Medscope: Developing an HMR System for Your GP Practices

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

2. Medscope Medication Review Business Management • Medscope Goal: Complete DMMR business system • Manage your whole medication review business • Innovative expert system issue identification • Journal of Clinical Pharmacy and Therapeutics, 2012, 37, 378–385 • Review Management (Report writing, claims etc) • Business development – assisting MMR service providers build successful businesses. • Reports/Statistics to analyse • Staff (sub-accounts) • Business performance • Health outcomes (QUM) • Your MRM account is the “value” of your business • Number of HMRAlert links with practices • Number of referrals – follow-up are future revenue

3. Dr Peter Tenni M Pharm (Curtin) PhD (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 • CPS does ~ 4000 RMMRs /yr and ~ 1000 HMRs /yr • The techniques discussed are those that have been successfully used by CPS.

4. This Webinar: Developing an HMR System for Your GP Practices • 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 – • 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

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

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

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

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

9. Chronic Disease Management • Item numbers relating to • 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

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

11. HMRs and Medical Practices • 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…

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

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

14. Practice Nurse Involvement

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

16. HMR Alert Installation • 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

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

19. Pharmacy Initiated Requests

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

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

22. Managing the relationship • Managing the Practice Manager relationship • 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) • HMRAlert activity reports (assessing practice performance) • Activity statements • New HMRs: Cross check referrals issued • Open: Patient unable to schedule • Completed: Practice to organise follow up appointment.

23. Managing the relationship • Managing the GP Relationship • Ask to present QUM finding at GP meetings • Be part of the health management team. • Present QUM findings (MRM reports) • 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 • Identify target group (medical condition, drug class) • Set HMRAlert to indentify candidates. • Report QUM findings

24. Medscope Partnership • Our role is to support accredited pharmacists develop their business. • Business development assistance • 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.

25. Key Take Home Points • Allocate appropriate time to business development • Evaluate/implement/Modify GP HMR system options • Practice Nurse(s) • HMR Alert • Pharmacy Initiated Requests • Managing the relationship • 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

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