Peninsula Regional Medical Center

Through this article, James Trumble explores how automating Comprehensive Medication Management (CMM) can improve patient outcomes and reduce readmissions. He details initiatives to streamline CMM referrals, pre-discharge and outpatient, leveraging technology and collaboration to enhance medication management and patient care.

Healthcare is rapidly adopting technological advancements, yet concerns about patient safety and quality necessitate human oversight, often slowing adoption compared to other industries. Pharmacy, particularly in inpatient settings, frequently utilizes automation, but outpatient pharmacy lags. Medication discrepancies are a leading cause of readmissions, prompting our health system to increase outpatient pharmacy automation to address this issue.

We leverage a statewide program supporting primary care advancement to engage patients and improve chronic care management, focusing on Comprehensive Medication Management (CMM). CMM, a component of the Maryland Primary Care Program's Comprehensive Primary Care plan, is supported by Care Transformation Organizations offering interdisciplinary care management, including pharmacy services.

CMM expands upon traditional Medication Therapy Management (MTM) by reviewing medications, treatment plans, and safety and addressing Social Determinants of Health, financial barriers to adherence, provider follow-up on compliance, and beneficiary screening.

Our goal is seamless service delivery for patients and providers. While past EMR-based CMM referrals from providers and case managers provided a functional patient count, engaging inpatients and outpatients is crucial for impacting outcomes, especially readmissions. We collaborate with a local university to automate predischarge CMM referrals, ensuring patients have the medications for outpatient success.

We are also developing criteria, in partnership with program practices, to trigger outpatient referrals. CMM pharmacists will confirm these referrals with providers, creating a proactive notification system to increase CMM referrals and patient engagement. While isolating the impact of CMM from other factors affecting readmissions is challenging, pre/post analysis suggests an approximate 10 percent reduction. Through these efforts, we are striving to automate processes and improve patient outcomes.