The Basics

This standard requires that your organization document the process by which it developed the DTM program, and by which it annually reviews that program with the assistance of licensed, practicing pharmacists and physicians.  The pharmacists and physicians serve as subject matter experts in both the development and review of the program.

Often, this program development and evaluation occurs within the context of the PT committee.  However, it is permissible to have outside licensed consultants participate outside the context of the committee.  In either event, it is important that the physicians and pharmacists be an active practice and treating consumers with conditions specific to the DTM program.

Management Tips

It will be important, again, to make sure your documentation on both the policy and implementation sides are strong.  First, your program description and/or policies and procedures should describe both the development and annual review processes.  Second, it will be essential that the physicians and pharmacists that you have used in these processes, indeed, are in the active practice of serving the kinds of consumers that are in your program.  Make sure you have documentation in the form of resumes of your subject matter experts.  It also will be important that you have very clear documentation of the processes by which your organization verifies the licenses of the pharmacists and physicians involved in the development and review of the program.

URAC Accreditation Tips

This is a mandatory standard.  

The desktop review submission is the combination of the DTM program description and/or policies and procedures along with the resumes for the pharmacists and physicians involved in the development and review of the program.

During the on-site review, the reviewer will ask to talk to one of the subject matter experts (perhaps by telephone), and also will talk to the senior clinical staff person about development and review process.  In addition, the reviewer will examine rather closely the documentation showing that your organization has verified the licenses of the pharmacists and physicians involved in program development and review.