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2000 White Paper: Certification, Credentials, and Credentialing in Pharmacy Donald Kishi TRIUMF

Jeffery A. Goad Chapman University, [email protected]

Nancy Korman San Francisco VA Medical Center

Teresa Miller Stanford University

Mary Ferrill Palm Beach Atlantic University

See next page for additional authors

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Recommended Citation Kishi D, Goad JA, Korman N, Miller T, Ferrill M, Strom H. White Paper: Certification, Credentials, and Credentialing in Pharmacy. California Journal of Health-System Pharmacists 2000;12(3):4-10

This Article is brought to you for free and open access by the School of Pharmacy at Chapman University Digital Commons. It has been accepted for inclusion in Pharmacy Faculty Articles and Research by an authorized administrator of Chapman University Digital Commons. For more information, please contact [email protected]. White Paper: Certification, Credentials, and Credentialing in Pharmacy

Comments This article was originally published in the California Journal of Health-System Pharmacists, volume 12, issue 3, in 2000.

Copyright California Society of Health-System Pharmacists

Authors Donald Kishi, Jeffery A. Goad, Nancy Korman, Teresa Miller, Mary Ferrill, and Holly Strom

This article is available at Chapman University Digital Commons: http://digitalcommons.chapman.edu/pharmacy_articles/27 CSHP White Paper: Certification, Credentials and Credentialing in Pharmacy l CSHP WHITE PAPER Certification, Credentials and Credentialing in Pharmacy

IIIII Donald Kishi, Pharm.D., FCSHP, Clinical Professor of Pharmacy, Department of Clinical Pharmacy, UCSF School of Pharmacy Jeffery Goad, Pharm.D., BCPS, Assistant Professor of Clinical Pharmacy, USC School of Pharmacy Nancy Korman, Pharm.D., FCSHP, Quality lmprovementi/Education Coordinator, San Francisco VA Medical Center Teresa Miller, Pharm.D., Executive Vice President, CSHP Mary Ferrill, Pharm.D., FCSHP, Associate Professor, UOP School of Pharmacy Holly Strom, R.Ph., Member, California State Board of Pharmacy

In August of 7999, the CSHP Board of Directors INTRODUCTION voted to commission a Blue Ribbon Committee of CSHP members to identify CSHP's role in creden­ The rapid evolution of the health care system has provid­ tialing pharmacists' skills. The group was asked to: ed the pharmacy profession with opportunities to expand (7) assess the current marketplace with respect to existing and develop new direct patient care roles. Two crit­ pharmacist credentialing and any potential benefits ical challenges that the pharmacy profession must contend or risks of various approaches; (2) identify potential partners or affiliations for CSHP to serve in this with to ensure the continued expansion and acceptance of venue; (3) develop a plan or recommendation for pharmacists in advanced practice roles (e.g. direct patient the CSHP Board to follow in the implementation of care roles) are: (1) To develop and implement a credible, sys­ such a program, if deemed feasible; and (4) deter­ tematic, standards-based, and profession-wide plan that mine if such a program would be consistent with includes a system for identifying the types of pharmacists' CSHP professional policies, and if not, develop rec­ ommended policy on this subject consistent with practices requiring credentials, a validated certification the Blue Ribbon Committee's findings. process, and a computerized credentialing process that is During their discussions, the Blue Ribbon current, comprehensive, and easily accessible; (2) To estab­ Committee identified the need to educate CSHP lish the credibility of these advanced practice credentials members · on the current status of credentialing and the certification and credentialing processes with other within the pharmacy profession. This "white paper" was developed by the members of the Committee health care providers, the public, employers and payers (gov­ to provide an overview of the issues involved. It is ernment and commercial). designed to stimulate further discussion of the still evolving concept of pharmacist credentialing and DEFINITIONS: COMPETENCY, CERTIFICATE PROGRAM, - does not reflect formal CSHP policy at this time. CREDENTIAL, CREDENTIALING AND CERTIFICATION The Blue Ribbon Committee is in the process of The concepts of competency, certificate programs, credentials, cre­ developing recommendations for CSHP policy on dentialing and certification of pharmacists for advanced practice roles the subject of pharmacist credentialing, which will are relatively new to the pharmacy profession. Inappropriate use of be presented to the CSHP Board for consideration these terms by pharmacists has led to confusion within, as well as out­ and action. side, the profession. Fundamental to this discussion is a clear under­ Thanks go to the members of the Blue Ribbon standing of these terms. Committee on Pharmacist Credentialing for their Competency: The American Council on Pharmaceutical Education participation in this process: Jeffery Goad and (ACPE) defines professional competencies as the demonstration of Donald Kishi (co-chairs), Mary Ferrill, Kari Franson, "professional qualities including knowledge, skills, abilities, attitudes, Nancy Korman (CSHP Board Liaison), Teresa Miller and values."' and Holly Strom.

