Service-Centered Pharmacies Mean New Roles

SupplementsNovember 2021 Technician Supplement
Volume 3

Technician Sirena Maxwell discusses how non-pharmacist staff members are emerging as key personnel for a strategic shift toward revenue outside dispensing.

A huge number of COVID-19 vaccinations are now provided by community pharmacies, and thousands of pharmacies are providing testing services under a clinical laboratory improvement amendment waiver, such as hemoglobin A1C, COVID-19, influenza, and strep.

Many have also started infusion services for monoclonal antibodies. All these new services were possible with a mishmash of advanced practice acts and collaborative practice agreements prior to the pandemic, but COVID-19 compelled the federal government to make these increases in scope of services provided at pharmacies uniform across the country.


With these services came new workflows. Scheduling utilities that create appointments for patients were now needed. Extra hands for looking up immunization registries or screening patients prior to services became in high demand. Medical billing solutions for sending claims for services became essential. Follow-up with patients after testing became the norm. All these things required more personnel and responsibilities and roles that went beyond what used to be required of technicians.


Duvall Family Drugs in Washington jumped on the opportunity early in the pandemic. Owner Kari VanderHouwen, RPh, sought to serve her community in need. Part of rolling out services was to train nonpharmacist staff members and elevate roles among some of them to lead efforts and even supervise the flow and billing of services, much like a primary care practice. Technician Sirena Maxwell, director of pharmacy operations, jumped at the opportunity. I asked her a few questions about the transition.

When did you first stumble upon pharmacy?

Maxwell: I just fell into pharmacy in 1997. I had just graduated high school and didn’t have a set out career path. I was attending community college and needed a part-time job. My local pharmacy was looking for a cashier, and I was looking for a job.

What work or training best prepared you to function well in a pharmacy environment?

My entire pharmacy career has been organic. I am by nature a caregiver, a seeker of knowledge, and a direction follower. Pharmacy has allowed me to take care of my patients and help my community. I love that pharmacy is always changing and always current. There is always a new medication coming out or new conditions that need to be treated or a new billing platform we need to learn.

What types of tasks did you do in your first year of work in a pharmacy?

I started as a cashier, so it was mostly [interacting] with patients that were coming in after work to pick up their medications, answering phones, counting pills, lots of filing of hard copies, and learning how to exist in the pharmacy workflow.

When did you get the opportunity to advance your role and responsibilities?

I was given the opportunity to go to the on-the-job training program for pharmacy technicians in 1998. I was happy to work in the pharmacy as “just a pharmacy technician” for 20 years. In 2018, the owner of the pharmacy I work at had the opportunity to buy a new pharmacy, so there was a need at my pharmacy for a director. I was honored to take on the role and start down a new, expanded career path. I was asked to coordinate the staffing schedule between the 2 locations for both pharmacists and technicians, [order] drugs and vaccine[s] for both locations, and [help] build the medical billing platforms. I was also asked to help develop intake forms for [COVID-19] vaccines [and to schedule] for [COVID-19] vaccines, [COVID-19] tests, and now monoclonal antibodies.

What is your title now, and what are the pharmacy functions over which you have oversight?

I am now the director of pharmacy operations. Currently, I am overseeing all scheduling for all pharmacy staff, ordering drugs and vaccines for both stores, and [handling] all things [COVID-19] related—ie, scheduling and testing of polymerase chain reaction (PCR), rapid PCR and rapid antigen, administering [COVID-19] vaccinations [and] boosters, [and] the screening and intake of patients for monoclonal antibodies, as well as the administration and medical billing.

What advice do you have for other technicians who wish to advance their roles and responsibilities in the pharmacy?

Love what you do. I have found a passion for community pharmacy, which has given me the drive to excel. When given an opportunity, always say yes, even if you don’t know how you are going to do it. The saying, “Where there is a will, there is a way” is very true. By showing up every day with a desire to excel, you will surpass others who are accepting just being another pharmacy technician. When we used to think of pharmacy technicians, we used to think of counting pills and typing prescriptions. Now the opportunities for pharmacy technicians are far beyond the pharmacy counter.

Troy Trygstad, PharmD, PhD, MBA, is vice president of pharmacy provider partnerships for Community Care of North Carolina. He also serves on the board of the American Pharmacists Association Foundation and the Pharmacy Quality Alliance.

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