CEO Blog/11.07.16


Susan A. Cantrell, RPh, CAE



Pharmacy Profession Comes Together to Help Document and Improve Patient Outcomes Through Medication Therapy Management


People can accomplish remarkable things when they work toward a common goal. That’s what happened recently when a diverse group of pharmacy stakeholders gathered to develop standardized terms for medication therapy management (MTM) services.

What I’m referring to is the newly released framework for documenting MTM services using SNOMED CT (Systematized Nomenclature of Medicine: Clinical Terms) codes. These codes provide the standard clinical terminology needed for providers to exchange information electronically and report consistent quality measures. Read them here:

I’ll admit that developing MTM terms for SNOMED CT codes is deep in the weeds of health care policy and pharmacy practice. But I also know this development will provide real-world benefits: the codes will lead to improved patient outcomes, and allow pharmacists to demonstrate the value that MTM brings to the health care system.

How so? SNOMED CT codes give providers a standardized language for documenting their patients’ findings, interventions and other clinical information. This information can then be passed along to other providers via an electronic health record (EHR), a process that is becoming increasingly common as more and more patients visit multiple providers for their care.

SNOMED CT codes give these providers a more complete and consistent picture of a patient’s clinical history, which in turn may contribute to better outcomes.

So important are they, in fact, the Office of the National Coordinator for Health Information Technology (ONC) has designated SNOMED CT codes as the official HIT standard for clinical communication. Participants in the Center for Medicare and Medicaid Innovation (CMMI) Part D Enhanced MTM Model, which begins January 2017, must use SNOMED CT codes to document and report clinical information.

So what’s in it for pharmacy? The SNOMED CT codes contain MTM “value sets,” which are subsets of codes used in EHRs and other software systems. These will allow providers and other health care stakeholders to compare MTM services and outcomes across various provider types, health care settings and patient populations. Because the value sets were developed by the entire pharmacy profession, along with input from other key stakeholders, we are in a position to ensure best practices are applied to MTM services in many settings, and that we drive continuous improvements in practice.

Getting to this point has been a highly collaborative and multipronged effort. Stakeholders developed the standardized framework through live meetings, workgroups, and an open public comment period. Groups that provided feedback and recommendations include pharmacy professional organizations, Medicare Part D sponsors, pharmacist clinicians, MTM vendors, technology vendors, EHR vendors, integrated delivery networks, government agencies and academia.

I have witnessed this type of high-level collaboration between such diverse stakeholders only a few times during my many years in the nonprofit pharmacy and pharmaceutical arenas. We have set the stage for even greater cooperation ahead, and we’re certainly not going to rest on our laurels. This is a continuing effort. The standardized framework will be reviewed and updated by organizations representing the pharmacy profession as evidence from the Enhanced MTM Model becomes available, as innovation in the delivery and documentation of MTM services continue, and as the practice of pharmacy continues to evolve.

So kudos to the following organizations that lent their support to the Standardized Framework for Cross-Walking MTM Services to SNOMED CT Codes. Together we have crossed an important starting line for documenting MTM services using SNOMED CT codes:

Academy of Managed Care Pharmacy (AMCP), Accreditation Council for Pharmacy Education (ACPE), ActualMeds Corporation, American Association of Colleges of Pharmacy (AACP), American Pharmacists Association (APhA), American Society of Consultant Pharmacists (ASCP), ASHP (American Society of Health-System Pharmacists), College of Psychiatric & Neurologic Pharmacists (CPNP), Fairview Pharmacy Services, Health Mart Systems, Inc., Hematology/Oncology Pharmacy Association (HOPA), Humana, Kaiser Permanente, Medication Management Systems, Inc., Mirixa Corporation, National Alliance of State Pharmacy Associations (NASPA), National Community Pharmacists Association (NCPA), OutcomesMTM, Pharmacy Health Information Technology Collaborative (PHIT Collaborative), Pharmacy Quality Alliance (PQA), PrescribeWellness, SinfoniaRx, The Ohio State University Medication Management Program, University of Arizona Medication Management Center, University of Florida Medication Management Center, and WellCare Health Plans, Inc.