4 cjbp May/June 2000 CSHP White Paper: Certification, Credentials and Credentialing in Pharmacy

Certificate Program: The ACPE defines a and a passing score on the licensing sions' certifications compared to those 10 certificate program as a specific type of examination) necessary to ensure public provided by pharmacy. ) continuing professional education pro­ health, safety, and welfare.' Within the practice of pharmacy, gram. It is a structured and systematic post­ there is a certification available to phar­ graduate education and training program CERTIFICATION, CREDENTIALS macy technicians through the Pharmacy that is designed to provide the practition~r AND CREDENTIALING IN OTHER HEALTH Technician Certification Board (PTCB). with knowledge, skills, judgment and/or CARE PROFESSIONS. The PTCB is a national board that grants attitudes needed to meet specific practice Other health care professionals who the CPhT (certified pharmacy technician) objectives. A certificate program is of provide direct patient care services and designation to technicians who pass a shorter duration than a degree program.' who are recognized as "providers" (e.g. certification exam and recertify every 2 physicians, osteopaths, nurse practition­ years. Over 50,000 technicians national­ Certification: The process by which a ers, physician assistants, etc.), are ly hold this credential, and so far, non-governmental agency or association required to be certified, maintain specific California technicians have not been grants recognition to an individual who credentials and participate in a creden­ required to participate in this credential­ has met certain predetermined qualifica­ tialing process as a means of assuring ing process. 11 tions specified by that agency or associa­ competency. Physicians are required to There are cross profession certifica­ tion. This formal recognition is granted to be certified by a national board, e.g., tion processes. For example, the an individual to designate to the public American Board of Internal Medicine American Diabetes Association (ADA) that this person is competent to practice (ABIM), to practice in internal medicine, promotes the Certified Diabetic Educator in the designated area of certification. specialties, and subspecialties. For inter­ (CDE) credential. The CDE credential Participation in both certificate and certi­ nal medicine, the applicant for board requires passage of an examination, fication programs is voluntary.2 certification must have graduated from 1 000 hours of diabetes patient contact Credential: A credential is documenta­ an accredited U.S. medical school, be a over at least a 2 year period prior to the tion or evidence of a q\-lalification. licensed physician, have completed 3 examination, post-certification continu­ Examples of credentials include: years of an internal medicine residency ing education requirements and recertifi­ Academic degrees, practice experience, or equivalent residency training and have cation every 5 years. This certification is post-graduate education and training, documentation of his/her clinical compe­ available to a variety of healthcare pro­ licensure, certifications, and certificate(s) tency. To be eligible for board certifica­ fessionals, including pharmacists.12 obtained. tion in a specialty or subspecialty, the A listing of nationally accredited applicant must be board certified in Credentialing: Credentialing is the allied health care provider certification process of gathering, verifying and evalu­ internal medicine and have had addition­ organizations is available through the al training in an accredited residency ating a healthcare provider's credentials National Organization for Competency program in the specialty or subspecialty 13 to ensure that the practitioner is qualified Assurance's website. practice area. The ABIM requires recerti­ to provide specific patient care services fication in internal medicine and in spe­ NEED FOR CREDENTIALS based on an organization's standards.3 It is similar to the "privileging" process cialty and subspecialty areas every 1 0 AND A CREDENTIALING PROCESS 4 5 years. • Some professionals, such as fam­ IN PHARMACY used by hospitals and health systems. ily practice physicians, require recertifi­ In contrast to other health care pro~ Clinical Privileging: Clinical privileging is cation in addition to license renewaiY fessions, pharmacy's only widely accept­ credentialing conducted by a health care Physician Assistants (PAs) are certified by ed credentials are an academic diploma organization (e.g. health system, hospital, the National Commission on and state board of pharmacy licensure. or HMO) of a health care practitioner to Certification of Physician Assistants Certification programs for specialists in ensure that a health care practitioner is (NCCPA). The NCCPA is the only nation­ specific disease states (e.g. asthma and qualified to provide specific patient care al credentialing body for PAs and issues diabetes) or broad classes of medical spe­ 3 services in that organization. the PA-C (Physician Assistant - Certified) cialties (e.g., oncology and psychophar~ licensure: Licensure is the process by designation to indicate certification. The macy) currently exist, but they have not which a governmental agency grants per­ NCCPA requires that PAs pass an initial been uniformly accepted within the mission to an individual to practice in a certification exam and then obtain recer­ pharmacy profession. Further, they have profession or occupation, upon finding tification every 6 years via an electronic yet to be widely recognized and/or val­ 8 9 that the applicant has attained the mini­ or a take-home multiple choice exam. • ued by other health care professionals, mum requirements (education, training, (See Table 1 for examples of other profes- payers and patients.

