Current through Register Vol. 18, September 20, 2024
(1) A
remote telepharmacy site shall be connected to its parent pharmacy via
computer, video, and audio link.
(4) A remote telepharmacy site shall comply
will all the requirements of pharmacy rules and statutes of Montana. The remote
telepharmacy site is considered to be under the personal charge of the
pharmacist at the parent pharmacy.
(a) The
remote telepharmacy site must have a registered pharmacy technician present and
a working computer, video, and audio link to a pharmacist at the parent
pharmacy to have the prescription area open.
(b) The technician at the remote telepharmacy
site must:
(i) be currently registered with
the board;
(ii) be currently
certified with the Pharmacy Technician Certification Board (PTCB), or Exam for
the Certification of Pharmacy Technicians (ExCPT), or other board-approved
certifying entity; and
(iii) have
at least 500 hours experience as a pharmacy technician, technician-in-training,
or experience deemed as equivalent by the board.
(c) The technician may unlock the
prescription and storage areas. While the technician is on duty, the
prescription area may remain open. Security standards for pharmacies shall be
maintained at all times pursuant to ARM
24.174.814.
(d) The technician will be subject to all
rules of ARM
24.174.701 through
24.174.714.
(e) All prescription records and consecutive
prescription numbers must be maintained at the parent pharmacy or remote site.
The remote telepharmacy site must transmit copies of new prescriptions via
secure electronic means to the parent pharmacy, keeping the original
prescription blank at the remote telepharmacy site.
(f) Prescriptions filled at the remote
telepharmacy site must be distinguishable in some manner from those filled at
the parent pharmacy.
(g) Daily
reports for both the parent pharmacy and remote telepharmacy site must be
maintained at the parent pharmacy or telepharmacy site.
(h) The remote telepharmacy site may have a
prescription inventory. Prescription medications including controlled
substances shall be securely maintained at the remote telepharmacy site in
accordance with current Montana pharmacy statutes and rules.
(i) If controlled substances are dispensed or
handled, both the remote telepharmacy site and the parent pharmacy must be
registered with the DEA and must obtain individual DEA numbers.
(j) All records must be stored at the parent
pharmacy or telepharmacy site, except those required by DEA to be at a DEA
registered site.
(k) The software
system utilized must be able to generate labels from the parent pharmacy or at
the remote telepharmacy site.
(l)
The input of drug information may be done by a pharmacist at the parent
pharmacy or a technician at either location if verified by a
pharmacist.
(m) New prescriptions
may be received at the parent pharmacy and entered there with a label printing
at the remote telepharmacy site.
(n) New prescriptions received at the remote
telepharmacy site may be entered into the computer system at the remote
telepharmacy site. The pharmacist at the parent pharmacy remains responsible
for all verification, interaction checking, and profile review.
(o) All filled prescriptions must have a
label meeting the requirements of ARM
24.174.511 attached to the final
drug container before the pharmacist verifies the dispensing process.
(p) Unless the remote telepharmacy site is a
remote telepharmacy dispensing machine site, a pharmacist shall compare via
video link the stock bottle, drug dispensed, and strength. The entire label
must be checked for accuracy on the video link.
(q) The computer, video, and audio link must
be operational at all times. In the event of connectivity loss to the parent
location, no new prescriptions may be processed, filled, or dispensed from the
telepharmacy site until connectivity is reestablished. Refill prescriptions
that have a final check by the pharmacist may be dispensed.
(r) A code containing both the pharmacist's
and technician's initials must appear on the fill screen, patient profile, and
prescription label.
(s) No
prescription medication may be released to a patient until approved by a
pharmacist in person or via the computer, video, and audio link.
(t) The pharmacist shall offer to counsel the
patient or the patient's agent via video and/or audio link on all new
prescriptions.
(u) When the
technician is not present, dispensing and counseling via video and audio link
may be done using a secure alternate delivery system with prior approval of the
board.
(v) The license holder,
agent of the parent pharmacy, or the pharmacist-in-charge of the parent
pharmacy, or the pharmacist-in-charge of the remote site, if different from the
parent pharmacist-in-charge, shall apply for a license for the remote
telepharmacy site.
(w) As
dispensing is considered to be done by the pharmacist, the pharmacist shall be
responsible for and held accountable for dispensing at the remote telepharmacy
site.
(x) Policies and procedures
must be in place to ensure the safe and effective distribution of
pharmaceutical products and delivery of required pharmaceutical care.
(y) The pharmacist at the parent pharmacy
shall perform an ongoing analysis of incident reports and outcomes, with
appropriate corrective action taken when necessary, to ensure patient
safety.
(z) The pharmacist at the
parent pharmacy or that person's designee shall conduct and complete monthly
inspections of the remote telepharmacy site. Inspection criteria must be
included in the policies and procedures for the site. The inspection report
must be available for review at the next board inspection.
37-7-201,
MCA; IMP,
37-7-101,
37-7-201,
37-7-321,
MCA;