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Updated: Jul 11, 2025
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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
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Telehealth Pharmacist Approach to Comprehensive Medication Management in Post-Discharge High-Risk Patients: A Quality
Tram Thai1, Melanie Plotke1, Greg Downing1,2
1Cureatr Clinic, New York, New York, USA.
Summary
Telehealth pharmacist-led Comprehensive Medication Management (CMM) significantly reduced hospital readmissions and emergency department (ED) visits for high-risk patients. This quality improvement initiative enhanced patient engagement and care coordination.
Area of Science:
- Health Services Research
- Clinical Pharmacy
- Quality Improvement
Background:
- Clinical Pharmacist-led Comprehensive Medication Management (CMM) shows promise for reducing medication errors during care transitions.
- Evidence for CMM's impact on hospital readmissions and Emergency Department (ED) utilization remains limited.
- Optimizing CMM services via telehealth is a novel approach to address these gaps.
Purpose of the Study:
- To evaluate the effect of an optimized telehealth CMM service on hospital readmission and ED utilization rates.
- To assess the impact of CMM on patient engagement, enrollment, and program volume.
- To identify process improvements for enhancing CMM delivery in a vulnerable patient population.
Main Methods:
- A quality improvement study involving adult patients discharged from an internal medicine unit at an urban hospital.
- Eligible high-risk patients were offered telehealth CMM visits at immediate, 30, and 60 days post-discharge compared to standard care.
- Primary outcomes included 30- and 90-day readmission and ED visit rates; secondary outcomes focused on patient engagement and enrollment.
Main Results:
- A 2.9% absolute reduction in 30-day readmissions was observed in the treated group compared to the untreated group (p=0.04).
- Thirty-day ED utilization decreased by 3.5% in the treated group versus the untreated group (p=0.03).
- Process improvements through Plan-Do-Study-Act cycles led to increased patient volume, enrollment rates, and engagement.
Conclusions:
- Optimized telehealth CMM services significantly reduced readmission and ED utilization rates in high-risk patients.
- The study demonstrated successful process improvements enhancing patient engagement and care coordination.
- Telehealth CMM presents a viable strategy for improving outcomes in vulnerable populations during care transitions.
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