mHealth

A colleague asked me if I had any information on the use of Medication Therapy Management (MTM) as a way to reduce healthcare cost and prevent, or decrease, readmissions.

I’m kind of a digital packrat and I knew that I had some stuff sitting in Evernote, so I spent the better part of a day rummaging through the information I had. The deeper I dug the more I realized that MTM is a no-brainer. There’s enough information out there to convince even the staunchest opposition.

Some thoughts I had as I read through my Evernote notes:

1. I find it interesting that we’ve coined the phrase Medication Therapy Management (MTM) for something that pharmacists have been doing for decades. I remember interning for a community pharmacy back in the late 90’s. Speaking to the patient about their medication, adherence, compliance, adverse effects, etc was simply part of the job. Have we forgotten about that?
2. MTM comes in many forms. Positive intervention can be achieved over the phone, via Telepharmacy, face-to-face with a pharmacist or technician, and so on. It is not a one size fits all approach.
3. Even the simplest interaction between provider and patient can create a positive impact.
4. MTM should start when a patient is admitted for any condition, continue throughout their hospital stay, and follow the patient out the door to their homes. In other words it should be continuous.
5. Not everyone will need pharmacist intervention once they leave the hospital. Healthcare systems should first target patients with chronic conditions, problems with cognition, poor history of compliance, or a heavy medication burdens. Like everything else in the world around us, some people will do better with more help while others will prefer less.
6. mHealth and sensors should be part of MTM. Continuous glucose monitoring, heart monitors, blood pressure sensors, smart bottles, devices to monitor and record inhaler use – classic area for pharmacist intervention, wireless digital scales for weight – think heart failure, and so on . This information should be fed directly into the patients MTM record for review by the pharmacist, physician and nurse.

Below is a summary of the MTM information I sent my colleague.

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