CHAPTER 182
PRACTICE OF OPTOMETRISTS
[Prior to 8/7/02, see 645—179.4(154), 179.5(154,272C), 179.7(154) and 179.8(155A)]
645—182.1(154) Code of ethics. The board hereby adopts by reference the Code of Ethics of the American Optometric Association as published by the American Optometric Association, 243 North Lindbergh Boulevard, St.	Louis, Missouri 63141, revised 1944.
645—182.2(154,272C) Record keeping. Optometrists shall maintain patient records in a manner consistent with the protection of the welfare of the patient. Records shall be permanent, timely, accurate, legible, and easily understandable.
	182.2(1) Optometrists shall maintain optometry records for each patient. The records shall contain all of the following:
	a. 	Personal data.
	(1)	Name, date of birth, address and, if a minor, name of parent or guardian; and
	(2)	Name and telephone number of person to contact in case of emergency.
	b. 	Optometry and medical history. Optometry records shall include information from the patient or the patient’s parent or guardian regarding the patient’s optometric and medical history. The information shall include sufficient data to support the recommended treatment plan.
	c. 	Patient’s reason for visit. When a patient presents with a chief complaint, optometric records shall include the patient’s stated visual health care reasons for visiting the optometrist.
	d. 	Clinical examination progress notes. Optometric records shall include chronological dates and descriptions of the following:
	(1)	Clinical examination findings, tests conducted, and a summary of all pertinent diagnoses;
	(2)	Plan of intended treatment and treatment sequence;
	(3)	Services rendered and any treatment complications;
	(4)	All ancillary testing, if applicable;
	(5)	Vision tests completed and visual acuity;
	(6)	Name, quantity, and strength of all drugs dispensed, administered, or prescribed; and
	(7)	Name of optometrist who performs any treatment or service or who may have contact with a patient regarding the patient’s optometric health.
	e. 	Informed consent. Optometric records shall include documentation of informed consent for procedure(s) and treatment that have potential serious complications and known risks.
	182.2(2) Retention of records. An optometrist shall maintain a patient’s record(s) for a minimum of five years after the date of last examination, prescription, or treatment. Records for minors shall be maintained for, at minimum, one year after the patient reaches the age of majority (18) or five years after the date of last examination, prescription, or treatment, whichever is longer.
Proper safeguards shall be maintained to ensure the safety of records from destructive elements.
	182.2(3) Electronic record keeping. The requirements of this rule apply to electronic records as well as to records kept by any other means. When electronic records are kept, an optometrist shall keep either a duplicate hard-copy record or a back-up unalterable electronic record.
	182.2(4) Correction of records. Notations shall be legible, written in ink, and contain no erasures or white-outs. If incorrect information is placed in the record, it must be crossed out with a single nondeleting line and be initialed by an optometric health care worker.
	182.2(5) Confidentiality and transfer of records. Optometrists shall preserve the confidentiality of patient records in a manner consistent with the protection of the welfare of the patient. Upon request of the patient or the patient’s new optometrist, the optometrist shall furnish such optometry records or copies of the records as will be beneficial for the future treatment of that patient. The optometrist may include a summary of the record(s) with the record(s) or copy of the record(s). The optometrist may charge a nominal fee for duplication of records, but may not refuse to transfer records for nonpayment of any fees. The optometrist may ask for a written request for the record(s).
	182.2(6) Retirement or discontinuance of practice. A licensee, upon retirement, or upon discontinuation of the practice of optometry, or upon leaving a practice or moving from a community, shall notify all active patients in writing, or by publication once a week for three consecutive weeks in a newspaper of general circulation in the community, that the licensee intends to discontinue the practice of optometry in the community, and shall encourage patients to seek the services of another licensee. The licensee shall make reasonable arrangements with active patients for the transfer of patient records, or copies of those records, to the succeeding licensee. “Active patient” means a person whom the licensee has examined, treated, cared for, or otherwise consulted with during the two-year period prior to retirement, discontinuation of the practice of optometry, or leaving a practice or moving from a community.
	182.2(7) Nothing stated in these rules shall prohibit a licensee from conveying or transferring the licensee’s patient records to another licensed optometrist who is assuming a practice, provided that written notice is furnished to all patients.
645—182.3(154) Furnishing prescriptions. Each contact lens or ophthalmic spectacle lens/eyeglass prescription by a licensed optometrist must meet the requirements as listed below:
	182.3(1) A contact lens prescription shall contain the following information:
	a. 	Date of issuance;
	b. 	Name and address of patient for whom the contact lens or lenses are prescribed;
	c. 	Name, address, and signature of the practitioner;
	d. 	All parameters required to duplicate properly the original contact lens;
	e. 	A specific date of expiration, not to exceed 18 months, the quantity of lenses allowed and the number of refills allowed; and
	f. 	At the option of the prescribing practitioner, the prescription may contain fitting and material guidelines and specific instructions for use by the patient.
	182.3(2) Release of contact lens prescription.
	a. 	After the contact lenses have been adequately adapted and the patient released from initial follow-up care by the prescribing practitioner, the prescribing practitioner shall, upon request of the patient, provide a copy of the contact lens prescription, at no cost, for the duplication of the original contact lens.
	b. 	A practitioner choosing to issue an oral prescription shall furnish the same information required for the written prescription except for the written signature and address of the practitioner. An oral prescription may be released by an O.D. to any dispensing person who is a licensed professional with the O.D., M.D., D.O., or R.Ph. degree or a person under direct supervision of those licensed under Iowa Code chapter 148, 150, 150A, 154 or 155A.
	c. 	The issuing of an oral prescription must be followed by a written copy to be kept by the dispenser of the contact lenses until the date of expiration.
	182.3(3) An ophthalmic spectacle lens prescription shall contain the following information:
	a. 	Date of issuance;
	b. 	Name and address of the patient for whom the ophthalmic lens or lenses are prescribed;
	c. 	Name, address, and signature of the practitioner issuing the prescription;
	d. 	All parameters necessary to duplicate properly the ophthalmic lens prescription; and
	e. 	A specific date of expiration not to exceed two years.
	f. 	A dispenser of ophthalmic materials, in spectacle or eyeglass form, must keep a valid copy of the prescription on file for two years.
	182.3(4) Release of ophthalmic lens prescription.
	a. 	The ophthalmic lens prescription shall be furnished upon request at no additional charge to the patient.
	b. 	The prescription, at the option of the prescriber, may contain adapting and material guidelines and may also contain specific instructions for use by the patient.
	c. 	Spectacle lens prescriptions must be in written format, according to Iowa Code section 147.109(1).
645—182.4(155A) Prescription drug orders. Each prescription drug order furnished by a therapeutically certified optometrist in this state shall meet the following requirements:
	182.4(1) Written prescription drug orders shall contain:
	a. 	The date of issuance;
	b. 	The name and address of the patient for whom the drug is dispensed;
	c. 	The name, strength, and quantity of the drug, medicine, or device prescribed;
	d. 	The directions for use of the drug, medicine, or device prescribed;
	e. 	The name, address, and written signature of the practitioner issuing the prescription;
	f. 	The federal drug enforcement administration number, if required under Iowa Code chapter 124; and
	g. 	The title “Therapeutically Certified Optometrist” following the name of the practitioner issuing the prescription.
	182.4(2) The practitioner issuing oral prescription drug orders shall furnish the same information required for a written prescription, except for the written signature and address of the practitioner.
These rules are intended to implement Iowa Code chapters 154 and 155A.
[Filed 7/18/02, Notice 5/15/02—published 8/7/02, effective 9/11/02]