Pharmacy Technician Workforce: Oh, the places you’ll go! Julie F Lanza CPhT, CSPT Neil A. Gilchrist, PharmD, MBA, BCPS Pharmacy Compliance Specialist Sr. Director, Pharmacy Services Beth Israel Deaconess Medical Center UMass Memorial Medical Center Boston, MA 02215 Worcester, MA 01655
Ob Objec ectives tives Pharmacy Technicians • Define the value of having pharmacy technicians in speciliazed roles • Describe how taking on a specialized role and accepting deeper responsibilities can strengthen the pharmacy team • List the impact of advanced technician roles on job satisfaction Pharmacists • Identify emerging roles for pharmacy technicians • List the potential impact of advanced technician roles in regard to job satisfaction and retention • Describe the opportunity for pharmacists created by utilizing pharmacy technicians in advanced roles
Ne Neil to o ad add co d cont ntent ent • Consensus-seeking event convened by ASHP • Published Am J Health-Syst Pharm 2011;68:1079-85 • Advancing pharmacy technician roles • Independent pharmacy technician drug distribution models • Mandatory training, documented competencies and licensure • Certification for advanced and specialized technician practice areas such as sterile compounding should be developed • Pharmacy has yet to face its responsibility for ensuring the competence of pharmacy technicians, and this is holding the profession back from adequately addressing patients clinical medication-use needs
ASHP P Fo Foundation undation Pharmacy rmacy Fo Forecast ecast • Strategic Planning Advice Document published annually • 2019: Future of Pharmacy Education and Workforce • Pharmacy technicians in patient care • Competency assured pharmacy technicians will be authorized to independently perform patient care activities • 2018 Advancing Pharmacy Technicians roles • Managing robotics, supervisory, clinical decision support • 2017 Pharmacy Work Force: Shifts in Roles, Responsibilities and Training • Pharmacy Technicians in a new light
2018 18 ASHP P Pharmacy armacy Fo Forecast: ecast: Advanced vanced Pharmacy armacy Te Techni chnician cian Roles: les: ASHP Foundation Pharmacy Forecast 2018. AJHP January 15, 2018.
MS MSHP HP Ph Phar arma macy cy Te Techn hnician ician Pa Pane nel Robert Fay, CPhT Pharmacy Revenue Analyst Baystate Health Springfield, MA
Baystate Health is a not for profit Health System consisting of 4 hospitals and numerous medical practices. The main hospital, Baystate Medical Center, is a 716 bed facility located in Springfield, MA. Only Level One Trauma Center in the area. Inpatient pharmacy with ~100 employees
Professional Pharmacy Background Retail pharmacy: 30 years Job Corps: Technician Training Course, 10 years Baystate Health: last 2.5 years Med Reconciliation Technician Billing Technician Pharmacy Analyst
Pharmacy Revenue Analyst: Partner with an outside vendor to help analyze purchasing feeds, revenue and usage , pharmacy formulary and our Charge Description Master, to maximize charge capture and revenue gains. Work closely with Revenue services, to correct billing errors for pharmacy claims and to participate in billing inquiries to determine the best course of action if errors are found. Waste billing compliance with Medicare guidelines (JW Modifier).
Identify: Drugs Purchased to be included for JW Modifier Missing HCPCs Codes Mismatched HCPCs Codes Multiplier Issues Financial opportunities for Cost vs. CDM charge CDM Workflow developed: IT system involvement CDM creation with accountability Testing CDM before utilization in charge system Goal 100% correct pharmacy charges according to Medicare and private insurance guidelines
MS MSHP HP Ph Phar arma macy cy Te Techn hnician ician Pa Pane nel Ashley Loverro, CPhT 340B Compliance Coordinator UMass Memorial Medical Center Worcester, MA
UMass Memorial Medical Center • 3 Main Campuses and 4 Offsite Clinics • Services: Emergency, Trauma, Inpatient, Outpatient, Surgery, Maternity, Oncology, Endoscopy, Health Centers, and Outpatient Clinics (Specialties) • 4 Hospital Pharmacies & 3 Inhouse Retail Pharmacies • 340B Covered Entity - Registered as DSH Hospital with HRSA • 125 340B Contract Pharmacies
Current Role as 340B Compliance Coordinator • Under the direction of the 340B Compliance & Business Office Manager, oversees the day-to-day operations of the 340B Team, compliance monitoring, and auditing of the 340B drug purchasing program. • Responsible for maintenance and troubleshooting issues with the 340B software vendors, and assist Pharmacy Buyers, Pharmacy Managers and IS Pharmacists with any questions or issues related to the 340B software.
