Medscope: Developing an HMR System for Your GP Practices

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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

Presentation downloadable from www.medscope.com.au
/businessdev
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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, 378385
• 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

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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.

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This Webinar Developing an HMR System for Your
GP Practices

• We will be outlining Medscopes 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

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This Presentation- A Medical Practice Focus

• Business Setup and Development
• Setting your goals and targets
• Understanding your clients (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 clinics health management
  team.

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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

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Factors to Consider

• Medical Clinic s)
• Size/ Structure
• Relationship

• Your Business
• Efficiency
• Capacity
• Structure

• Local Pharmacy
• Existing relationships

• Other Accredited Pharmacists
• Relationships

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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

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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

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

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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
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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

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Practice Nurse Involvement
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Medscopes HMR Alert

• HMR Alert is installed on the GP computer system
• Identifies patients based on the GPs 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

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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

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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

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

• 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
Practice Nurses
Pharmacy Initiated
Work
HMR Alert
HMR Alert
Work
Work
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HMR System Implementation

• Developing the relationship
• Understand HMRs from the GPs 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

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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.

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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

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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.

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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 clients team
• Use Medscope as a resource- We can help
• For more information http//www.medscope.com.au

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Medscope Developing an HMR System for Your GP
PracticesQuestions

• Dr Peter Tenni M Pharm (Curtin), PhD (UTAS),
  AACPA
• Manager, Clinical Division
• Medscope