The Basics

This standard lists the essential service components of a DTM program:

• services must be specific to the consumer and matched to his/her needs
• consumers must have access to care delivery methods -- this means that communications to consumers about appropriate services must be such that the consumer can understand and obtain the information (e.g., by telephone, in-person, mail)
• scientifically-based practices
• a mechanism to document each consumer's drug therapy management in a central record
• communications mechanisms that get both the prescriber and other healthcare providers involved in the care management
• interventions and other approaches to maximize the effectiveness of medications
• a mechanism for consumer self-management that involves the provision of accurate information and evaluation of the consumer's ability to self-Minister medication.

If the consumer is in no condition to process health-related information or self-administer medication under the DTM program, the information may be provided to other caregivers.

Management Tips

Again, the drug therapy management program description is an excellent document to address all of these issues.  The program description should include a detailed description of procedures to identify eligible patients, criteria for inclusion in each program, and a clear methodology for documenting the implementation of each element of the program.

URAC Accreditation Tips

Most of the elements of the standard are mandatory.

For the desktop review, all you will need to submit is your DTM program description, so long as it includes all of the above elements.  In addition, a sample of any data runs that illustrate the implementation of your patient identification process will help.

During the on-site review, the reviewer will examine consumer files for evidence of implementation of your policies and procedures.  In addition, he/she will interview staff members regarding the process of identifying candidates for inclusion in the program.