Medscope Developing an HMR System for Your GP

Medscope: Developing an HMR System for Your GP Practices Dr Peter Tenni M Pharm (Curtin), Ph. D (UTAS), AACPA Manager, Clinical Division Medscope Presentation downloadable from www. medscope. com. au/businessdev 1

Medscope Medication Review Business Management u Medscope Goal: Complete DMMR business system u u Innovative expert system issue identification u u Manage your whole medication review business Journal of Clinical Pharmacy and Therapeutics, 2012, 378– 385 Review Management (Report writing, claims etc) Business development – assisting MMR service providers build successful businesses. Reports/Statistics to analyse u u Staff (sub-accounts) Business performance Health outcomes (QUM) Your MRM account is the “value” of your business u u Number of HMRAlert links with practices Number of referrals – follow-up are future revenue 2

Dr Peter Tenni u u M Pharm (Curtin) Ph. D (UTAS) AACPA Research into Medication Reviews and Clinical Interventions Member of the AACP National Advisory Group Clinical manager at Medscope. Practicing accredited pharmacists and MRM user u u CPS does ~ 4000 RMMRs /yr and ~ 1000 HMRs /yr The techniques discussed are those that have been successfully used by CPS. 3

This Webinar: Developing an HMR System for Your GP Practices u u We will be outlining Medscope’s HMR Alert which is one of the key strategies that will be discussed We will refer to various MRM statistical reports, but will not cover how MRM works – u u u we are continually holding training webinars on MRM. Email us and we will let you know when the next training session is on. Due to the large numbers we will take questions at the end. You can type questions as we go and we will answer at the end. We will record the webinar and have an edited version posted on-line 4

This Presentation- A Medical Practice Focus u Business Setup and Development u u GP Practices- How they operate u u u Business Structures Chronic Disease Management Item Numbers Setting up an HMR system in a practice u u Setting your goals and targets Understanding your client’s (GPs) HMR needs u What problems do you need to solve Be careful what you ask for (capacity) Health Assessments, HMR Alert, Pharmacy Initiated Referrals **Relationship Management u u u Followup of systems Monitoring of outcomes, performance, targets Become part of the clinic’s health management team. 5

Setting up and Developing a Medication Review Business u What is your aim? u Increase HMRs as a part of Pharmacy activity u u Single pharmacist part time Single pharmacist full time Multiple pharmacists u u Partnership, employer relationship Work out your targets u u In house accredited pharmacist, outsourced AP Structure, capacity, income, margins, staffing Develop Relationships with the Practice(s) u How many? - depends on your targets 6

Factors to Consider Medical Clinic s) • • Size/ Structure Relationship • Your Business • • • Local Pharmacy Existing relationships • Efficiency Capacity Structure Other Accredited Pharmacists Relationships 7

Developing Relationships With Medical Practices u How does a clinic operate? u Goals/Focus u u Ownership Structure u u Corporate, Partners Business Structure u u Clinical/business Profit Share, Medicare Chronic Disease Management u u Practice Nurses Health Assessments, Team Care Arrangements, GP Management Plans 8

Chronic Disease Management u Item numbers relating to u u u Assessment of a patient (701 -705) with a chronic disease and then developing either a team care arrangement (723) or GP management plan (721) to manage the disease (also 2710 for Mental health) The plan (TCA or GPMP) can be reviewed up to every 3 months (732) and (re)developed every 12 months All patients that receive TCAs or GPMPs are likely to be eligible for HMRs 9

TCAs and GPMPs occur ~20 x more often than HMRs GPMP ~ 200, 000 services/ month TCA HMR ~ 8, 000 services/ month 10

HMRs and Medical Practices u u u Mostly seen as beneficial (good patient outcomes and feedback) Payment of item number on preparation of management plan The HMR Process can often defeat the GP Practice… 11

