Chapter 4729-29 Management of Drug Therapy under Consult Agreement with Physician
As used in division (b) of section 4729.39 of the Revised Code, a "reasonable attempt to contact and confer" shall be deemed to have occurred if the pharmacist provides the physician with notification of the intended action to be taken pursuant to the consult agreement and provides the physician with the opportunity to respond in a timely manner. Such notification may include, but is not limited to, one of the following methods:
(A) Personally meeting with the physician;
(B) Telephone discussion with the physician;
(C) Facsimile in a manner that confirms delivery;
(D) Electronic mail that confirms delivery;
(E) Any other method in writing that reaches the physician in a timely manner; or
(F) Any other method of notification as outlined in the consult agreement between the pharmacist and physician that might reasonably be expected to allow for the notification of the physician prior to the implementation of the intended action.
For the purpose of implementing any actions initiated as a result of a consult agreement whereby the consulting pharmacist is not the dispensing pharmacist or the person administering the dosage ordered, the consulting pharmacist shall be deemed to be acting as the agent of the consulting physician as the term agent is used in rules 4729-5-21 and 4729-5-30 of the Administrative Code unless the physician has specified otherwise in the consult agreement. The pharmacist's copy of the signed consult agreement shall be made available to the dispensing pharmacist or the person administering the dosage ordered if it is requested in order to prove the right of the pharmacist to act in this manner.
As required by section 4729.39 of the Revised Code, all consult agreements and the records of actions taken pursuant to such consult agreements shall be in writing. These records shall be maintained in such a manner that they are readily retrievable for at least three years from the date of the last action taken under the consult. Such consult agreements shall be considered confidential patient records and are therefore subject to the requirements of rule 4729-5-29 of the Administrative Code.
The requirements of section 4729.39 of the Revised Code do not apply within an institutional facility as defined in rule 4729-17-01 of the Administrative Code when the pharmacists are following the requirements of a formulary system that was developed pursuant to section 4729.381 of the revised code.
An institutional policy for consult agreements developed pursuant to division (C) of section 4729.39 of the Revised Code must include at least the following criteria:
(A) The appropriate institutional credentialing or privileging procedures for each individual pharmacist prior to the pharmacist acting under any consult agreement;
(B) The credentialing or privileging procedures that delineate an individual pharmacist's scope of privileges when acting under a consult agreement;
(C) An appropriate quality assurance mechanism to ensure that pharmacists who act under a consult agreement do so only within the scope of privileges granted;
(D) A written description for each of the following:
(1) The mechanism to be used for coverage when the consult agreement pharmacist or physician is not physically present;
(2) How the consult agreement will be made in writing;
(3) How the consult agreement shall be communicated to the patient or legal guardian;
(4) How the pharmacist shall document each action taken under the consult agreement;
(5) The methods to be used for the required communication between a pharmacist and physician;
(6) The appropriate methods for terminating a consult agreement.
An institutional policy for consult agreements developed pursuant to division (C) of section 4729.39 of the Revised Code shall be subject to review by the state board of pharmacy as follows:
(A) Upon the request of the state board of pharmacy, a hospital or long-term care facility shall immediately make available its policy for consult agreements. The state board of pharmacy, after review, may approve the policy or return it to the hospital or long-term care facility for revision without approval.
(B) If a policy for consult agreements has been returned for revision without approval to a hospital or long-term-care facility by the state board of pharmacy, such policy may not be implemented until it has been approved by the board.
(C) Policies for consult agreements that are requested by, or that are required to be submitted to, the state board of pharmacy may be reviewed with the state medical board, as appropriate.