cjhp California Journal of Health-System Pharmacy 5 CSHP White Paper: Certification, Credentials and Credentialing in Pharmacy

NEED FOR A SYSTEM TO ASSURE and physician assistants are considered nized credentials and a credentialing PRACTITIONER COMPETENCE "non-physician providers," they can be process would likely facilitate the accep­ The pendulum that swings between reimbursed by Medicare for direct tance of pharmacists in advanced prac­ public concern regarding cost-contain­ patient care services. As a result, phar­ tice roles. The consistency provided by ment and the quality of health care has macists may be at a competitive disad­ nationally accepted credentials may pro­ begun to swing back toward quality. The .vantage for direct patient care positions vide assurances to other health care unacceptably high incidence and cost of in clinics, physician .groups and with providers that they may depend upon the medical errors cited in the Institute of other health care provider employers. capabilities and qualifications of these Medicine's report, "To Err is Human: The California Pharmacists Association pharmacists. Building a Safer Health System,"'4 has recently reported that the Legislative further increased the concern of regulato­ Counsel for the State of California has CURRENT PHARMACY PROFESSION ry agencies, legislative bodies, health provided the following opinion on phar­ CERTIFICATION PROGRAMS professional organizations and the public macists as health care providers in A number of organizations within the about the quality of health care. Public ... California: "The term 'health care pharmacy profession currently offer certi­ concern has also been voiced about the provider' includes a licensed pharmacist fication programs for pharmacists. The ineffective, inconsistent, uncoordinated, who provides non-dispensing services Board of Pharmaceutical Specialties politically influenced processes in health that are within a pharmacist's scope of (BPS) offers certification for pharmacists care provider regulation that have result­ practice ... "17 Legislative recognition of in the following specialty practice areas: ed in problems in access to health care, the pharmacist as a "health care Nuclear Pharmacy, Pharmacotherapy, wasted resources, and concern over the provider" is also being proposed in Pharmacotherapy with "added qualifica­ post-licensure competency of health care California Assembly Bill AB 2804.18 tions" in Infectious Diseases, Nutrition providers. The 1998 PEW Health Some California pharmacists have Support Pharmacy, Oncology Pharmacy, 19 20 Commission's report, "Strengthening successfully billed and obtained payment and Psychiatric Pharmacy. • The Consumer Protection: Priorities for for services provided to patients in the National Institute for Standards in Health Care Workforce Regulation," cites fee-for-service health insurance plans, but Pharmacist Credentialing (NISPC) offers examples of these problems.'5 Further, these plans are quickly being replaced by disease state management (DSM) certifi­ '" there has been concern, as reported by managed care capitated plans, which cation for pharmacists for the following '" the Associated Press, over the inconsis­ usually do not recognize a pharmacist as disease states: asthma, anticoagulation, '"hi

