Wash. Admin. Code § 246-875-030

Minimum Required Information in an Pharmacy Automated Patient Medication Record System

An automated patient medication record system is an electronic system that must have the capability of capturing any data removed on a hard copy.  Such a record system must maintain the following information with regard to ambulatory patients:

• The patient’s full name and address
• A serial number assigned to each new prescription
• The date of each dispensed drug
• The identification of the dispenser who filled the prescription
• Name, strength, dosage form and quantity of the drug dispensed
• Any refill instructions by the prescriber
• The prescriber’s name, address and DEA number
• Complete directions for use of the drug
• Any patient allergies or chronic conditions which may relate to drug utilization

With regard to institutional patients, automated systems must maintain the following information:

• Patient’s full name, location and unique identifier
• All patient allergies or chronic conditions which relate to drug utilization
• Prescriber’s name, address and DEA number
• Drug name, dose, route, form, directions for use, prescriber
• Start and stop date and times
• Amount dispensed when appropriate
• Any special medication statuses for individual prescriptions

Related Laws: Wash. Admin. Code § 246-875-030