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Ohio Administrative Code (Last Updated: January 12, 2021) |
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4729:1 Licensing and Consult Agreements |
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Chapter4729:1-6. Consult Agreements with Physicians |
4729:1-6-03. Standards for managing drug therapy
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(A) A managing pharmacist shall prescribe in accordance with a valid prescriber-patient relationship. This includes, but is not limited to, the following:
(1) Reviewing a thorough history of the patient;
(2) Except as provided in paragraph (G)(2) of this rule, conducting an initial consultation with the patient via in-person meeting, video conference or by telephone;
(3) Ordering tests and evaluation of test results in accordance with section 4729.39 of the Revised Code;
(4) Prescribing medication in accordance this division of the Administrative Code, ruling out the existence of any recognized contraindications;
(5) Consulting with the authorizing physician on the consult agreement when necessary; and
(6) Documenting these steps in the patient's medical record.
(B) The pharmacist's prescriptive authority shall not exceed what is specified in the consult agreement.
(C) A managing pharmacist shall comply with the same requirements of a physician pursuant to Chapter 4731-11 of the Administrative Code .
(D) A pharmacist, as part of an opioid treatment program licensed by the state, may administer controlled substance narcotics pursuant to a consult agreement in accordance with this division of the Administrative Code for the maintenance or detoxification treatment of opioid addiction.
(E) Except as provided in paragraphs (F) and (G)(1) of this rule, a managing pharmacist shall, at a minimum, conduct a follow-up consultation with the patient on an annual basis. The review shall be conducted via in-person meeting, video conference or by telephone and shall be documented in the patient's medical record.
(F) Paragraphs (A)(2) and (E) of this rule do not apply to the inpatient management a patient's drug therapy pursuant to a consult agreement in an institutional facility .
(G) A hospital, clinic or other healthcare facility that utilizes managing pharmacists for the purposes of authorizing prescriptions that were originally issued by a consulting physician shall comply with the following:
(1)
(a) A managing pharmacist, consulting physician, or agent of the consulting physician shall, at a minimum, conduct a follow-up consultation with the patient on an annual basis. The review shall be conducted via in-person meeting, video conference or by telephone and shall be documented in the patient's medical record.
(b) The required follow-up consultation with patients pursuant to paragraph (G)(1)(a) of this rule does not apply if the patient, or an individual authorized to act on behalf of a patient, elects to opt-out of the follow-up consultation.
(2) The initial consultation requirement by a managing pharmacist is not required if the managing pharmacist is only engaged in the authorization of prescriptions.
(3) In addition to the communication requirements in paragraph (C) of rule 4729:1-6-01 of the Administrative Code, the hospital, clinic or healthcare facility shall:
(a) Obtain patient consent specifically authorizing the use of managing pharmacists to authorize prescriptions pursuant to a consult agreement.
(b) Provide contact information, either electronically or in writing, of the person or persons at the hospital, clinic or other healthcare facility who are responsible for answering questions regarding the patient's drug therapy.
(4) Notwithstanding any other provision of the Administrative Code, all prescriptions authorized pursuant to this paragraph shall include the name of the managing pharmacist authorizing the prescription and the telephone number where the managing pharmacist can be personally contacted during normal business hours.
(5) Managing pharmacists authorizing prescription refills in accordance with this paragraph shall utilize an electronic health records system that complies with the following:
(a) The system shall provide managing pharmacists and consulting physicians with real-time access to the patient's complete medical record maintained by the consulting physician, including patient lab results and prescriber and pharmacist notes.
(b) The electronic health records system shall have the capability to allow communication between managing pharmacists and consulting physicians.
(6) The consult agreement shall include an algorithm that is specific to refill authorizations. The algorithm must include, but is not limited to, the following decision criteria for managing pharmacists to follow when conducting prescription refill authorizations:
(a) Required lab results;
(b) Any restrictions or limitations; and
(c) The maximum amount of time between prescriber visits a refill may be authorized based upon prevailing standards of care.