Transitions of Care (TCM)

Transitions of Care (TCM)

Transitions of care (TOC/TCM) is defined as the movement of a patient from one health careprovider or setting to another and the corresponding provision of patient care services. The goal is for pharmacists to improve the quality of patient-centered care and reduce health care expenditures. Non–face-to-face services provided by our clinical pharmacists include: Reviewing discharge documents; Reviewing need and follow-up of lab, imaging, and test results; Establishing referrals; Scheduling follow-up appointments; Interacting with providers who will assume or reassume patient care; Arranging community resources needed; Educating patient, family, caregiver, or guardian; Assessing adherence and manage medications; Assisting with patient access to care and medications. The essence of TCM services is to reduce hospital readmission rates and reduce overall healthcare spending costs.

Potential TCM Partners:
-Hospitals
-ACOs
-Healthcare systems