'"!:1 tent oversight of pharmacy technician a "non-physician provider." (Credible cre­ diabetes, and dyslipidemia. The NISPC roles in community pharmacies by state dentials and a certification process for was founded by the National Association boards of pharmacy.'6 Increasing public advanced practice roles may provide the of Chain Drug Stores (NACDS), National concern for quality will likely turn into a Health Care Financing Administration Community Pharmacists Association demand for action. It would behoove us (HCFA) and third party payers with a suf­ (NCPA), National Association of Boards within the pharmacy profession to be ficient basis to recognize pharmacists as of Pharmacy (NABP) and the American prepared with a well organized, profes­ providers of direct patient care.) Pharmaceutical Association (APhA) and sion-wide, credible system of credentials, now includes PCS, lnc.21 The Commission Pharmacist Employers: From the employer's certification and a credentialing process for Certification in Geriatric Pharmacy perspective, credentials based on a credi­ that is proactive and not reactive to leg­ (CCGP) offers certification in geriatric ble, national system of certification can be a islative mandates. pharmacy practice. The CCGP was valuable tool for employee selection. founded by the American Society of The PEW Health Commission recom­ THE NEED TO ESTABLISH CREDIBLE Consultant Pharmacists (ASCP). 22 The mended national certification, creden­ CREDENTIALS REFLECTIVE Commission on Credentialing in tials, a credentialing process and evi­ OF ADVANCED PRACTICE ROLES. Pharmacy (CCP) was established by the dence based, coordinated scopes of Health Care Payers: Medicare does not following pharmacy organizations: the practice for health care providers.'5 A recognize pharmacists as "providers" of American Association of Colleges of national system could facilitate practi­ direct patient care. As a result, pharma­ Pharmacy (AACP), the American College tioners moving from state to state and an cists are ineligible for Medicare reim­ of Apothecaries (ACA), the American employer's ability to hire qualified out of bursement at the "non-physician College of Clinical Pharmacy (ACCP), the state practitioners. provider" level for direct patient care ser­ American Council on Pharmaceutical vices, such as collaborative drug therapy Other Health Care Providers: Education (ACPE), the Academy of management. Since nurse practitioners Establishing credible, nationally recog- Managed Care Pharmacy (AMCP), the

6 cjhp May/June 2000 ~ « ~ ~'i lft"-!0\\S"'~«'8KC J&lSI 1 ,.,p "'\/'j'i H ~ l 0:l1;- I ' " e 1 1 'h'< lij""'!); ""JS~f;(c(?fo-J!l~'j~Yf(\\fed\~!f:i,l"li,>A!:P 0 tl t:t;dff%.\1><'\ A;n", !able 1: Examples of Certification in Pharmacy and in Other Health Professions

4 7 16 19 PHYSICIANS • PHYSICAN NURSE DSM PHARMACISTS " ASSISTANTS"·" PRACTITIONERS'" Internal Medicine Family Practice25 Geriatric Pharmacy Oncology

Certifying American Board American Board Ntnl Commission American Ntnl lnst. Of Commission for Board of Agency of Internal of Family on Certification Academy of Nurse Standards for Credentialing in Pharmaceutical Medicine Practice of Physician Practitioners Pharmacy Geriatric Specialties Assistants Credentials Pharmacy

Education MD Degree MD or DO Graduate of an MS in Nursing or Graduate of an Graduate of Graduate of Degree accredited PA Graduates of FNP accredited accredited accredited program Program pharmacy school " pharmacy school pharmacy school or BPS approved school

Post Graduate Residency Residency None None None 2 years as Oncology resi- Training/ (3 years) (3 years) pharmacist dency and 1 year Experience experience OR 3 years experience

