However, as previously noted, these innovations are largely unproven, so the focus should remain on the effectiveness and evidence, rather than the form of these tools. In addition, these programs will require a clear and effective way for care teams to receive, analyze, and act on the information. Low-tech approaches, such as daily weights and algo- rithms for management of HF, may be suf cient for some patients to assist in self-management. In all cases, un- derstanding who receives and acts upon the data is as important as having established programs for monitoring patient-generated data. Patient and caregiver educational tools also support team-based HF care. Recent advances in optimizing health literacy and empowering patient engagement and self-management in HF care are TABLE 7 Essential Skills for an HF Team n HF diagnosis and monitoring for progression n Treatment prescription, titration, and monitoring n Patient and caregiver education on disease and treatments n Lifestyle prescription (e.g., diet, exercise), education, and monitoring n Psychological and social support assessment, treatment, and monitoring n Palliative and end-of-life counseling and care n Coordination of care for concomitant comorbidities HF heart failure. J Maddox et al. promising in this respect (97,98). Ongoing monitoring of team-based care implementation, outcomes, and safety through periodic data collection, analysis, benchmarking, and as needed process improvements are an essential aspect of optimal team-based HF care. 5.5. How to Improve Adherence 5.5.1. Medication Nonadherence Patient adherence is fundamental to the therapeutic effectiveness of GDMT. Medication adherence is de ned as the extent to which medications are taken as pre- scribed, such that nonadherence is not dichotomous, but rather a spectrum of types and degrees of discordance with medication prescription (99). 