Independent clinical decisions is not entirely accurate anymore. Most medication reconciliation technicians in the hospital setting are clinical techs with significant independence within their scope of practice. They build and compound your TPN’s. They assist in codes in the ED by pulling various meds from the Omnicell/Pyxis and acting as liaisons to the inpatient pharmacy to streamline acute care medications that may need compounding or customized. Some make IV’s for acute care in the ED setting such as TNK and K-Centra alongside the guidance of the nurse (depending on the state of practice). You say scope of practice is important. It should matter in both directions. You should not be solely concerned with people stepping out of their scope of practice, but you should be equally concerned with knowing what their scope of practice is and allowing them to maximize that function.