Licensure Yes Yes None Yes Yes Yes Yes

Clinical Yes Yes None None None None None Competence Evaluation

Certification Yes Yes Yes Yes Yes Yes Yes Examination

Recertification Yes Yes Yes Yes None Yes Yes

Examination Every 1 0 years; Every 6 years Every 6 years Every 5 years or Every 5 years, Every 7 years, Other Self evalutaion plus CME CME meeting CE active license active license exam, active license, pt. requirements of license, attesta- Records review 75 hours of CE tion of clinical plus 1 000 hours competency of specialty clinical practice '- CSHP White Paper: Certification, Credentials and Credentialing in Pharmacy

American Pharmaceutical AssoCiation are needed, what prerequisite qualifica­ advanced practice roles of the pharma­ (APhA), the American Society of tions are required, or what types of eval­ cist. Today, based on the increasing num~ Consultant Pharmacists (ASCP), the uations are needed to establish a practi­ ber of states with collaborative drug ther­ American Society of Health-System tioner's competence to provide specific apy management provisions, there is a Pharmacists (ASHP), the BPS, the CCGP, services. need for credible, national credentials for and the PTCB. The CCP's intent is not to advanced pharmacy practice roles. provide certification programs for phar­ CURRENT PHARMACY PROFESSION macists, but rather to provide coordina­ CREDENTIALING SYSTEMS WHICH IS THE BEST APPROACH? tion, leadership and quality assurance for The only attempt to date to develop a Should all disease states and specialties the profession's post-licensure certifica­ national database of pharmacists and be credentialed? tion activities.3 their credentials is NABP's Pharmacist As discussed in the following section, and Pharmacy Achievement and if the profession continues down the road OTHER TYPES OF PHARMACY Discipline (PPAD) Internet database. The of multiple disease state management PROFESSION CREDENTIALS ·only information it currently contains is a certifications, confusion is likely to occur In addition to certification programs, list of individuals who have passed the among other providers, payers, and phar­ the pharmacy profession awards other NABP DSM exam and received that cre­ macists. In the current healthcare envi­ types of credentials. Examples of these dential. In line with the public's demand ronment that stresses primary care, a gen­ include residency certificates and "fel­ for both positive and negative information eralist's approach to certification is likely low" recognition programs. Residencies on their healthcare providers, it also lists to be the most successful. are structured, comprehensive, and prac­ disciplinary actions as reported by partic­ '" tice-based postgraduate 12-to-24 month ipating state boards of pharmacy. A more WHO SHOULD CREDENTIAL II:'" iu training programs offered in a variety of promising credentialing system is one PHARMACISTS? 1:: settings, including health care systems, currently being developed by the Veterans Profession vs. Government. Currently, I" 3 23 24 h• managed care organizations, health care Administration, called VetPro. • • It is an states' pharmacist licensure examinations '" institutional and academic medical cen­ internet-based credential database that are insufficient to ensure a pharmacist's '" ter settings and in community pharma­ currently provides information on physi­ competency to provide advance pnic­ '" cies. ASHP is the organization that cians and dentists caring for veterans, but tices. This type of advanced practice "''" accredits pharmacy residency programs will soon be expanded to cover other competency evaluation goes beyond '" through an intense initial evaluation and healthcare professionals, including phar­ most current state licensing examination '" periodic re-evaluation. Graduates of these macists. Its utility in the private sector has requirements. Most state licensing exams programs receive a residency certificate. yet to be tested. focus predominantly on drug products, Some pharmacy organizations, such cursory disease state management, laws as the California Society of Health­ DIFFERENT CREDENTIALS FOR and calculations that are essential for System Pharmacists (CSHP) and the DIFFERENT PATIENT CARE ROLES? safe medication dispensing and patient American Society of Health-System The dispensing and counseling counseling. As a division of the State of Pharmacists (ASHP), grant "fellow" patient care roles of the pharmacist have California's Department of Consumer recognition (FCSHP and FASHP, respec­ been traditionally regulated through state Affairs, the California State Board of tively) to practitioners based on peer board of pharmacy licensing examina­ Pharmacy's purpose is to protect the pub~ review of the individual's academic, tions. The profession has been develop­ lie's safety by ensuring that pharmacists community, and professional contribu­ ing practitioners who are engaged in have met the· minimal educational ·and tions to the organization and the profes­ advanced practice roles involving expan­ experience requirements to practice sion. This credential ~is not intended to sion of the traditional roles or totally dif­ pharmacy. The minimum standard of grant specific practice privileges, but ferent activities and responsibilities that practice, however, is in part determined rather, to serve as peer recognition. require a different set of competencies, by the pharmacy practice act, which, as it While the profession has a variety of (e.g., collaborative drug therapy manage­ evolves, will eventually force the phar~ pharmacist certification programs, the ment). These advanced practice roles macist licensure exam to test for a higher overall approach to their development have been evolving at different rates in level of practice. While it is the govern­ has been inconsistent and lacking in pro­ the different segments of the profession ment's role to protect the public, it is the fession-wide acceptance. There are no Cl,nd in the various parts of the country. As profession's role to establish the stan­ standards recognized profession-wide for a result, there has been little impetus for dards of practice for the profession. By determining what types of certifications developing a national credential for setting high standards, the profession

