The profession of pharmacy has certainly evolved in the 40+ years since my graduation and licensure. Significant improvements to patient care and an increase in quality outcomes are evident to any long-term observer of the profession. But this progress has revealed a major vulnerability. My goals are to bring this deficiency to light and to do something about it.
In addition to being the president and founder of RxTOOLKIT.com, I am also the operations manager of a large (700 bed) hospital. Our pharmacy department is fortunate to have the latest technology and a state of the art facility. We offer a PGY 1 residency program and are also a practice site for six different local schools of pharmacy.
As I interact with students and residents, two things have become apparent:
1. They are much better prepared for the clinical challenges of the profession than I was at that stage of my career
2. Most have little or no interest in operational jobs like mine (focused on dispensing and distribution)
Both observations make sense when you see the expanded role pharmacy is taking into so many different areas. At our hospital, we now have many different specialized areas in the pharmacy: clinical specialists, oncology specialists, and anticoagulant specialists.
Those clinical positions are the most sought after by recent graduates and the ones they are most prepared to do. But I wonder, “In the future, who is going to take care of dispensing and distribution?”
I ask that question often and the answer that I usually receive is, “These jobs will be done by technology and technicians.” My reaction is two-fold, “You really don’t understand the limitations of the existing technologies” and “Where are we going to find these technicians?”
As I mentioned, the hospital where I work has the very latest in pharmacy technologies, including state of the art robotics. I am absolutely a strong proponent for technology and my company RxTOOLKIT.com, offers many technologically based solutions.
Frequently, technologies are singular components in a larger workflow involving many moving parts.
As an example, let’s look at preparing a NICU stock solution and then repackaging the solution into individual syringes. We utilize the following separate silos of technology:
1. Printer Application: Print the stock solution label capturing lot numbers / expiration dates
2. Barcode Verification Application: Barcode verify ingredients in preparation
3. Follow Established Procedure: Paper or electronic, centrally stored for reference
4. Printer Application: Print syringe labels for repackaging the stock solution dose into a syringe
5. Electronic or Paper Storage: Logging all of this in a book or online for regulatory compliance and quality control
Often times, these individual technology silos can be extremely expensive, severely limiting their practical use in smaller hospitals.
And I caution, that technology alone is not the answer. I have yet to see a technology that can be a substitute for good judgment, prioritizing work, and understanding workflow. And even the best technology won’t work without well-trained people and an established process. Check out RxWORKFLOW™: Integrating Technology, Process, and Competency for more on this topic.
RxTOOLKIT advocates for smarter solutions that incorporate technology with process and competency. We work hard to make the solutions we offer accessible and affordable.
I drive a car. Before I could get behind the wheel, I had to prove my competency with both a written and observational exam.
I get my hair cut at a local barber. My barber has a framed license hanging on the wall proving her competency at cutting hair.
If I were admitted to a hospital in the United States, a pharmacy technician would almost certainly prepare any drugs given to me. Would there be a license I could point to that would demonstrate their competency? In almost every state in the country the answer is NO! Only 16 states currently require licensure as of this post, please see this post and the interactive map on the Emily Jerry Foundation’s site for more information.
Most hospitals do have an internal training program or may require technicians to pass a national certification exam. But there is no consistent, enforceable, governmental mandate. Who is responsible if something goes wrong? The pharmacist is the one who is accountable for what happens and is typically the only one with a license to loose.
How prepared are they for this responsibility? The answer: not particularly! Especially when education is moving further away from the skills required to supervise and perform operational tasks.
The extreme case of what can go wrong is former pharmacist Eric Cropp. The pharmacy technician’s error—missed by Eric—resulted in the death of two-year-old Emily Jerry. It also resulted in the loss of license, his career, and ultimately his freedom. Eric was the second victim in this medication error.
The pharmacy technician is a complex, sensitive, and extremely important job! We need to treat it as such.
We, at RxTOOLKIT, see the lack of standardization and training for pharmacy technicians as a significant patient safety issue and have made the decision to act.
We have become advocates for national pharmacy tech certification and are also lobbying for hospital pharmacy technician certification on a state-by-state level.
We have partnered with a nationally recognized college of pharmacy to develop an online training program for prospective pharmacy techs and specialized training for pharmacists and techs already in the field. We are focusing on the skills necessary to work in a clinical hospital pharmacy environment as well as offering continuing education credits for more specialized training (Sterile Product Compounding, USP 800, USP 797). We have assembled a multidisciplinary team of very talented individuals to work with us on this project.
Because there is currently no pool of trained hospital pharmacy technicians out there, we also plan to assist hospitals in identifying potential candidates based on their motivation and capacity to learn.
Only after Emily Jerry’s tragic death, did the State of Ohio pass Emily’s Law requiring certification, background checks, and proven competency for pharmacy technicians. We don’t think it should take another senseless death to motivate change—We want Emily’s to be the last innocent life lost! If we can help prevent losing ONE MORE LIFE, isn’t it worth all of the ideas, energy, and passion we can muster?
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