Pharmacy Informatics Board Certification Petition
Photo by Milos Lopusina on Unsplash
On July 16, 2025, the BPS - Board of Pharmacy Specialties (BPS) received a petition from the American Pharmacists Association and ASHP to recognize Pharmacy Informatics as a BPS specialty certification. The petition is open for public comment and will close on August 20, 2025. I plan to add my thoughts to the petition, but will also expand on my comments in this article. I encourage my colleagues in pharmacy and informatics to do the same.
In short, I'm in strong support of a new BPS specialty for pharmacy informatics. Though I'm hoping that the examination content extends a bit beyond pharmacy informatics to include other areas, be it health IT policy or biomedical informatics, more transparency occurs with the board maintenance fees, and increased ROI for candidates who are investing their time and resources into getting board certified. In this article, I'd like to dive a bit deeper into my opinions.
Strong support
To reiterate, I am in strong support of BPS recognizing pharmacy informatics as a new specialty. In review of the petition, the case for why such a board certification should exist is well articulated. In fact, I think it's both obvious and late considering how ubiquitous electronic health records (EHRs) are, how rapidly artificial intelligence (AI) applications are being developed, especially with large language models (LLMs), and how our fellow healthcare colleagues, both physicians and nurses, already have board certifications in informatics. For more reading, I'd encourage you to check out the 2010 article that details the journey taken by AMIA (American Medical Informatics Association) in developing the clinical informatics sub-specialty for physicians.
Certification must sit within pharmacy
I vividly recall the many conversations I've had at ASHP Midyear, even back in 2015, about this very topic - one of which was at an informatics round table with Gordon Mann in 2017 that formed many of my initial opinions on the matter - and how I've always wondered why it didn't exist back then. I had mixed feelings about it back then because I felt as though it was important that informatics pharmacists exhibit skillsets beyond the pharmacy domain (e.g. biomedical informatics) to be practicing at the top of our license. However, having completed ~20 credits of biomedical informatics during my MPH studies at Johns Hopkins Bloomberg School of Public Health and a graduate certificate in biomedical data science at Stanford University School of Medicine, I feel much more strongly about having a pharmacy board specialty in informatics.
Why? Because I've often found that the foundations of what we learn and do as informatics pharmacists is missing in these other types of curriculum. Thus, I think that an assessment of an informatics pharmacists' knowledge and skills must be housed within the pharmacy profession. Board certification makes a lot of sense here for ensuring we continue to produce a strong pipeline of well-trained, informatics pharmacists. More on this later.
Goal setting & alternative paths
An informatics board certification will also, I imagine, be on the short and/or long-term goals of aspiring pharmacy students who are interested in informatics. Personally, board certification was on mine the first time I heard about it in pharmacy school. I just never had the option to pursue one that was directly in informatics. Goal setting can be quite beneficial in helping students focus and I think it'll be a net positive in helping develop the next generation of informatics pharmacists.
I remember looking up to my role models in informatics as a student and seeing that many of them were board certified in pharmacotherapy (i.e. BCPS) or had a masters in informatics (MHI). Certainly, it was very influential in my own professional development as I also obtained my BCPS, but went with an MPH in stead of an MHI. I won't expand on that here, but you can watch my YouTube series about my MPH journey and my rationale behind pursuing an MPH vs. an MHI, MBA, or MHA if you are curious.
I also think a board certification in informatics may provide our pharmacy colleagues that were not able to complete a PGY-2 in Pharmacy Informatics (or other post-graduate training) an alternative path towards an informatics career. I don't think it'll replace the experience from residency training, but I do think it'll give more confidence and a more structured path towards making informatics as a career.
Breadth, but also depth
Circling back on my comments about my didactic experiences of biomedical informatics and data science, I feel quite strongly that our pharmacy curriculums must expand to include broader domains like public policy in health IT and biomedical informatics. Especially our training programs that are focused on pharmacy informatics (e.g. PGY-2, other post-graduate training). I feel that way because the experiences I've had in the biomedical informatics courses at Johns Hopkins Bloomberg School of Public Health, many of which were in Informatics Education - Johns Hopkins University School of Medicine, or Stanford University School of Medicine's Biomedical Data Science courses, fundamentally shifted how I approached solving informatics problems when I was an informatics pharmacist at Mayo Clinic.
