Looking Ahead in Pharmacist Labor Allocation

May 3, 2024

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Pharmacy Automation Leads to Better Pharmacy Labor Allocation

Ted Sandoval | 2 May, 2024

Pharmacist Moving to Broaden Their Impact

In a previous blog, I described a future where pharmacy automation continues to relieve pharmacists from the mundane and mind-numbing tasks of distributive pharmacy. This shift, spurred by the development of AI driven hospital inventory software and robotics, leaves pharmacists and pharmacies with time to move from being considered a hospital “cost center” to metamorphosing into a “revenue center” where their significant education and experience allow the pharmacist to perform clinical activities designed to become paid services. Imagine pharmacists performing paid services like other healthcare providers, such as Advanced Nurse Practitioners and Physician Assistants.

As we know “National Pharmacy Week” is observed during the third full week of October in the United States where we in the United States recognize the unique contributions pharmacists and technicians make to patient care.

Last year, the American Society of Healthcare Pharmacists (ASHP) celebrated National Pharmacy Week by publishing the following quotes: “National Pharmacy Week acknowledges the invaluable contributions pharmacists and technicians make to patient care in hospitals, outpatient clinics, and other healthcare settings.”
ASHP also wrote, “Pharmacy Week is a time to recognize the powerful impact you make on your patients. It is an opportunity to raise your patients’ and colleagues’ awareness about the vital role pharmacists play on the healthcare team. It also provides a meaningful way for you to affirm your staff's hard work to ensure medication use at your organization is safe and patients are achieving optimal outcomes.”

pharmacist scanning medication container

The Changing Roles of Pharmacists

Depending on the philosophy of a healthcare organization, pharmacists and pharmacy technicians continue to participate in routine and advanced clinical pharmacy activities to improve their patients’ quality of life and clinical outcomes. Some of these roles are not new and include:

Formulary Management
Concurrent Drug Utilization Review (DUR)
Retrospective DUR
Developing Drug Dispensing Limits
Assist with Prior Authorization Decisions
Pharmacy Step Therapy
Patient and Provider Medication Education

Below are a few nontraditional, advanced pharmacist activities to consider:

Point-of Care (POC)
Pharmacogenetic Testing
Testing for Flu and Strep
Pharmacy Clinical Research
Expanded Immunization Programs
Population Health Analytics
Administering Long-Acting Injectable Drugs
Specialty Drug Patient Management
Smoking Cessation Counseling
Medication Prescribing

Pharmacist Prescribing In The UK

It is curious to note that most US patients do not realize pharmacists can perform an extensive list of clinical functions, not just dispensing medications. As of 2021, 53% of US-licensed pharmacists are Doctors of Pharmacy, who receive as much classroom clinical instruction as medical doctors. Pharmacist prescribing began in the United Kingdom in 2003. In many respects, UK nurse prescribers and pharmacists in the UK can prescribe at an autonomous level equivalent to a physician/doctor.

The UK pharmacist independent prescriber (PIP) role was created in 2006 and excluded controlled drugs until allowed in 2012. In 2022, within the United Kingdom, the NHS have reported a severe shortage of more than 100,000 staff with all groups being affected. To meet this challenge, the NHS Long-term Plan has prioritized a strategy for workforce transformation which includes pharmacist prescribing.

While pharmacists in the UK and other countries around the world retain extensive autonomous prescribing rights, pharmacists in the US continue to make, compared to other countries, slower advancement. Pharmacists in all US states currently have some type of medication prescribing, categorized as either independent or dependent prescribing. Three states allow independent prescribing which is the least restrictive level.

Pharmacist prescriptive authority in the U.S. occurs within four models:

1.) Patient-specific prescribing through collaborative practice agreements (CPAs)

2.) Population-specific prescribing through CPAs

3.) Statewide protocols

4.) Class-specific prescribing

Physician Acceptance

In the United States, debate continues concerning the appropriateness of pharmacist prescribing. In Canada, please see this link to read an interesting update on pharmacist prescribing.

About Author Ted Sandoval:

Pharmacist Ted Sandoval happily resides with his family in colorful Colorado and has many years of Hospital based acute care medication supply chain, robotics, ADC and Continuous Quality Improvement experience.