Pharmacy Techs' education, roles increasingly expanded, now includes telepharmacy

Modern Medicine's Fred Gebhart published an article today about pharmacy technicians increasing role in running pharmacies and the expanded training and CE that is being required of them in today's (especially in health-systems) pharmacy environment:

More accreditation activity sounds good to Barbara Lacher, BS, R.Ph.Tech, associate professor and assistant director for the North Dakota State College of Science Pharmacy Technician Program. NDSC modeled its technician program based on pharmacy programs focused on professional education. "We don't train somebody to work 'just retail' or 'just hospital,' " Lacher said. "We educate techs to work in all settings, just as we educate pharmacists to work in all settings. That's why we are comfortable with technicians running telepharmacy operations where there is no pharmacist. We know that our techs aren't just trained to perform specific job functions; they're educated professionals."

The underlying cause (a major shortages of pharmacists) isn't mentioned, however, leaving technicians as the only option to run the pharmacy for many health systems, especially in rural areas. While they are increasingly well-trained and educated, patients still need the better-yet educated eye of a pharmacist making the final call on what medications are delivered, making telepharmacy a great option for communities lacking on-site pharmacists.

Two Telepharmacy CE Presentations at NRHA

UPDATED! There will be two telepharmacy presentations that you can get CE credits for at the National Rural Health Association's "Medication Use in Rural America" conference in Kansas City, Missouri on September 10^th (Conf. Starts the 9^th). David Conejo of Red River Regional Hospital in Bonham, TX, along with Emily Alexander and Becky Harvey of Envision Telepharmacy are presenting:

A telepharmacy case study: Escaping the past and planning for the future
Patient safety, manpower shortages and cost containment help determine the best practice model when hospitals reevaluate pharmacy services. Hear a case study of a critical access hospital in rural Texas using electronic supervision of pharmacy technicians. Topics include obstacles encountered, redirection of resources, a clinical management program addressing medication patient safety goals, and expanding pharmacy services.

Next up is REACH IN (Resources to Enhance the Achievement of Community Health for Indiana)'s presentation entitled Launching your telepharmacy program: It's not about the technology which will "assess the role of community pharmacists by pharmacists and patients in Health Profession Shortage Areas."

Here's a PDF of the entire agenda. See the NRHA website for more details.

Telepharmacy service instituted in Barry's Bay hospital

St. Francis Memorial Hospital in Barry’s Bay has solved its pharmacist problem by using a telepharmacy service. Kevin McDonald, manager of the Hospital Pharmacy Telepharmacy program for the North West Company, and pharmacist Monique Yurkiw work with Joan Kuiack, Director of Patient Care Services at the hospital and (seated) Joan Sullivan, pharmacy technician to test the system. Heather Kendall

The shortage of health care professionals across the province has made it difficult for small rural hospitals to offer the services needed. For the past 18 months, for example, St. Francis Memorial Hospital in Barry’s Bay has been trying to find a pharmacist, without luck.

But it has now solved the problem by connecting with Northern Pharmacy Limited (a division of The North West Company), which offers telepharmacy services.

“A small hospital can safely operate a medication storage and distribution system for their patients under the management of a registered nurse,” says Joan Kuiack, Director of Patient Care Services. “However, the addition of a pharmacist offers an enhanced quality of care to our patients.”

A pharmacist has the expertise to look at the whole patient, his or her disease and relate the effectiveness of the medication they are receiving to their progress, she adds.

The hospital first contacted Kevin McDonald, manager of the hospital pharmacy telepharmacy program at Northern Pharmacy, about a year ago, but decided to try to organize a partnership with Renfrew Victoria Hospital for services of a pharmacist.

“We advertised nation-wide, but couldn’t find a pharmacist and so we went back to Kevin,” says Kuiack.

The North West Company is based out of Winnipeg; the Northern Pharmacy provides similar services to hospitals in areas such as Deep River, Cornwall and Moose Factory. McDonald, who hails from Deep River, initiated the telepharmacy project in 2004.

“A hospital pharmacist is very different from a retail pharmacist,” he says. “In smaller hospitals, there is not enough work to employ a pharmacist full-time, so it’s hard to attract them. We fill that need.”

Monique Yurkiw, a pharmacist with the company since July, will look after St. Francis Memorial. She and McDonald were at the hospital last week to test the system.

“It’s good,” she says. “We’re set to go.”

When a patient is admitted to hospital, order forms for medications are written up and the pharmacist technician enters the information into the patient profile on the computer, and then prints up labels and dispenses the drugs, which go to the nursing unit. Under the new system, the order forms will be scanned to Yurkiw. She will verify the order, ensure the medication, dosage and strength are appropriate; she can watch for possible drug interactions, misinterpreted drugs, or duplicates.

“It’s really a clinical review,” says Darlene Sernoskie, the hospital’s director of operations. “She can also look at lab results online. If there is an issue, she can contact the physician or nursing staff.”

Yurkiw will work from a computer terminal in her home office in Kemptville and will have direct contact with the pharmacy technician working in the St. Francis pharmacy. She will sit on the pharmacy and therapeutics committee and expects to visit the hospital once a month. When she comes to Barry’s Bay, she will attend meetings, review the pharmacy stock and check batch refills for long-term care patients. She’s excited to be connected to this hospital.

“I do some other locations, but this is my site,” she says. “I like the sense of belonging, of being a part of the team.”

“Monique fits in well,” says Sernoskie. “This is a proven system that addresses the national shortage of pharmacists and allows us to enhance the quality of care we offer to our patients. We’re excited.”

The physicians are also happy to have Yurkiw on board.

“The pharmacist is an important support to the physicians and plays a vital role on the health care team,” says Dr. Denise Coulas. “There is no doubt that the right combination of medications is a large part of the treatment plan while in hospital. A pharmacist works with the physicians and staff to provide effective care and a safe transition after discharge.”