The Basics

This standard sets forth a set of requirements for the services that the DTM program offers:

• the services must be developed with oversight of the P&T committee (or equivalent committee);
• the services must be provided consistent with the coverage policies of affected payers;
• the services should include specifications for the target population;
• the services should include, at the least, an initial assessment of drugs to determine whether they are appropriate or inappropriate;
• the DTM program should include education about drug side effects, interactions, and other safety precautions;
• the services should coordinate the development of the care and service plans;
• the DTM program should monitor and promote medication adherence;
• the program should strive to minimize the incidence of adverse events;
• the program should optimize outcomes by promoting continuity of care;
• the program should promote appropriate referrals to other health care providers;
• services should include accommodation of differences in languages among consumers.

Your organization no doubt has a program description and/or a set of policies and procedures that govern all of these issues.  Make sure you're familiar with these documents.

Management Tips

As is true for many of the standards in this module, the DTM program description can easily carry most of the documentary burden for this standard.  What is essential is that as you review and/or develop this program description, you make sure that every single component of this standard is clearly addressed in the document.  Make sure that the program description doesn't merely recite these requirements, but also describes who in the organization is responsible for implementing each component.

In addition, it will be important to make sure that the program description is consistent with the policies and procedures for the P& committee to the extent those procedures are implicated by this standard.

Finally, it will be important that you make sure that you document implementation of each of these elements through reports, committee meeting minutes, training, etc.

URAC Accreditation Tips

The elements of this standard are, for the most part, mandatory, with a couple of more lightly weighted elements thrown in.

For the desktop review, the only documentation you should need is the program description, the relevant policies and procedures, and particularly the relevant P&T committee policies and procedures.

The on-site review well focus on an interview with senior clinical staff and an examination of PMT committee meeting minutes to ensure implementation of the organization's program description and policies and procedures.