HMRs - Reducing hospital admissions and growing your practice

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For those of you who may not have heard of a Home Medicines Review (HMR), an HMR is an all-encompassing in-home clinical assessment of a patient’s various medicines and medications. Essentially, HMRs are set up by General Practitioners (GPs), carried out by an Accredited Pharmacist and then completed with an HMR review during consultation with the GP. On top of that, the process is highly subsidised by the Australian government, in what is viewed as a win-win for patient outcomes, GP’s and community pharmacy. HMRs are becoming increasingly popular as they facilitate greater shared care of the patient and their management of medications.

What's the point of having an HMR?

In short, to avoid having to go to the hospital due to a “medication misadventure”. To quote the Pharmaceutical Society of Australia, the aim of an HMR is to “…identify, prevent and resolve actual or potential medication-related problems, optimise pharmacotherapy and assist in achieving better health outcomes for consumers living at home.”. In layman’s terms, HMRs are designed to minimise and eliminate health complications due to a mis-match of medications consumed by an individual patient which can pose a threat to their health. Many Australian’s take multiple medications to manage various health conditions. To make matters more complicated, Patients often visit different doctors, and without shared patient information of medications, issues can quickly get out of hand.

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How important are HMRs then?

Incredibly important. Every year, hundreds of thousands of patients are admitted to hospitals for medication-related health issues, and this is just in Australia. Moreover, these hospital admissions are of significant cost to the Australian economy. According to researchers from the University of South Australia, there are approximately 230,000 medication-related hospital admissions per year Australia wide, costing us about $1.2 billion AUD.

Which Patients are most at risk of medication misadventures?

The most at risk patients that shoud get an HMR are those managing their chronic disease and dealing with a complex regimen of medication. Typically, these are patients demographically older in age. In 2013, 12% of all medical admissions to hospital were people aged over 65, with 20% to 30% estimated to be medication-related. With an ever-aging population in Australia, that is a staggering figure that is on the increase, prompting many clinics to seriously consider patients for HMRs when they come in for a 75-year-old health assessment.

So, how do HMRs work?

An HMR is a process with a series of steps that can take a couple of weeks to complete. To start with, an HMR is initiated by a GP, who generates an HMR referral in consultation with their Patient. The referral is then picked up by an Accredited Pharmacist who then visits the patient at their home to carry out a complete evaluation of the medicines said patient is currently using. Following that, the Accredited Pharmacist completes an HMR report and then sends it back to the patient’s GP. Finally, the GP recalls their patient for an HMR review to go over the report and address any medication issues that may be apparent from the report.

Once the HMR process is complete, the consulting GP can charge MBS Item 900. For the practice, this is a significant financial incentive. More importantly, this helps ensure that patients avoid being admitted to hospital for unknowingly taking a dangerous mix of medication, or at the very least, provides peace of mind for GP’s and their patients.

How long does an HMR take to complete?

An HMR typically takes an Accredited Pharmacist between one and two hours to complete in home, depending on the patient’s questions and the medications being assessed. Additionally, a patient may require help both organising and storing their medication, which can make a one-hour consultation extend to two.

How do I get HMRs for my practice and patients?

Every GP clinic across Australia has access to the MBS Item 900. Most practices use simple printing and faxing of the HMR referrals followed by looking for someone to perform the at-home review. Over the last two years, clinics throughout Australia have shifted to paperless referrals with the HMR Referrals® platform that completely integrates with clinical systems. Recently the company has provided this to clinics at no additional cost, making the transition to paperless referrals simple.

Check out HMR Referrals if you’d like your clinic to go paperless.

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