Section R4-23-621. Shared Services

A.      Before participating in shared services, a pharmacy shall have either a current resident or non-resident pharmacy permit issued by the Board.

B.       A pharmacy may provide or utilize shared services functions only if the pharmacies involved:

1.        Have the same owner, or

2.        Have a written contract or agreement that outlines the ser- vices provided and the shared responsibilities of each party in complying with federal and state pharmacy stat- utes and rules, and

3.        Share a common electronic file or technology that allows access to information necessary or required to perform shared services in conformance with the pharmacy act and the Board’s rules.

C.      Notifications to patients.

1.        Before using shared services provided by another phar- macy, a pharmacy permittee shall:

a.         Notify patients that their orders may be processed or filled by another pharmacy; and

b.        Provide the name of that pharmacy or, if the phar- macy is part of a network of pharmacies under com- mon ownership and any of the network pharmacies may process or fill the order, notify the patient of

this fact. The notification may be provided through a one-time written notice to the patient or through use of a sign in the pharmacy.

2.        If an order is delivered directly to the patient by a filling pharmacy and not returned to the requesting pharmacy, the filling pharmacy permittee shall ensure that the fol- lowing is placed on the prescription container or on a sep- arate sheet delivered with the prescription container:

a.         The local, and if applicable, the toll-free telephone number of the pharmacy utilizing shared services that has access to the patient’s records; and

b.        A statement that conveys to the patient or patient’s care-giver the following information: “Written infor- mation about this prescription has been provided for you. Please read this information before you take the medication. If you have questions concerning this prescription, a pharmacist is available during normal business hours to answer these questions at (insert the local and toll-free telephone numbers of the pharmacy utilizing shared services that has access to the patient’s records).”

3.        The provisions of subsection (C) do not apply to orders delivered to patients in facilities where a licensed health care professional is responsible for administering the pre- scription medication to the patient.

D.      A pharmacy permittee engaged in shared services shall:

1.        Maintain manual or electronic records that identify, indi- vidually for each order processed, the name, initials, or identification code of each pharmacist, graduate intern, pharmacy intern, pharmacy technician, and pharmacy technician trainee who took part in the order interpreta- tion, order entry verification, drug utilization  review, drug compatibility and drug allergy review, final order verification, therapeutic intervention, or refill authoriza- tion functions performed at that pharmacy;

2.        Maintain manual or electronic records that identify, indi- vidually for each order filled or dispensed, the name, ini- tials, or identification code of each pharmacist, graduate intern, pharmacy intern, pharmacy technician, and phar- macy technician trainee who took part in the filling, dis- pensing, and counseling functions performed at that pharmacy;

3.        Report to the Board as soon as practical the results of any disciplinary action taken by another state’s pharmacy reg- ulatory agency involving shared services;

4.        Maintain a mechanism for tracking the order during each step of the processing and filling procedures performed at the pharmacy;

5.        Provide for adequate security to protect the confidential- ity and integrity of patient information; and

6.        Provide for inspection of any required record or informa- tion within 72 hours of any request by the Board or its designee.

E.       Each pharmacy permittee that provides or utilizes shared ser- vices shall develop, implement, review, revise, and comply with joint policies and procedures for shared services in the manner described in R4-23-610(A)(2). Each pharmacy permit- tee is required to maintain only those portions of the joint poli- cies and procedures that relate to that pharmacy's operations. The policies and procedures shall:

1.        Outline the responsibilities of each of the pharmacies;

2.        Include a list of the name, address, telephone numbers, and all license and permit numbers of the pharmacies involved in shared services; and

3.        Include policies and procedures for:

a.         Notifying patients that their orders may be processed or filled by another pharmacy and providing the name of that pharmacy;

b.        Protecting the confidentiality and integrity of patient information;

c.         Dispensing orders when the filled order is not received or the patient comes in before the order is received;

d.        Maintaining required manual or electronic records to identify the name, initials, or identification code and specific activity or activities of each pharmacist, graduate intern, pharmacy intern, pharmacy techni- cian, or pharmacy technician trainee who performed any shared services;

e.         Complying with federal and state laws; and

f.         Operating a continuous quality improvement pro- gram for shared services, designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, pursue opportu- nities to improve patient care, and resolve identified problems.

F.       Nothing in this Section shall prohibit an individual pharmacist licensed in Arizona, who is an employee of or under contract with a pharmacy, or an Arizona-licensed graduate intern, phar- macy intern, pharmacy technician, or pharmacy technician trainee, working under the supervision of the pharmacist, from accessing that pharmacy’s electronic database from inside or outside the pharmacy and performing the order processing functions permitted by the pharmacy act, if both of the follow- ing conditions are met:

1.        The pharmacy establishes controls to protect the confi- dentiality and integrity of patient information; and

2.        None  of  the   database  is  duplicated,  downloaded,  or removed from the pharmacy’s electronic database.

Historical Note

New Section made by final rulemaking at 13 A.A.R. 520, effective April 7, 2007 (Supp. 07-1). Amended by final

rulemaking at 19 A.A.R. 97, effective March 10, 2013

(Supp. 13-1).