As the Biden administration settles in, healthcare organizations are focusing on the policies it will enact in a number of key areas. While retooling healthcare policy, it’s imperative that the administration address the need for national medication management reform. A crucial opportunity is at hand to embolden healthcare strategy by ensuring patients understand their medications and are able to work with a clinical pharmacist and physician to verify that the medicines prescribed are right for them.
With over 10,000 drugs on the market, appropriate, effective, safe and precise use of medication and gene therapies is more important now than ever before. The move toward medication management reform requires comprehensive and validated clinical data securely integrated into health IT systems at the point of care. This data must be actionable, and it must be available to the entire care team, including the clinical pharmacist. Without the right health IT to support it, a transition to comprehensive medication management (CMM) will be severely hindered.
How Data Drives Comprehensive Medication Management
CMM is a team-based care solution that involves the patient working with a physician and other health providers, including a clinical pharmacist. This interprofessional team relies on the skills and expertise of each member to achieve optimized medication use. The team’s efforts are rooted in a robust, data-driven record of the patient’s health and medical history in combination with clinical and diagnostic findings. Many of today’s health IT systems don’t allow access to the necessary clinical data to comprehensively manage, monitor and evaluate a patient’s medication regimen. To move toward CMM, the healthcare industry must adopt, implement and enforce data sharing requirements in both the public and private sectors.
When technology-enabled clinical information (such as lab and diagnostic data that include pharmacogenetic test results, clinical notes and patient status) is available to the entire team at the point of care, health providers can fulfill important activities in the CMM process. This data helps teams identify patients who have not achieved the clinical goals of therapy — or who are experiencing medication therapy problems — and evaluate actual use patterns of all medications (including over-the-counter medicines, supplements, prescribed drugs and biologics). With complete clinical data access, patient care teams can assess each medication for safe, effective and appropriate use.
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Comprehensive Medication Management Improves Clinical Outcomes
With an overtaxed health system fighting COVID-19 nationwide, physician appointments, emergency room availability and hospital beds are in short supply. Data shows that improper medication therapy — misuse, underuse and overuse — can result in treatment failure, new medical problems or both. Annually, 275,000 avoidable deaths and health costs of approximately $528.4 billion are the result of nonoptimized medication use. Studies reveal that CMM reduces the drain on the healthcare system by improving clinical outcomes and reducing hospital readmission rates.
With CMM, health IT enables a process of care designed to identify, manage and resolve medication therapy problems for patients systematically as they move across the continuum of care. Participation in CMM services — designed to optimize medication use through identification and resolution of medication therapy problems — can be correlated with broader changes in health status or healthcare utilization patterns, thus demonstrating contribution and value to the nationwide healthcare system.
The estimated annual cost of prescription drug–related morbidity and mortality resulting from nonoptimized medication therapy
Source: Annals of Pharmacotherapy, "Cost of Prescription Drug–Related Morbidity and Mortality," March 2018
Coming Together to Achieve Medication Management Reform
Achieving medication management reform requires alliances among providers, payers, patients and policymakers. Our organization, the GTMRx Institute, developed a course of action titled “The GTMRx Blueprint for Change,” based on five principles:
- A personalized, patient-centered, systematic and coordinated approach to medication use will vastly improve outcomes and reduce overall healthcare costs.
- Aligning systems of care to integrate comprehensive medication management and engaging patients to ensure they are willing and able to take indicated, effective and safe medications will optimize outcomes.
- Immediate delivery system, payment and policy transformation will streamline clinical trials and reduce costs of bringing drugs to market while enabling successful, broad-scale adoption of integrated CMM services.
- Access to advanced diagnostics with complementary and pharmacogenetic testing is essential to target correct therapy.
- Team-based, patient-centered care models that recognize appropriately skilled clinical pharmacists as medication experts who work in collaborative practice with physicians and other providers are required for success.
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We propose that the Biden administration adopt this roadmap to effect significant policy change focused on team-based healthcare to get medications right. Our nation is suffering from multiple crises: a pandemic, opioid addiction and the fact more than a quarter of American adults live with multiple chronic health conditions. Now is the ideal time for multidisciplinary collaboration and reform centered on personalized medication management that optimizes care.