Rule 4729:5-9-02.14 | Remote medication order processing.
(A) As used in this rule:
(1) "Remote medication order processing" means the processing of a medication order for an institutional pharmacy licensed as a terminal distributor of dangerous drugs by a remote pharmacist. Remote medication order processing does not include the dispensing of a drug, but may include receiving, interpreting, evaluating, clarifying, and approval of medication orders. Additionally, remote medication order processing may include order entry, other data entry, performing prospective drug utilization review, interpreting clinical data, performing therapeutic interventions, providing drug information services, and authorizing release of the medication for administration. The requirements of this rule shall be limited to the processing of medication orders dispensed in or into this state.
(2) "Remote pharmacy" means either:
(a) A pharmacy licensed as a terminal distributor of dangerous drugs that dispenses dangerous drugs; or
(b) A pharmacy licensed as a limited category II terminal distributor of dangerous drugs that does not stock, own, or dispense any dangerous drugs and whose sole business consists of entry, review, and/or verification of prescriber orders and consulting services under contract for institutional pharmacies in this state.
(3) "Remote pharmacist" means any of the following:
(a) If performing remote medication order processing in this state: an Ohio licensed pharmacist, either employed or a contract employee of an institutional pharmacy or remote pharmacy, who either processes orders from a remote site, which may include the pharmacist's residence or other location where the pharmacist and the institutional or remote pharmacy can ensure the confidentiality and integrity of patient information, or on the premises of a remote pharmacy or institutional pharmacy; or
(b) If performing remote medication order processing outside of this state: a pharmacist licensed or registered in the state where the remote medication order processing is occurring, either employed or a contract employee of an institutional pharmacy or remote pharmacy who holds a nonresident pharmacy license in accordance with Chapter 4729:5-8 of the Administrative Code, who either processes prescriptions from a remote site, which may include the pharmacist's residence or other location where the pharmacist and the institutional or remote pharmacy can ensure the confidentiality and integrity of patient information, or on the premises of a remote pharmacy or institutiona pharmacy.
A pharmacist shall only be permitted to conduct remote medication order processing within the United States, to include the District of Columbia, the Commonwealth of Puerto Rico or a territory or insular possession subject to the jurisdiction of the United States.
(B) An institutional pharmacy may outsource medication order processing to a remote pharmacy provided the pharmacies are under common ownership or control or the institutional pharmacy has entered into a written contract or agreement with a pharmacy that outlines the services to be provided and the responsibilities and accountabilities of each party to the contract or agreement in compliance with federal and state law, rules, and regulations.
(C) The institutional pharmacy and remote pharmacy must maintain a copy of the contract or agreement in a readily retrievable manner for inspection and review by an agent, inspector, or employee of the board.
(D) An institutional pharmacy utilizing remote medication order processing shall ensure that all remote pharmacists providing such services have been trained on the institutional pharmacy's policies and procedures relating to medication order processing. The training of each pharmacist shall be documented.
(1) Such training shall include, but is not limited to, policies on drug and food allergy documentation, abbreviations, administration times, automatic stop orders, substitution, and formulary compliance. The institutional pharmacy and the remote pharmacy shall jointly develop a procedure to communicate changes in policies and procedures related to medication order processing.
(2) A terminal distributor of dangerous drugs may utilize one training program for all institutional pharmacies under the terminal distributor's common ownership and control.
(E) An institutional pharmacy utilizing remote pharmacists shall maintain or have access to a record of the name and license number of each pharmacist, evidence of current pharmacist licensure in the state where the pharmacist is performing remote order processing, and the address of each location where the pharmacist will be providing remote medication order processing services.
(F) An institutional pharmacy shall ensure that any remote pharmacist shall have secure electronic access to the institutional pharmacy's patient information system and to other electronic systems that the on-site pharmacist has access to when the pharmacy is open.
(G) The remote pharmacist must be able to contact the prescriber issuing a medication order to discuss any concerns identified during the pharmacist's review of patient information and the medication order. A procedure must be in place to communicate any problems identified with the prescriber and the nursing staff providing direct patient care.
(H) Each remote entry record must comply with all record keeping requirements for institutional pharmacies, including capturing the positive identification of the remote pharmacist involved in the review and verification of the medication order.
(I) An institutional pharmacy utilizing remote medication order processing is responsible for maintaining records of all medication orders entered into their information system, including orders entered by a remote pharmacist. The system shall have the ability to audit the activities of the remote pharmacists.
(J) An institutional pharmacy utilizing remote medication order processing services shall develop and implement a policy and procedure manual. A remote pharmacy shall maintain a copy of those portions of the policy and procedure manual that relate to the remote pharmacy's operations. Each manual shall include all the following:
(1) Outline the responsibilities of the institutional pharmacy and the remote pharmacy;
(2) Include a list of the names, addresses, telephone numbers, and all license numbers of the pharmacies/pharmacists involved in remote medication order processing; and
(3) Include policies and procedures for:
(a) Protecting the confidentiality and integrity of patient information;
(b) Ensuring that no patient information is duplicated, downloaded, or removed from the institutional pharmacy's patient information system;
(c) Maintaining appropriate records of each pharmacist involved in order processing;
(d) Complying with federal and state law, rules, and regulations;
(e) Reviewing written policies and procedures at least every three years, or upon the implementation of a significant change of written policies and procedures, and documentation of the review; and
(f) Annually reviewing the competencies of pharmacists providing remote order entry processing services.
Last updated November 30, 2021 at 8:29 AM
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