Implementing Clinical Pharmacy Technician Roles to Scale Pharmacogenomics Services in a Large Integrated Health System.

PURPOSE: To describe the development and early implementation of a clinical pharmacy technician model to support pharmacogenomics (PGx) services within Veterans Health Administration (VHA). SUMMARY: VHA is the largest integrated health system implementing PGx, with 157 facilities offering testing and over 150,000 PGx orders completed. As the National Pharmacogenomics Program (NPP) scaled, Clinical Pharmacist Practitioners (CPPs) faced increasing operational demands from tasks such as patient identification, outreach and consent, laboratory coordination, and post-test triage that did not require advanced clinical training. In 2023, national PGx leaders, regional pharmacy executives, and local PGx champions designed a PGx Clinical Pharmacy Technician (CPhT) role to reallocate operational duties while preserving pharmacist responsibility for advanced PGx care and program leadership. Six CPhT positions were created in 2024 at national, regional, and local levels as a pilot in 2 regions with differing models and nationally to support targeted PGx care.PGx CPhT responsibilities include reviewing dashboards to identify patients for testing, providing scripted PGx education and answering common questions, documenting oral informed consent, triaging low- and moderate-risk gene-drug alerts, and preparing draft notes for pharmacist review. PGx pharmacists provided standardized training in PGx fundamentals, communication, informatics tools, and electronic health record workflows. CPhTs also coordinated lab appointments when needed and reminded Veterans when PGx orders were nearing expiration. Early qualitative experience suggests reduced administrative workload for CPPs, improved timeliness and reliability of PGx processes, and enhanced technician career advancement, with no voluntary CPhT turnover to date. CONCLUSION: This paper describes a PGx technician-pharmacist model that has been successfully piloted within our healthcare system and may be feasible in other settings. It outlines roles and training structures to support replication and offers a potentially adaptable approach for health systems seeking to operationalize PGx within existing pharmacy resources.