Home' Australian Pharmacist : August 2011 Contents Vol. 30 -- August #08
What do the HMR changes
mean for me?
By Claire Antrobus
As a pharmacist who is not yet
accredited and currently working
my way through the accreditation
process, I find myself asking ...
How do the recent changes to the
HMR and RMMR business rules
affect me? I chose to complete the
Medication Review Stage 1 course
after the accreditation incentive
payments were no longer being
paid. I felt that with the impending
changes to the HMR business rules
under the Fifth Community Pharmacy
Agreement there would be increasing
opportunities for independent
accredited pharmacists to expand
their practice by undertaking HMRs as
an Approved HMR Service Provider.
Following the announcement of the
changes, there are still a number
of unanswered questions. I'm not
hoping to answer all these questions
here, only to get people thinking
about the impact of these changes
on their own practice. The Accredited
Pharmacist Special Interest Group
(APSIG) discussion forum available on
the PSA website enables pharmacists
to discuss these and other questions
with their colleagues.
If I'm a newly accredited pharmacist,
how can I best market myself to the
GPs in the area raise my profile and
inform them of the HMR service that I
am ready and willing to deliver?
We hear feedback that some GPs are
selective with regards to the format
and style of HMR reports they prefer.
The GP may have a collaborative
working relationship with one
accredited pharmacist and have, over
time, developed a preferred method
of communication and report format.
If I don't have any example reports to
show a GP, how can they be confident
that the service I provide or the
reports I write will meet their needs
Claire Antrobus is a Project Pharmacist with
the PSA Practice Support Unit in Canberra.
and therefore feel comfortable to refer
patients directly to me?
The best answer I've heard to this
question is to go and speak with
the GPs face-to-face. Talking to the
GP is the first step to forming a
collaborative working relationship.
Experienced accredited pharmacists
may consider approaching GPs for
whom they have completed HMRs
in the past and meeting with them
to advise them of the changes to the
HMR business rules. Meeting with the
GP face-to-face gives the opportunity
to strengthen the collaborative
working relationship between the GP
and accredited pharmacist and when
the GP wants a HMR done, they will
be more likely to refer them to the
accredited pharmacists they know
than to those they don't. For the
GPs who you don't have a working
relationship with, it may be useful
to again meet with them face-to-
face with a few examples of some
of the HMRs you have completed in
What happens if I get too
busy to do the HMRs?
Workflow management could
potentially be of concern if a GP likes
the HMR service you provide and has
quite a few patients he/she would like
to refer to you. What is the best way
to manage the workflow when the
referrals come through sporadically?
Feedback from colleagues indicates
that in some months there may be no
HMR referrals and in other months
you may be inundated and not have
enough time to complete them all.
In the case of a direct referral, if
you have marketed yourself and a
GP is referring HMRs to you and
you are unable to complete it within
an agreed timeframe (both GP and
patient), what does that mean for
the working relationship with the GP
The workflow issue may not only
arise in relation to being too busy to
complete a HMR, it may also occur
if you are unwell for a period of time,
away on holidays or completing some
locum work in a community pharmacy.
A number of solutions may be
proposed for this conundrum.
Underpinning these is the need to
maintain a good working relationship
with the community pharmacies
in your area. This is essential as,
despite the option for direct referral,
a patient's community pharmacy
remains an important link in this
service particularly in the provision
of additional patient information
relevant to the review and follow-up
after the review. Maintaining this
collaborative working relationship with
the community pharmacy will enable
the accredited pharmacist to perform
more holistic HMRs.
If you are unable to provide the HMR
service to a patient referred to you
directly by aGP, you can suggest
that the GP sends the referral to the
patient's regular community pharmacy
for the service to be completed.
Alternatively, you could also potentially
join with an accredited pharmacist
colleagues and work together to
market HMR service to GPs. If one
accredited pharmacist from your group
is unavailable, another may be able to
complete the review. You may wish
to ensure that the GP is comfortable
with the HMR services performed by
the other accredited pharmacists in
The changes to the HMR business
rules open up new opportunities for
accredited pharmacists. However, we
need to ensure we fully consider the
implications of these changes to the
way we practice under these new
rules to not only make the changes
work in our favour but also for the
benefit of the patient.
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