When you decide to incorporate medication therapy management (MTM) services into your practice, creation of a plan is essential.  MTM required a shift in focus from the role of provide and educator of appropriate and safe medication use for individual prescriptions to a role that includes evaluation of the patients’ entire medication regimen and collaboration with the patient’s health care team.  Incorporating MTM into your practice also calls for a shift in the roles of everyone working with the pharmacy as well as change sin billing and compensation methods for the service and in the way the service is marketed.  The following list can help you create a “game plan” for you MTM practice.

1. Devise a vision and mission statement for your service.  Before you initiate your MTM service, establish your vision for the service and determine how that vision relates to your current practice.  Consider the scope of your practice.  Will your MTM service be based out of your pharmacy or will you be available for outside consultations?  Will you include disease-based or public health services and/or focus on patients from a particular payer source?  At what rate do you expect your service to grow?  As you clarify your vision for the MTM service, write a mission statement.  A number of MTM resources, general references, and a summary of electronic documentation tolls are available from APhA at 222.pharmacist.com/mtm.
2. Create a timeline to accomplish your goals.  Establishing  set of goals with associated time frames will guide you as you move forward in developing your MTM service.  Be realistic and willing to revise your goals and timeline as you encounter successes and challenges.
3. Develop your business plan.  Compensation for servidce3s is essential to sustaining an MTM service, so design a reasonable business plan that is integrated with your goals and timeline.  Consider what payment sources are already available nationally and in your area and those that you can seek out in your own community.  The Pharmacist services Technical Advisory Coalition (www.pstac.org) provides up-to-date information on pharmacists-specific bhilling and coding, you can find a number for Medicare resources and contact information for Medicare prescription drug programs from APhA at www.aphanet.org/ga.
4. Engage the pharmacy and staff.  Your MTM practice will have a greater opportunity for success with the team effort of the entire pharmacy and support staff.  Consider how you can engage the staff in planning, workflow adjustment, patient referral, and outreach.
5. Identify necessary workflow adjustments.  Wile most MTM service occur outside of the pharmacy dispensing workflow, dispensing of prescriptions provide an important opportunity to identify patients in need of MTM services.  Deanna Willis, MD, MBA, offers suggestions for mapping and timing workflow to identify problem areas and create solutions to better serve patient needs in her article "Making every minute count:  Tolls to improve office efficiency" (www.aafp.org/fpm/20050-400/61maki.html).
6. Design and test your marketing message and strategy.  Patients physicians and the community will all need to know what your MTM service is, how it is different or the same as your current services, what it's benefits are, and how to participate. 
7. Foster relationships with physicians, community groups, and patients.  Build on already-established relationships and create new ones.
8. Gather patient care documentation tools.  Documenting your MTM services is an essential component for ht actual service and for billing.
9. Collect patient education materials and resources.  Patient-friendly materials are available from a  variety of sources, including all of the national pharmacy associates, disease-focused associates (e.g. the American Diabetes Association, www.diabetes.org), and many community-health-based organizations (e.g. the National Association of  Area Agencies on Aging.www.n4a.org).
10. Including continuous quality improvement measures.  Each patient encounter, billing process, and following-up visit provides an opportunity to learn about an improve your MTM service.  Quality measures, checkpoints, and mechanisms to adapt and improve your practice will be essential for you and the patients you serve.

Your interest in establishing an MTM practice shows your commitment to providing quality care for your patients.  Now it's time to develop your game plan.