Board committee to seek public feedback on 'duty to consult' and software/workflow barriers
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Summary
Committee members supported holding public listening sessions to gather patient and provider perspectives on Title 16 CCR §1707.2 (duty to consult), including software issues that force repeated consults, unclear enforcement practices, and access barriers for mail-order and non-English speakers.
The Enforcement & Compounding Committee agreed on Jan. 7 to pursue public listening sessions to gather data on the board’s duty-to-consult regulation (Title 16, CCR §1707.2), aiming to understand barriers to meaningful pharmacist-patient consultation.
Chair Maria Serpa said the sessions would seek public feedback on how to improve patient understanding, reduce medication errors and identify barriers to pharmacist-provided consultation. "The purpose of the listening session is to gather feedback from the public in an open forum to assure that the diverse perspectives on consultation are considered," Serpa said.
Licensee member Nicole Thiebaud told the committee that pharmacy software often treats reissued prescriptions as "new" and "most software can't designate that, and so it flags for a consult," which can degrade trust when patients are repeatedly flagged without clinical change. She recommended adding a listening-session question to probe whether software vendors can mark reissued-but-unchanged prescriptions to avoid unnecessary consults.
Members debated trade-offs between making consultations routine for safety and avoiding burdensome, repeated consults that could distract pharmacists. Seung Oh (President) described how drug-utilization-review systems constantly ping clinicians and said that pharmacists often must triage alerts and consult prescribers when interactions appear significant. Public commenters reinforced both views: Andre Peters urged considering the regulation in the context of an emerging statutory "standard of care," while John Gray asked the board to remove "gotcha" enforcement ambiguity—citing inconsistent inspector expectations about physical proximity to a consultation window for a valid declination.
The committee discussed whether to take a formal motion authorizing sessions or to allow staff to schedule them; legal counsel advised the committee that staff can proceed without a formal motion but that the committee could also bring draft questions to the full board for review. Members agreed to report the committee’s discussion to the full board and to have staff proceed with planning listening sessions while refining questions to capture software, mail-order, language-access and reimbursement issues.
Public commenters included registered pharmacists and pharmacy technicians who asked the board to consider standard-of-care framing, consistent enforcement guidance, and software features that route prescriptions to pharmacists for review.
Next steps called for staff to draft final listening-session questions (including a question on software designation of reissued prescriptions), schedule sessions, and report plans and sample questions to the full board for additional input.
