mSMART helps Primary Care Practices to meet PCMH Plan and Manage Care goals. Specifically, it helps PCPs to achieve: (4A.1) consider behavioral conditions to identify care management, (4B.1) develop a (medication management) plan that includes patient’s preferences and goals, (4B.3) assess and address patient’s barriers in meeting treatment goals (e.g., glycemic targets for diabetes), (4C.4) assess patients understanding of medication, and (4C.5) assess patient response to adherence barriers.
mSMART itself is a self-management tool (PCMH 4E.3) that provides individualized educational material including care plan (PCMH 4E.2), it is also a shared-decision making (SDM) aid (PCMH 4E.4). Provider is informed of only the significant barriers to patient's treatment adherence. mSMART helps providers to build a relationship by targeting education and consultation on patient's most difficult issues. Care team engages with patients productively during short and quick visits, yet improves their experience.
COST EFFECTIVE CARE PLAN DELIVERY
mSMART provides ability for the care team to track and monitor treatment goals (e.g., glycemic targets), reliable medication adherence data, therapeutic issues and symptom management outcomes. With mSMART portal, care team can create a care plan and make changes to existing care plan, that is delivered directly to the chronic patients' or their caregivers' app. mSMART offers innovative delivery of targeted care plans that are easy to navigate and motivating to engage – a cost effective means to provide value-based care.
mSMART for PCMH Primary Care
Please contact us at firstname.lastname@example.org for the details on how we offer mSMART for you to provide efficient PCMH care model to your patients.