To give an example, I spent a lot of time developing clinical decision support for my infectious diseases colleagues. In doing so, I had to also define many value sets (understatement. IYKYK) for medications, conditions, labs, and of course, organisms like MRSA and pseudomonas. The focused didactics on ontologies and standard healthcare terminologies like RxNorm, LOINC, and SNOMED-CT made me think more modular - especially in terms of semantics - and I ended up redesigning a lot of my decision support with composability in mind. Further, the late and painful hours I spent reading Stack Overflow and official code documentation about how to write Python and R to analyze EHR data and develop AI models, be it simple logistic regressions like Lasso or more advanced methods like convolutional neural networks (CNNs) to read diagnostic images, made me a better informatician in guiding the development of artificial intelligence applications. Which, IMO, is almost an non-negotiatable nowadays.
As board certification is meant to convey expertise in a given specialty, I think board certification in informatics should assess competence in not only depth (pharmacy informatics), but also breadth in topics that may be considered orthogonal to what we see in traditional pharmacy didactics.
Return on Investment (ROI)
Although I am in strong support of an informatics board certification, I still have some skepticism around its ROI. Granted, I think, on average, the pros outweight the cons. My stance is also a bit ironic considering I let my BCPS lapse in 2023 because of ROI. It's not exactly apples to oranges though as I imagine the ROI of an informatics certification is significantly different. However, I think my decision would not have changed considering my own personal career path into health tech as I had to expand my skillset to be more technical in nature, but also broader in healthcare.
Employer incentives
One of the most obvious reasons to get board certified are the incentives from your employer. This can take the form of certification reimbursements, salary increases, and promotions. I didn't dig too deep into this, but from a 2022 study involving hospital pharmacy directors in California, it was found that 47% of them considered board certification during hiring and 38% reward board certified employees. In my own experience, my initial certification exam ($400) was reimbursed, if I passed, but all other costs were out of pocket. No other incentives, perhaps beyond academic ranks and being a preceptor, were there. In review of some other, very anecdotal findings from reddit (don't @ me), some employers make board certification a no brainer with 3-5% increases in salary, which using the Bureau of Labor Statistics's 2024 median salary of pharmacists would equate to $4,124 - $8,249/annual increase and easily justify the ROI. The US PUBLIC HEALTH COMMISSION CORPS seems to give an annual $6k incentive too.
Even so, it'd seem like the employer incentives are broadly lagging and there is certainly room for improvement. I'll expand on this later, but perhaps this is an area BPS - Board of Pharmacy Specialties can help stimulate as the assumption here is that board certification improves patient care. Thus, more incentives = more board certified pharmacists = better patient care.
High financial costs
The BPS - Board of Pharmacy Specialties markets the ROI to be 0.13% of their lifetime salary. That's not insignificant. Especially in the context of an average pharmacy student loan debt of $167,711, pharmacy licensing fees, pharmacy organization membership fees, and general cost of living in this economy in 2025. I personally graduated with ~135k in federal student loans and it was painful to pay the ~$730/month in interest alone. I contributed $1k/month initially with gradual increases to $3k/month to temper the interest payments.
This alone doesn't necessarily make me question the costs of board certification. One of the other things on my mind is where the revenue is going towards? As a nonprofit organization, I'd imagine the money is being spent on furthering the mission of improving patient care. As a data person, I figured I'd do some very speculative analysis of what the finances may look like at BPS using good ole ChatGPT. See below.
Estimated Revenue
Based on their fees, their primary revenue is likely from the annual certification maintenance fee of $125 and their initial certifcation and recertification fees of $600 and $400, respectively. Based on their certifcation stats, there are currently 56,444 individuals that are board certified around the world with 52,448 of them being in the US. I couldn't find anything that suggested that non-US candidates pay different fees. Thus the revenue from annual maintenance fees alone for all individuals would be $7,055,250 (56,444 x $125). As for certification fees, there were 5,289 candidates that sat for the certification and/or recertification exams. That'd lead to a revenue range of $2,115,600 - $3,173,400 depending on the distribution of certification and recertification exams administered. Let's just take the average and assume the revenue is $2,644,500. This would put the estimated 2024 revenue at $9,699,750 ($7,055,250 + $2,644,500).