GP Practices and HMRs Work • Identification of patients • During other consultation, specific • Obtain patient consent Work • Generate HMR referral Work • Work out who to send it to • Recall patient and generate management plan Work 12

Setting up a System for HMRs in a Medical Clinic u The Usual Process u u The Usual Result u u Chat to the GPs about how great HMRs are A burst of activity followed by a decline Some Alternative Approaches (in addition to the usual process) u u 1. Involve the Practice Nurses 2. Install HMR Alert 3. Consider Pharmacy initiated requests 4. Continuous management of the relationship 13

Practice Nurse Involvement 14

Medscope’s HMR Alert u HMR Alert is installed on the GP computer system u u Identifies patients based on the GP’s own criteria Creates a comprehensive electronic referral u u Paperless, Instant Securely transferred to pharmacy or pharmacist MRM account Increases referrals manyfold u u (Pathology etc all included) Especially if managed appropriately Generates relationship management reports 15

HMR Alert Installation u u u Clinic must have Best Practice or Medical Director clinical systems Doctors must (windows) log on to computer Downloadable msi file from Medscope website Must obtain site ID and password from Medscope Administrator password required for clinical system server 16

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Experience with HMR Alert u General Acceptance rate is ~ 5% of alerts u u u Most GPs are happy with the default alerts Needs to be supported with a handout for the patient u u Many GPs doing at least 1 per session Good opportunity for marketing anyway Needs followup meetings to keep the enthusiasm up 18

Pharmacy Initiated Requests 19

GP Practices and HMRs. The Medscope Solution takes away the work HMR Work Pharmacy Alert Initiated HMR Work Alert • Identification of patients • During other consultation, specific Pharmacy Practice Work • Obtain patient consent Initiated Nurses • Generate HMR referral HMR Work • Work out who to send it to Alert • Recall patient and generate management plan Work Practice Nurses 20

HMR System Implementation u Developing the relationship u u u Understand HMRs from the GP’s perspective u Find out the potential problems before you start Know the overall plan and process u Get the clinic to set goals and targets u GPs must be able to visualise the system before they will buy into it. u Value add – what QUM stats reporting is desired? Set up initial meetings u Doctors, nurses, practice manager, business manager Talk to the reluctant participants Define your role as part of the health management team 21

Managing the relationship u Managing the Practice Manager relationship u u u Regular monthly meetings (sample meeting template) Feedback and tweak the HMR system Set and review HMR performance targets Obtain feedback on Your performance Reports (automatically generated by MRM) u u HMRAlert activity reports (assessing practice performance) Activity statements u New HMRs: Cross check referrals issued u Open: Patient unable to schedule u Completed: Practice to organise follow up appointment. 22

Managing the relationship u Managing the GP Relationship u Ask to present QUM finding at GP meetings u u Present QUM findings (MRM reports) u u Be part of the health management team. Issue stats: drug class causing QUM issues (sample) Medication related problems: details of common QUM issues (sample). Medscope can generate custom reports as requested. QUM programs u u u Identify target group (medical condition, drug class) Set HMRAlert to indentify candidates. Report QUM findings 23

Medscope Partnership u Our role is to support accredited pharmacists develop their business. u Business development assistance u u u Webinars GP information pack (download) One-on-one phone support MRM features to support business development (HMRAlert, PIR, Follow ups, HMR management, Referral requests etc) Responsive to feedback and ideas for new supportive features. Statistical reporting to assist in relationship management. 24

Key Take Home Points u u Allocate appropriate time to business development Evaluate/implement/Modify GP HMR system options u u Managing the relationship u u Practice Nurse(s) HMR Alert Pharmacy Initiated Requests Regular practice manager meetings Become part or your client’s team Use Medscope as a resource- We can help For more information: http: //www. medscope. com. au 25

Medscope: Developing an HMR System for Your GP Practices Questions Dr Peter Tenni M Pharm (Curtin), Ph. D (UTAS), AACPA Manager, Clinical Division Medscope 26