Medscope: Developing an HMR System for Your GP

PracticesDr Peter Tenni M Pharm (Curtin), PhD (UTAS), AACPA

Manager, Clinical DivisionMedscope

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Presentation downloadable fromwww.medscope.com.au/businessdev

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

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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 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

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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.

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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 targets6

Factors to Consider

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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 Plans8

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

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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

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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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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

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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 up18

Pharmacy Initiated Requests

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GP Practices and HMRs- The Medscope Solution takes away the work

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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

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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 client’s 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 Practices

QuestionsDr Peter Tenni M Pharm (Curtin), PhD (UTAS), AACPA

Manager, Clinical DivisionMedscope

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