Estimated Expenses
Staff usually account for the majority of expenses in a company so I used their 2024 annual report to get the names and titles of all the staff to do an estimate of their estimated salary (+ fringe benefits of 30%). I know there is a physical office in DC so I assumed some were in DC, but noticed that some of their staff were remote (e.g. lower salary). I used ChatGPT to help me with some estimates and came up with salary expenses for their 27 staff members to be $3,010,000 and their associated fringe benefits (30%) to be $903,000 for a total of $3,913,000 for staff expenses. Tinkering with the likely expenses a typical company has along with reviewing their website for other expenses like award programs and research grants, I came up with the following:
$3,913,000 | Staff + fringe benefits
$270,000 | Office & facilities (DC)
$425,000 | Exam development
$475,000 | Exam administration (5,289 x $90/exam)
$200,000 | Technology systems
$185,000 | Marketing & outreach
$175,000 | Governance and board
$145,000 | Legal, accounting, and insurance
$130,000 | Recertification and CE operations
$50,000 | Administrative overhead
$12,500 | Award programs
$15,000 | Research grants
For a total of $5,995,500 in terms of 2024 expenses.
Net Profit
Considering both the revenue and expenses, my napkin math estimate would be that BPS - Board of Pharmacy Specialties has a net profit of $3,704,250 ($9,699,750 - $5,995,500) in 2024. Just to level set, I'd probably take this estimate with a grain of salt as I clearly made a lot of assumptions. However, it does make me question what their actual operating expenses are and how the fees are being utilized.
Also, if there truly is such a surplus, can it be directed towards the mission of improving patient care. Some ideas off the top of my head:
Encourage development of content that reflects both depth and breadth as discussed earlier. I imagine there may need to be solicitation for non-pharmacy expertise here and monetary compensation may make this both attractive and higher quality. Further, it seems like a lot of content development is done via volunteers (1,508 total in 2024 with 330 of them being item writers). I think compensation, even minimal, may help incentivize contributions.
Encourage timely updates to content. Especially given the rapid changes occurring in the technology world (e.g. artificial intelligence). Again, compensation likely is a factor here to maintaining high-quality content.
Contribute towards employer incentives. Perhaps an annual stipend that employers can apply to help offset some of the costs, especially those that have fewer incentives (e.g. non-urban, non-teaching, and fewer hospital beds) to encourage more pharmacists to get board certified.
Contribute towards subsidizing BPS-education. The cost of BPS-approved education isn't cheap and those that have purchased American College of Clinical Pharmacy (ACCP)'s Pharmacotherapy Self-Assessment Program (PSAP) or ASHP's Recertification programs or Midyear programs can attest to this. If there's excess revenue, perhaps some of this can be subsidized to ease the financial burden on pharmacists who are maintaining their board certifications.
More financial transparency from BPS. It'd be great to get more insight into how these fees are distributed beyond what's described in the recertification overview as it seems like there's a significant amount of volunteers (n=1,508) that likely contribute to what is described.
Criticism of board certifications across healthcare
The financial costs of board certification is a fairly hot topic in other healthcare circles too like the major revolt in 2015 from physicians leading to the creation of a new recertification organization called National Board of Physicians and Surgeons (NBPAS) and distrust in the physical therapy world about their ROI. There's lots of interesting takes from the physician world and you can find some of the interesting ones here, here, and here. Honarable mentions from our pharmacy colleagues about the fees on reddit here and here.
Opportunity costs
Personally, the opportunity costs for me is too high for me to pursue given my own personal career path. Further, I think you can loosely quantity the opportunity costs here using the CE numbers of 120 (pre-2023) to be $7,932 (BLS hourly pay of $66.10 x 120) and 80 + 20 CPD (post-2024) to be $6,610 (BLS hourly pay of $66.10 x 100). Which, is likely an understimate considering the time that goes into the studying and assessments. Still, that doesn't change my mind about the value of having a new BPS specialty in informatics as I truly believe that it'll yield a net positive.
Concluding thoughts
Introducing a new BPS specialty for pharmacy informatics is a no brainer. The current petition did a great job in outlining the reasons, but I'll also point readers towards the 2010 article from AMIA about its rationale towards development of the clinical informatics sub-specialty for physicians along with a 2016 article about the emergence of the chief clinical informatics officer (CCIO) - encompassed by c-suite leadership from physicians, nurses, pharmacists, and dentists. Despite some of my skepticism, I am in strong support of the petition and firmly believe that it'll strengthen and promote a pipeline of future informatics pharmacists that are well-positioned to lead and tackle the increasingly complex healthcare environment that is tightly coupled to technology.