8 qhp May/June 2000 CSHP White Paper: Certification, Credentials and Credentialing in Pharmacy stimulates the evolution of practice and be required by each pharmacist to ade­ credential. The BPS decision to place a hence provides the impetus for advanc­ quately and economically care for the moratorium on the creation of more spe­ ing the scope of practice. general population? What would a phar­ cialty certification examinations provides macist do if he or she was certified in dia­ an example of the lack of a profession­ State vs. National. If a state by state betes management, but the patient also wide strategy for certification. Instead, approach to the credentialing process had a problem with anti-hypertensive they created a process by which pharma­ were used, the resultant inconsistency in therapy managem~nt? Patients may not cists may earn an "added qualification" the standards and certification processes be satisfied with the potential discontinu­ designation in a specialty, provided they used in each state could result in a less ity of care and the potential need to see possess an appropriate BPS certification credible credential. Hypothetically, if a multiple pharmacists depending on their and pass a structured credentials review. pharmacist were certified by a national DSM credentials. From the payer's per­ Although the BPS' "added qualification" certification body, a practitioner could spective, would it be cost-effective to (e.g. in infectious diseases pharmacother­ move from state to state without the phar­ have to pay for multiple visits because apy) follows the model established by the macist needing to re-establish certifica­ the providers are certified to care for one American Board of Internal Medicine, tion in each state. Nationally recognized, disease, but not others? From the physi­ the debate and discussion that it has cre­ evidence based scope of practice stan­ cian's perspective, pharmacist-care refer­ ated is evidence of the lack of profession­ dards would significantly decrease the rals may become cumbersome, requiring wide acceptance. potential for state legislatures to exert them to keep track of many different Currently, all schools of pharmacy are influence on the development of profes­ pharmacists, each with different DSM converting their curricula to only offer sional standards. A coordinated, evi­ credentials. the Pharm.D. as the entry level degree for denced based, national approach to The NISPC DSM credential requires pharmacy. It is unclear what impact a health care provider scopes of practice only that the pharmacist be licensed and population of "all Pharm.D." profession­ were key recommendations made by the in good standing for two years and pass als will have on the types of activities that PEW Health Commission as methods to the written or computerized examination will need certification and the process to facilitate patient access to health care to qualify for the credential. There is no achieve it. Indeed, in the future, the providers.15 Currently, since each state requirement for clinical experience, Pharm.D., followed by a residency, may has its own pharmacy practice act, a much less experience in the management prove to be the only credential needed to national template for certification and of the disease for which the applicant is provide collaborative drug therapy man­ credentialing would likely create con­ attempting to gain certification. The agement. flicts with individual state laws and regu­ NABP indicates that the examination ~y continuing on this path of incon­ lations, unless a national profession-spe­ tests the application of knowledge and sistent, non-systematic approaches to the cific scope of practice were adopted. judgment. However, assessment of a creation of certification processes and Further, since it is the profession's, not practitioner's competency to perform credentials that lack external input and the government's, responsibility to set drug therapy management should require validation, pharmacists' credentials are standards of practice, coordination of evaluation not only of the practitioner's likely to remain the best kept secret in health care providers' scopes of practice knowledge, application of knowledge healthcare. · at the national level could eliminate the and judgment, but also should require state-by-state variability that exists today. clinical experience and should assess the CONCLUSION ••• OR.IS IT The PEW Health Commission recom­ pharmacist's skills, behaviors, and atti­ THE BEGINNING? mended the formation of a national poli­ tudes. Currently, it is not clear whether The profession needs to develop and cy advisory body to develop standards for the NISPC DSM examination has been implement a credible system of certifica­ uniform health professions' scopes of validated in any way. tion, credentials, and credentialing. This practice.15 In addition to current licensure as a system is key to the future of pharmacy. A pharmacist,. BPS certification examina­ failure to do so will put the profession at CRITIQUE OF PHARMACY'S tions also require a specific number of a significant disadvantage for current and CURRENT CERTIFICATION AND years in clinical practice based on degree future collaborative, direct patient man­ CREDENTIALING PROCESSES and pharmacy residency status. The dura­ agement roles as the health system con­ The concept of certification of phar­ tion of these experiential qualifications tinues to evolve. It is the profession's macists on a disease-by-disease basis has vary, depending on the specialty. responsibility, . not the public's, or the several drawbacks. Considering the mul­ Practitioners ·must also be recertified government's, to establish its direction, titude of comorbidities patients may every seven years to maintain their BPS its standards of practice and to develop have, how many DSM certifications will

