comfort level regarding the level of competence their technician colleagues possess."

Idaho would be the first state to allow pharmacy technicians to administer immunizations. The proposed changes are expected to be under review in January, and if approved, to take effect in 2017.

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