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Medscope: Developing an HMR System for Your GP Practices Dr Peter Tenni M Pharm (Curtin), PhD (UTAS), AACPA Manager, Clinical Division Medscope 1 Presentation.

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Presentation on theme: "Medscope: Developing an HMR System for Your GP Practices Dr Peter Tenni M Pharm (Curtin), PhD (UTAS), AACPA Manager, Clinical Division Medscope 1 Presentation."— Presentation transcript:

1 Medscope: Developing an HMR System for Your GP Practices Dr Peter Tenni M Pharm (Curtin), PhD (UTAS), AACPA Manager, Clinical Division Medscope 1 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 2

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. 3

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 4

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. 5

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 6

7 Factors to Consider 7 Medical Clinic s) Size/ Structure Relationship Medical Clinic s) Size/ Structure Relationship Your Business Efficiency Capacity Structure Your Business Efficiency Capacity Structure Local Pharmacy Existing relationships Local Pharmacy Existing relationships Other Accredited Pharmacists 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 8

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 9

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

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… 11

12 GP Practices and HMRs 12 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 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

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 13

14 Practice Nurse Involvement 14

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 15

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 16

17 17

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 18

19 Pharmacy Initiated Requests 19

20 GP Practices and HMRs- The Medscope Solution takes away the work 20 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 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 HMR Alert Practice Nurses Pharmacy Initiated Practice Nurses Pharmacy Initiated HMR Alert

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 21

22 Managing the relationship  Managing the Practice Manager relationship  Regular monthly meetings (sample meeting template)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. 22

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)sample  Medication related problems: details of common QUM issues (sample).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 23

24 Medscope Partnership  Our role is to support accredited pharmacists develop their business.  Business development assistance  Webinars  GP information pack (download)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

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.auhttp://www.medscope.com.au 25

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


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