qhp California Journal of HeaJth,System Pharmacy 9 CSHP White Paper: Certification, Credentials and Credentialing in Pharmacy

the means of achieving them. To this end, tial in advanced practice roles. Certifying Agencies (NCCA). the pharmacy profession must: E. how to manage the existing post­ 4. Develop and implement or adopt a graduate certifications and cre­ nationally recognized system that pro­ 1 . Come to profession-wide consensus on: dentials. vides for the credentialing of pharmacists. A. which advanced practice roles F. the need for requirements and 5. Develop a nationally recognized, today and in the future will periodicity of recertification. independent agency that oversees, require certification and creden­ G. the value of the concepts of coordinates, and ensures the quality tials to perform. national scopes of practice. of the profession's system for certifi­ B. the certification methodologies 2. Collaborate with the other participants cation, credentials and credentialing. required for the various advanced in the health care system (providers, practice roles that exist today and insurers, employers, and the public) in A credible system for providing cre­ those that will be needed as new the development of these and future dentials, certification, and credentialing roles develop in the future. credentials and certification standards. of pharmacists will provide assurances to c. the credentials that will be .}· Seek and obtain validation of the other health care providers, employers, required for today's advanced quality, methods, standards, policies the public and insurers of the quality and practice roles and those that and procedures used in the certifica­ capabilities of the pharmacist. Such a develop in the future. tion and credentialing process system, and the assurances that it could D. how the entry level Pharm.D. (as through accreditation by an appropri­ provide, will facilitate the acceptance of the only professional degree award­ ate non-governmental organization, the pharmacist as a provider of advanced ed), should be valued as a creden- such as the National Commission on pharmacy practice services. +