Tasks as 340B Compliance Coordinator • Audits the 340B usage to determine usage is compliant as per the 340B regulations and HRSA guidelines. Audits to ensure prevention of duplicate discounts or diversion to ineligible patients. • Presents results of the internal audit findings to 340B Compliance Manager and 340B Oversight committee as appropriate, make corrective action plan recommendations, and assist with implementation of the same as appropriate.
Tasks as 340B Compliance Coordinator (continued…) • Coordinates meetings with the 340B software vendors and contract pharmacy partners to discuss any issues, system enhancements, and new report requests that would help enhance 340B compliance or help reduce WAC spend • Assists 340B Compliance & Pharmacy Business Office Manager with a variety of tasks and projects such as contract management, implementing new contract pharmacies, validation and testing of the new reports or software enhancements, assist in distributing the 340B workload to the 340B team members, etc.
Impact of 340B Compliance Coordinator • Savings from the 340B Program is critical to allow us to continue to serve low-income medically underserved population through a variety of programs like providing financial assistance, offering community Benefit programs like Ronald McDonald Care Mobile, etc. • Monitoring 340B Compliance through regular audits and implementing appropriate controls is therefore important to ensure that we don’t put our program at risk. • Government (Health Resources and Service Administration) and manufacturers could audit us anytime to verify our compliance with the program requirements.
Thoughts on Technicians in Advanced Roles • Technicians are so familiar with the overall operations of retail, hospital, and/or compounding pharmacies that we can apply our knowledge and experience to different roles. • Softens the divided line between Pharmacists and Technicians. You don’t have to be a pharmacist to be a “340B Expert.” • Strengthens team morale and respect in the pharmacy itself.
“A Pessimist sees the difficulty in every opportunity. An Optimist sees the opportunity in every difficulty.” -Winston Churchill ACCEPT A CHALLENGE!
MS MSHP HP Ph Phar arma macy cy Te Techn hnician ician Pa Pane nel Erin Smith, CPhT Medication Reconciliation Supervisor Boston Medical Center Boston, MA
Th The e ro role e of of Me Medication dication Re Reconcil conciliati iation on Te Technici chnicians ans at at Bo Boston ston Me Medical dical Ce Center nter
Objectives • List the two key components of a best possible medication history. • Describe the role of a Medication Reconciliation Technician (MRT).
Inpatient Outpatient Boston Medical BMC Pharmacy Boston Medical Center Center Specialty Health System Boston Medical Healthcare Plan Ambulatory Boston Healthnet Boston Accountable Care Organization
Components of a Best Possible Medication History Interview with patient or caregiver Patient presents from home 90 day fill history from preferred pharmacy or Best Possible pharmacies Medication History Patient presents from skilled nursing facility MAR from facility or correctional institution
Establishment of ED MRTs March 2016 • Day shift hours 7a-3:30p Sunday Monday Tuesday Wednesday Thursday Friday Saturday 7A • Evening shift hours 3p-11:30p 8A 9A • At the start, average med 10A recs/shift is 5 due to training 11A and establishing workflow 12P 1P • After approximately 3 months 2P 3P and 2 part time positions (32 4P hours total), average med recs 5P per shift reaches 8 6P 7P • Majority of evening and 8P 9P weekend med recs 10P characterized as incomplete 11P
Adjustment of Hours January 2018 • Day shift hours 8a-4:30p Sunday Monday Tuesday Wednesday Thursday Friday Saturday 8A • Evening shift hours 1p-9:30p 9A • Consolidated weekend shift 10A 11A • New hours align with 12P outpatient pharmacy hours 1P 2P and allows technicians to 3P capture patients at peak 4P transport times 5P • Med rec average per shift 6P 7P increases to 10 with decrease 8P in incomplete notes 9P 10P
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