Section 22-B1917. TELEPHARMACY SERVICES

 

1917.1The purpose of this section is to provide standards for the provision of remote pharmacy services by a provider pharmacy in a facility that is not at the same location as the provider pharmacy through a telepharmacy system.

 

1917.2Telepharmacy systems may only be used in institutional settings.

 

1917.3A provider pharmacy may provide remote pharmacy services directly, or through the use of a Director-approved subcontractor, using a telepharmacy system to a health care facility or other appropriate facility located in the District of Columbia if:

 

(a)The provider pharmacy submits an application to the Director for permission to provide remote pharmacy services using a telepharmacy system. The application shall include:

 

(1)The name, address, and license number of the provider pharmacy;

 

(2)The name and address of the facility where the remote pharmacy services will be provided;

 

(3)The name and address of the subcontractor who will provide after-hours remote pharmacy services; and

 

(4)An affidavit with the notarized signatures of the pharmacist-in-charge or Director or Pharmacy, and the medical director or the person responsible for the on-site operation of the facility affirming that the provider pharmacy and the facility have entered into a written agreement outlining the responsibilities of each party in complying with this chapter and the applicable federal and District laws and regulations.

 

(b)The Director approves the application. Upon approval of the application, the provider pharmacy will be sent a certificate which must be displayed at the remote site.

 

1917.4A provider pharmacy may only utilize a subcontractor for the provision of after-hours and weekend remote pharmacy services; or as emergency staffing where the President of the United States or the Mayor has declared a disaster or bio-terrorism related event in the District of Columbia.

 

1917.5A provider pharmacy and the facility shall notify the Director in writing within ten (10) days of a change of location, discontinuance of service, or closure of a remote site or remote pharmacy service.

 

1917.6The pharmacist-in-charge or director of pharmacy, of the provider pharmacy is responsible for all pharmacy operations involving the telepharmacy system located at the remote site including supervision of the telepharmacy system and compliance with this section.

 

1917.7The following duties shall be performed only by a licensed pharmacist at the provider pharmacy:

 

(a)Receiving an oral prescription drug order;

 

(b)Interpreting the prescription drug order;

 

(c)Verifying the accuracy of the prescription data entry;

 

(d)Interpreting the patient's medication records and conducting a drug regimen review;

 

(e)Authorizing the telepharmacy system to print a prescription label at the remote site;

 

(f)Performing the final check of the dispensed prescription to ensure that the prescription drug order has been dispensed accurately as prescribed. The final check shall be accomplished through a visual check using electronic methods; and

 

(g)Counseling the patient. This counseling may be performed using electronic methods such as telephone, email, video conferencing, and webcam.

 

1917.8Nonsterile drugs which require reconstitution through the addition of a specified amount of water may be dispensed by the remote site only if a registered pharmacy technician or an authorized licensed healthcare provider reconstitutes the product.

 

1917.9Drugs shall only be dispensed at a remote site through a telepharmacy system if:

 

(a)An original prescription drug order has been received, or reviewed electronically, by a pharmacist at the provider pharmacy;

 

(b)A pharmacist at the provider pharmacy has approved the release of the initial dose of a prescription drug order;

 

(c)A pharmacist at the provider pharmacy has conducted a drug regimen review prior to releasing a prescription drug order to the telepharmacy system; and

 

(d)A pharmacist is able to electronically supervise the telepharmacy system and the dispensing of the prescription drug order.

 

1917.10Drugs may be dispensed by the provider pharmacy through a telepharmacy system at a remote site only in unit-of-use or unit dose containers that are:

 

(a)Prepackaged in suitable containers at the provider pharmacy and appropriately labeled as required under this Title; or

 

(b)In original manufacturer's or distributor's containers.

 

1917.11A provider pharmacy shall only store drugs at a remote site within an area that is locked by key or combination so as to prevent access by unauthorized personnel.

 

1917.12A pharmacist from the provider pharmacy shall be accessible at all times to respond to a patient's or other health professional's questions and needs pertaining to drugs dispensed through a telepharmacy system at a remote site. The access may be by telephone or through a twenty-four (24) hour pager service.

 

1917.13The provider pharmacy shall be responsible for ensuring that the requirements set forth under §§ 1913 and 1914 of this Title are met and for maintaining all required records.

 

1917.14The pharmacist-in-charge or Director of Pharmacy of the provider pharmacy shall be responsible for ensuring that the remote site and telepharmacy system comply with all applicable federal and District laws and regulations.

 

1917.15Nothing in this section shall be construed to permit a pharmacy, or provider pharmacy, located within the District of Columbia to provide remote pharmacy services to a facility or individual located outside of the District of Columbia without legal authorization under the laws of the recipient state or jurisdiction.

 

source

Notice of Final Rulemaking published at 55 DCR 270 (January 11, 2008).