University of Cincinnati, Cincinnati, OH
St. Elizabeth Physicians, Erlanger, KY
St. Elizabeth Physicians (SEP) has expanded pharmacy technician services to support value-based care initiatives in two different capacities: respond to medication refill requests and as clinical support staff for pharmacists. The purpose of this project is to describe these advancements and impact these services have had on the organization and pharmacy profession.
As the health care system in the United States continues to evolve and expand to meet the growing needs of an aging population, the need for process optimization and quality improvement is crucial. Since the Affordable Care Act of 2010, payment models have shifted from fee for service to value-based care, which has opened opportunities for the expansion of pharmacy services. SEP is a multi-specialty ambulatory physicians’ network in the Northern Kentucky and Southeast Indiana area that has nearly 170 medical offices throughout the region with more than 2,000 employees. The organization is considered an accountable care organization that participates in 12-17 value-based contracts with insurance companies each year to promote the provision of quality care through population health. SEP has also partnered with two faculty members from the University of Cincinnati College of Pharmacy since 2014 to promote the expansion of pharmacy services, evaluate these advancements, and disseminate knowledge gained specifically in value-based care and population health.
The first certified pharmacy technician (CPhT) was hired in April 2019 as part of a centralized refill service (CRS). The CRS technicians respond to medication refill requests received by participating provider offices based on specific protocols. Since 2019, the CRS team has expanded to 18 CPhTs that touch approximately 80% of all refill requests. The first clinical CPhT was added in February 2020 to support the growing team of ambulatory care pharmacists. Currently there are four clinical CPhTs that support the team of eight pharmacists, two PGY2 Ambulatory Care Pharmacy residents, and one clinical faculty member. The entire CPhT team is notably innovative for several reasons including that all members of the team work remotely, the CRS does not require pharmacist oversight, and the clinical CPhT team assists in many different areas including population health and achievement of quality measures.
These innovative roles for pharmacy technicians have been tremendously impactful in the organization and beyond. At the organizational level the refill service has streamlined medication refills, freed up office staff time, and helped ensure prompt follow-up. The clinical technicians support the pharmacist staff, allowing them to focus on direct patient care and have contributed to the organization’s high performance on quality measures. Additionally, the expansion of pharmacy services has continued to elevate the role of pharmacy technicians and pharmacists throughout the organization. From a broader perspective, these roles can serve as a model for other organizations in how to incorporate pharmacy technicians into ambulatory care settings and maximize their impact even without the traditional in-person working model.
Remote ambulatory care pharmacy technician services have been integral to continued improvement in quality of care provided by St. Elizabeth Physicians through the centralized refill service and clinical support to the pharmacist team.
Left to Right: Lenny Llambi, TJ Hoffman, Ana L. Hincapie, Elizabeth G. Schlosser