1. (a) The purpose of this section is to provide standards for remote or off-site order entry in hospital pharmacies within the State of Arkansas.
2. (b) The Arkansas State Board of Pharmacy may approve a request for off-site order entry where the hospital pharmacy can demonstrate that the procedure will result in an improvement in patient care by increasing the amount of time of pharmacist involvement in the process of medication review for safety and efficacy prior to the administration of the medication to the patient.

3. (c)

   1. (1) The pharmacist-in-charge of the hospital pharmacy shall submit a written request for off-site order entry a minimum of thirty (30) days prior to the board meeting at which the pharmacist seeks board approval.

   2. (2) The request shall be accompanied by policies and procedures for off-site order entry to include:

      1. (A) Only a pharmacist holding a current license in good standing shall enter orders at a remote or off-site entry location;
      2. (B) The pharmacist-in-charge at the hospital shall ascertain and maintain on-site documentation that all pharmacists that participate in the order entry process are:

4. (i) Licensed with the board; and

   1. (ii) Competent to enter faxed or scanned orders for patients in that facility, including but not limited to the ability to accurately:
5. (a) (a) Receive, interpret, and accurately enter medication orders from any physician on staff at that facility;

6. (b) (b) Access and interpret clinical data as it pertains to that patient’s drug regimen;

   1. (c) (c) Perform therapeutic interventions;

      1. (d) (d) Perform cross checks for known:
   2. (1) (1) Drug allergies;
   3. (2) (2) Adverse drug reactions; and
   4. (3) (3) Contraindications;
7. (e) (e) Perform drug-drug interaction as well as drug-food interaction review;
8. (f) (f) Identify any overutilization or underutilization; and

9. (g)

   1. (1) (g)(1) Be available via telephone for any questions or issues from nursing staff as well as from staff physicians.

   2. (2) (2) This number shall be posted in a visible place:

      1. (A) (A) At each nursing station;
      2. (B) (B) In all dictation rooms; and

      3. (C) (C) In all other areas within the facility that a:

         1. (i) (i) Physician might write orders; or
         2. (ii) (ii) Nurse might fax or scan orders;

      4. (C)

         1. (i) A clearly defined backup system in the event of:
10. (a) (a) Connection or communication failure; and/or

11. (b) (b) The need for on-site pharmacist is deemed necessary.

    1. (ii) The above competencies shall be in written policy and procedure and shall include training, testing, and ongoing assessment of skills;

       1. (D) Documentation that any remote or off-site order entry facility shall:

          1. (i) Have compatible systems utilized at both the hospital as well as the facility itself; and
          2. (ii) Include:
12. (a) (a) Software;

13. (b) (b) Hardware; and

    1. (c) (c) Connectivity; and

       1. (E) Documentation that the remote or off-site order procedures and other requirements of this part have been approved by medical staff and/or P&T Committee at that hospital as reflected in the minutes or comparable record.

          1. (d) In the operation of the off-site order entry, patient confidentiality and full compliance with HIPAA requirements shall be observed at all times.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: “(6/23/05)" "HIPAA" means the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104–191.