opportunity to investigate medication therapy management. The committee recommends that CMS carry out studies on the use of medication therapy management addressing the following issues:

  • The specific services that should be provided as part of medication therapy management

  • The target populations that would benefit most from these services

  • The types of health care personnel that would provide the lowest-cost, highest-value outcomes through these services

  • Whether and how medication therapy management should be reimbursed

  • How potential savings might be shared between insurers and providers

MINIMUM FUNCTIONALITY STANDARDS FOR INFORMATION TECHNOLOGY

Recent IOM reports have strongly recommended greater use of information technology in the delivery of health care (IOM, 2000, 2001, 2004). A national health information infrastructure—a foundation of systems, technologies, applications, standards, and policies—is required (IOM, 2004). The IOM’s report on patient safety (IOM, 2004) called upon the federal government to facilitate the deployment of this infrastructure through the provision of targeted financial support and the ongoing promulgation and maintenance of standards for data needed to improve patient safety. That report also called on health care providers to invest in EHR systems that would enable the provision of safe and effective care and the continuous redesign of care processes to improve patient safety (IOM, 2004).

Less than 1 year after the IOM report To Err Is Human: Building a Safer Health System (IOM, 2000) was released, the California legislature enacted Senate Bill 1875, requiring all California hospitals to submit a plan to the Department of Health that would substantially eliminate medication-related errors (SB 1875, 2000). A 2003 analysis of 344 hospital plans revealed that California hospitals were planning on average to implement 2.8 error-reducing technology applications by 2005 (Spurlock et al., 2003). The most frequently cited technology was CPOE (46 percent of hospitals), followed by pharmacy information systems (44 percent), automated dispensing units (38 percent), and electronic medication administration records (31 percent).

In September 2005, an expert panel published estimates of the likely investment by health care providers in EHRs and CPOE systems, based on current trends. The experts projected that in 5 years, 25–38 percent of office practices, 29–41 percent of hospitals, 14 percent of skilled nursing



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