Jane Calligeros, Founder and CEO CDM Plus
A Home Medicine Review could literally save your patient’s life! It’s not something I’d say about Care Plans or Health Assessments or pretty much any other kind of Chronic Disease Management activity. Like all things of value, it isn’t easy to complete. A Home Medicines Review requires a practice team effort as the whole process is a bit involved and can take between 6-8 weeks to complete. Practices that are completing Home Medicine Reviews consistently would be considered a high performing team.
For those health professionals that haven’t heard of or aren’t using this Chronic Disease Management activity, I’ll break it down into the processes for you. The Home Medicine Review (HMR) as it is commonly known is as it says a review of the patient’s medications by a Pharmacist. In primary health care lots of what we do is fee for service so the GP can’t actually finalise the MBS billing for the HMR until they have the report back from the Pharmacist and then goes through the report with the patient. The process for a Home Medicine Review looks a bit like this:
- Home Medicine Review referral generated (by Nurse/AHW/GP)
- HMR Referral signed by GP and given to Reception
- Pharmacist receives HMR Referral and contacts patient to complete the HMR at the patient’s home
- Pharmacist completes HMR with the patient in their home
- Pharmacist writes the HMR Report with suggestions to GP
- Pharmacist sends report to GP
- GP reviews HMR Report
- Reception book an appointment for patient with the GP to review HMR Report
- GP goes through HMR Report with the patient and may make changes to medication regime
- GP completes the section on the HMR report
- Reception send this back to the Pharmacy
- GP bills for the Home Medicine Review
You can understand why most health professionals put it in the too hard basket. I didn’t add in the calls back and forth with the pharmacy chasing reports, resending referrals (as the referral only lasts for 3 months), and for that extra challenge Pharmacists are only allowed to do 20 per month.
What is in a Home Medicine Review report? The Pharmacist provides recommendations for medication regime such as combination therapy, reducing or increasing medication dosage, changing medication, possible interactions, over the counter medication and feedback regarding medication aids. At the end of the day it’s a process and one of the reasons the whole practice team needs to be involved to deliver long term Chronic Disease Management. The reason I’m such an advocate is because what I’ve seen in some of these HMR Reports. The Pharmacists are technically the specialists of Medication, so if your patient has multiple medications and falls into the target groups then you need to refer. Because they do the review in the patient’s home, they usually find other over the counter medication and other medication not listed. Pharmacists also are the wizards of drug interactions and contraindications and can prevent possible complications and potentially save your patient’s life.
The supplied referral form in all clinical software is a bit outdated and still mentions receiving the report by floppy disk??? We’ve created a FREE Online Module for the Home Medicine Review to help your practice team and have even supplied a couple of templates that you can import straight into your clinical software. The template will let you add in recent pathology, and we’ve added in all the relevant fields like family and social history, immunisations and made the selection of medications aids and reason for referral a couple of clicks. Medicare also changed the criteria for a Home Medicine Review this year and a patient needs to meet the three criteria or they can still be referred but the patient may pay the remainder of the service if determined by the Pharmacist.