Christine Cline-Dahlman, B.F.A., C.Ph.T
Christine
Cline-Dahlman, B.F.A., C.Ph.T

When everything about pharmacy technician training focuses on dispensing tasks, I get excited when I hear how technicians can engage with technology for a next step in their career. With all the public discussion of “burnout” for pharmacy personnel this past year, I kept thinking that technicians face burnout sooner because they do not know the variety of opportunities ahead for them. How does the profession get them to imagine the future of pharmacy and their role? I smile, because we have the same challenge with pharmacists.

Does Central Fill Replace Pharmacy Technicians?

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In January, I attended a webinar on central fill. The presentation focused on central fill in a large healthcare system.

I concluded from the Q&A chat that I was an outlier attendee, as I am a pharmacy technician. But the presenters made a point to state that automation was “NOT” designed to eliminate technicians. Their roles would change, but more technicians would be required for the workflow. They would be “repurposed” and retrained for task assignment. Technicians would actively incorporate the tech-check-tech practice in verification, and they would be involved in medication history review and then follow through with selected patient communication.

Is your first response to the concepts of central fill and tech-check-tech to stop reading this article because these two realms are not permitted in your state? Please read on.

We all know about the Great Resignation —and have probably experienced it. How can we keep the good staff we have? Let’s find ways to help them advance so they are ready to adapt to new roles.

Technician Product Verification (TPV)

Tech-check-tech is more formally known as technician product verification (TPV). Studies that measure accuracy for technician verification that were completed in hospitals, chain pharmacies, and independent pharmacies show that technicians are accurate 97% to 99% of the time. Any inaccurate occurrence revealed that an error occurred in the workflow and was caught by the verifying technician. The error was process based, not person based.

TPV does not just focus on the verification process. A technician must have a current and broad knowledge for medications, their pharmacology, their therapeutic purpose, potential drug interactions along with recommended dosing requirements. Technicians need to know what the prescription is saying and what is needed to keep that patient safe.

If you are working alongside a technician for traditional dispensing, have you thought about monitoring the accuracy of their work? Could you begin to introduce the points of verification that you use as a pharmacist, as your measure? Demonstrate the technology that your software provides for the verification process.

If you are a hospital pharmacist who works with automated sterile compounds, could you work with your technicians to develop their skills in verification? Could you work with them to introduce the software you use that calculates the formula to make those compounds? The software that controls the dispensing of fluids and medications into the bag?

Remember — medication knowledge is comprehensive for this process, and a technician is accountable.

Why am I bringing these points forward? Do you want to keep the technicians you have? The Great Resignation revealed that workers will seek the environment, the job description, and the wage they desire.

Chain Pharmacy Central Fill

Chains have already been implementing the ideas presented in the January webinar. The Dallas Morning News reported in February 2021 that Walgreens central pharmacy fulfillment acquired 100,000 square feet of space to establish a central fulfillment operation. In July 2021, Supply Chain Dive reported that Walgreens would open an additional 11 micro-fulfillment operations in the United States by the end of 2022. In March 2022, CNBC reported that the Dallas fulfillment center was up and operating. They made a point to report that this location “is staffed by about 220 workers, with only a handful of pharmacists.”

The entire time of the webinar, I was imagining how this information could be adapted for independent community pharmacy owners. For example, an owner of three to four pharmacies in rural locations could hold the bulk of their inventory at a single location, particularly the controlled substances, then use automated dispensing equipment to fill the script.

I could see how the concepts of central fill could also assist the owner who owns multiple pharmacies in a metro area with efficiencies for inventory, workflow, and staff wages through identified locations with automated packaging equipment. Limiting inventory of select medications to designated locations but using central-fill could reduce exposure to burglary and robbery of controlled substances. There is not a state that has not seen a rise in pharmacy break-ins, for all practice settings.

Look at a chain’s use of central fill as an opportunity for you, the independent community pharmacy owner, to pivot and adapt. Develop your staff now so they are ready when the concepts of central fill and TPV come to your state. They are just around the corner. CT

Christine Cline-Dahlman, C.Ph.T.-Adv, is a pharmacy technician who has served in advanced roles within independent, chain, and health-system pharmacies. She can be reached at CClineDahlman@gmail.com.

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