Iowa’s standard of care (SOC) regulatory framework modernizes pharmacy practice by shifting from prescriptive, task-based, bright-line rules to a professional standard grounded in competence and accountability. 

Under SOC, pharmacists may provide patient care services when those services are: 

• Within the pharmacist’s education, training, and experience 

• Supported by appropriate clinical judgment and documentation 

• Delivered in the patient’s best interest 

• Referred appropriately when patient needs exceed pharmacy-based care 

Rather than requiring a specific protocol or collaborative practice agreement for every service, SOC allows pharmacists to exercise professional judgment—similar to other healthcare providers—while remaining accountable to established clinical guidelines and standards of practice. 

This framework can help to expand access to care, particularly in rural and underserved areas, while maintaining patient safety and quality.

Pharmacies considering expanded patient care services under Iowa’s standard of care (SOC) framework may find it helpful to ask the following questions during planning and implementation: 

Clinical Readiness

• Are the services we want to offer clearly within our pharmacists’ education, training, and experience? 

• Do pharmacists on staff feel confident assessing patients and making independent clinical decisions for these conditions? 

• What red flags or exclusion criteria will trigger referral to another provider? 

• What additional training may be required to provide expanded services in accordance with your scope of practice? 

Workflow & Operations

• How will patients enter the service (walk-in, referral, self-identification at the counter)? 

• Where will assessments and documentation occur within the existing pharmacy workflow? 

• How will follow-up or continuity of care be handled, if needed? 

Documentation & Accountability

• Does our documentation clearly reflect clinical reasoning, decision-making, and patient counseling? 

• Are we prepared to explain why a service was appropriate under SOC—not just what was done?  

• How does your current pharmacy management software handle clinical documentation or e-prescribing? 

Patient Communication

• How will we explain the pharmacist’s role as a care provider to patients who may be unfamiliar with SOC? 

• Are staff aligned on how to describe these services consistently and confidently? 

Practice Growth

• Should we start with a narrow set of conditions and expand over time? 

• How will we evaluate success—patient outcomes, access, satisfaction, or sustainability? 

These questions can help pharmacies move from regulatory permission to practical, patient-centered implementation.