(1) A hospital pharmacy may outsource medication order processing to another pharmacy provided the pharmacies have the same owner or the pharmacy has entered into a written contract or agreement with an outsourcing company 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 statutes and regulations.
(2) The hospital pharmacy must provide a copy of the contract or agreement to the board and receive approval from the board or its designee prior to initiation of remote order entry services.
(3) A hospital pharmacy utilizing remote order entry shall ensure that all pharmacists providing such services have been trained on the pharmacy's policies and procedures relating to medication order processing. The training of each pharmacist shall be documented. 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 pharmacy and the pharmacy/outsourcing company shall jointly develop a procedure to communicate changes in formulary and changes in policies and procedures related to medication order processing.
(4) A hospital pharmacy utilizing a remote order entry pharmacist shall maintain a record of the name and address of such pharmacist, evidence of current licensure in Montana, and the address of each location where the pharmacist will be providing remote order entry services.
(5) The director of pharmacy shall ensure that any remote order entry pharmacist shall have secure electronic access to the hospital pharmacy's patient information system and to other electronic systems that the on-site pharmacist has access to when the pharmacy is open.
(6) The remote order entry pharmacist must be able to contact the prescribing practitioner to discuss any concerns identified during the pharmacist's review of patient information and the drug order. A procedure must be in place to communicate any problems identified with the practitioner and the nursing staff providing direct patient care.
(7) Each remote entry record must comply with all recordkeeping requirements and shall identify by name or other unique identifier, the pharmacist involved in the review and verification of the drug order.
(8) A pharmacy utilizing remote order entry processing services is responsible for maintaining records of all orders entered into their information system, including orders entered from a remote location. The system shall have the ability to audit the activities of the individuals remotely processing medication orders.
(9) All records shall be readily available upon request by the board, its designee, or agent of the board for inspection, copying, or production.
(10) A pharmacy utilizing remote order entry processing services shall maintain a policy and procedure manual. A remote pharmacy/order processing company shall maintain a copy of those portions of the policy and procedure manual that relate to that pharmacy's operations. Each manual shall:
(a) outline the responsibilities of the pharmacy and the remote pharmacy/order processing company;
(b) include a list of the names, addresses, telephone numbers, and all license numbers of the pharmacies/pharmacists involved in remote order entry processing; and
(c) include policies and procedures for:
(i) protecting the confidentiality and integrity of patient information;
(ii) maintaining appropriate records of each pharmacist involved in order processing;
(iii) complying with federal and state statutes and regulations;
(iv) annually reviewing the written policies and procedures and documentation of the annual review; and
(v) annually reviewing the competencies of pharmacists providing remote order entry processing services.