(Management Case Study) Expanded Clinical Pharmacy Technician Roles: Comprehensive Medication Management and Population Health

Purpose: A key 2030 Practice Advancement Initiative focus is pharmacy technician health system role advancement. Across the facility, clinical pharmacy technicians (CPT)s historically completed tasks related to anticoagulation clinic scheduling and communication of laboratory results. As the pharmacy department moved towards a regional centralized anticoagulation clinic, there was an opportunity to leverage CPT talents in medication management, virtual care, and population health. Transitioning workload from clinical pharmacy practitioners (CPP)s to CPTs would expand access to medication management services.

Methods: Pharmacy management completed a needs assessment regarding CPP clinical and administrative tasks to identify CPT opportunities. This included reviewing clinic structure and access. Additionally, pharmacy management asked CPPs to identify clinic inefficiencies.

CPPs led a medication history clinic for new primary care patients and an antidepressant follow-up clinic. For both, CPPs were completing a patient history, documenting in the electronic health record (EHR) and alerting the provider to actionable items. The visits did not involve clinical decision making and were an identified opportunity for CPTs.

Review of CPP clinic access found new patient comprehensive medication management (CMM) visits took longer than 30 minutes. CPPs collected data such as blood pressure and glucose readings, completed medication histories, and triaged virtual care technical issues. An opportunity was identified for CPTs to lead a clinic visit scheduled prior to CPP new patient visits to complete a medication history, provide education on the CPP appointment purpose, address virtual care problems, and obtain any required data before the CPP appointment.

Pharmacy management developed a training plan, EHR documentation templates, scripts for patient care visits and nonpharmacological education, clinic grids, and CPT competency assessments. CPTs were then trained by CPPs and pharmacy management utilizing the following methods: direct instruction, modeling, coaching, and facilitating. When CPTs were confident in their new role, the competency assessment was completed.

Results: CPPs are able to provide more direct patient care time after transitioning 30 hours of CPP clinics to CPTs and improving efficiency of CMM appointments by creating CPT pre-CPP visit clinics. One primary care CPP increased the number of primary care CMM encounters by 54 percent and another increased home-based primary care CMM encounters by 23 percent. Overall primary care CPPs increased encounters by 9 percent. CPTs assisting in resolving virtual care issues resulted in a 14 percent increase in virtual video visits, a sustained increase even as face-to-face modalities have increased post-pandemic.

With the improvement in efficiency, CPTs and CPPs were able to implement population health management. CPTs reviewed the corresponding dashboards, contacted patients to discuss referral to CPPs, and assisted with scheduling patients into the CPP clinics for CMM. The areas of focus were a deprescribing initiative and a hypoglycemia safety initiative in which all identified patients were contacted to offer CMM services.

Conclusion: CPTs successfully provide ambulatory medication management services such as medication history taking, medication adherence and tolerance assessments, providing structured nonpharmacological education, navigating patients through virtual care, and utilizing population health dashboards to refer patients to CMM services. Utilizing CPTs in this advanced role has increased job satisfaction and role optimization for CPTs and CPPs while increasing CPP direct patient care time.