References

1. The American Council on Pharmaceutical 8. National Commission for Certification of Physician http://www.cnn.com/2000/HEALTH/02/14/noexpe­ Education, Standards and Quality Assurance Assistants: Details About Certification. Retrieved on rience.necessary.ap/index.html Procedures for ACPE-Approved Providers of March 23, 2000, from the World Wide Web: Continuing Pharmaceutical Education Offering http://www.nccpa.net/pages/certproc-det.htm 17. California Pharmacists Association. Legislative '" Certificate Programs in Pharmacy. Retrieved on Highlights: Pharmacists are health care providers! '" November 2, 1999, from the World Wide Web: 9. National Commission for Certification of Physician Insights 1999; 11 (16) "''" http://www.acpeaccredit.org/docs/AppProv/ Assistants: Recertification Exam Details. Retrieved '" standards/cpstandard.hem on March 23, 2000, from the World Wide Web: 18. California Assembly Bill 2804. Retrieved on March http://www.ncpa.net/pages/recert2.htm 27, 2000, from the World Wide Web: 2. Board of Pharmaceutical Specialties. Frequently http://www.assembly.ca.gov/acs/acsframeset2text.htm Asked Questions. Retrieved on February 17, 2000, 10. American Academy of Nurse Practitioners: from the World Wide Web: http://www.bps.org Certification Examination. Retrieved on March 23, 19. The Board of Pharmaceutical Specialties: Exam 2000, from the World Wide Web: Information: 2000 Candidates Guide. Retrieved on 3. Credentialing in Pharmacy: No Simple Matter. http://www.aanp.org/certific.htm March 23, 2000, from the World Wide Web: Coalition Seeks to Build Professionwide http://www.bpsweb.org Consensus. ASHP Newsletter February 2000. 11. The Pharmacy Technician Certification Board. Retrieved from the World Wide Web: Retrieved on March 27, 2000, from the World 20. The Board of Pharmaceutical Specialties: http://www.ashp.org/publidnews/newslet­ Wide Web: http://www.ptcb.org Recertification. Retrieved on March 23,2000, from ters/2000/feb/coalition.htm the World Wide Web: http://www.bpsweb.org 12. The National Certification Board for Diabetes 4. The American Board of Internal Medicine: Policies Educators: Certification Program for Diabetes 21. National Institute for Standards in Pharmacist and Procedures. Retrieved on March 21, 2000, Educators. Retrieved on March 27, 2000, from the Credentialing: Disease State Management from the World Wide Web: World Wide Web: http://www.ncbde.org Credentialing for Pharmacists. Retrieved on March http://www.abim.org/about/P&P.htm#27 23, 2000, from the World Wide Web: 13. National Organization for Competency Assurance. . http://www.nispcnet.org/NISP(_about_fr.html 5. The American Board of Internal Medicine: Retrieved on February 16, 2000, from the World Components of the ABIM Recertification Program. Wide Web: http://www.noca.org 22. Commission for Certification in Geriatric Retrieved March 23, 2000 from the World Wide ' · Pharmacy: Exam Fees and Requirements. Retrieved Web: http://www.abim.org/info/recrtcom.htm 14. Institute of Medicine Committee on Quality of . on March 23, 2000, from the World Wide Web: Health Care in America. To Err is Human: Building .· http://www.ccgp.org/pharmacistslbody_fees.htm 6. The American Board of Family Practice: a Safer Health System. Retrieved on February 16, Certification Requirements. Retrieved March 23, 2000, from the World Wide Web: 23: Health Resources and Services Administration: 2000, from the World Wide Web: http://bob.nap.edu/htmVto_err_is_human · Federal Credentialing Initiative. Retrieved on http://www.abfp.org/certific.htm , September 24, 1999, from the World Wide Web: 15. PEW Health Professions Commission Task Force on http://www.hrsa.dhhs.gov/bhpr/dqa/fedcred.htm 7. The American Board of Family Practice: Health Care Workforce Regulation. Strengthening Requirements for Recertification. Retrieved on Consumer Protection: Priorities for Health Care 24. Tomich N. VA, HHS Construct Credential System: March 23, 2000, from the World Wide Web: Workforce Regulation. October 1999 VetPro Will Centralize Verification of Data. U.S. http://www.abfp.org/recertif.htm ··Medicine, May 1998. 16. Associated Press. Proliferation of pharmacy techni­ cians raises questions of quality. Retrieved on 25:.:American Academy of Family Physicians Reference February 15, 2000, from the World Wide Web: ' Manual, updated 1996

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