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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 Medscope Medication Review Business Management.

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Medscope developing an hmr system for your gp practices
Medscope: Developing an HMR System for Your GP Practices

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

Manager, Clinical Division


Presentation downloadable from

Medscope medication review business management
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

  • Dr peter tenni m pharm curtin phd utas aacpa
    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.

    This webinar developing an hmr system for your gp practices
    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

    This presentation a medical practice focus
    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.

    Setting up and developing a medication review business
    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

    Factors to consider
    Factors to Consider

    • Medical Clinic s)

    • Size/ Structure

    • Relationship

    • Your Business

    • Efficiency

    • Capacity

    • Structure

    • Local Pharmacy

    • Existing relationships

    • Other Accredited Pharmacists

    • Relationships

    Developing relationships with medical practices
    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

    Chronic disease management
    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

    Tcas and gpmps occur 20x more often than hmrs
    TCAs and GPMPs occur ~20x more often than HMRs

    ~ 200,000 services/ month




    ~ 8,000 services/ month

    Hmrs and medical practices
    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…

    Gp practices and hmrs
    GP Practices and HMRs


    • 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





    Setting up a system for hmrs in a medical clinic
    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

    Medscope s hmr alert
    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

    Hmr alert installation
    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

    Experience with hmr alert
    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

    Gp practices and hmrs the medscope solution takes away the work
    GP Practices and HMRs- The Medscope Solution takes away the 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


    Pharmacy Initiated

    Practice Nurses


    HMR Alert

    HMR Alert



    Hmr system implementation
    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

    Managing the relationship
    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.

    Managing the relationship1
    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

    Medscope partnership
    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.

    Key take home points
    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:

    Medscope developing an hmr system for your gp practices questions
    Medscope: Developing an HMR System for Your GP PracticesQuestions

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

    Manager, Clinical Division