Information for General Practice & Medical Practitioners

I am now set up to receive referrals via Secure Electronic Document Delivery via HealthLink using my recipient address “swmedrev”.

Alternatively, referrals to me can be send in paper-format via Australia Post addressed to:

​PRIVATE & CONFIDENTIAL

Matt Pettit

South West Medication Reviews

PO Box 7099,

Eaton WA 6232, Australia

A Home Medicines Review (HMR) involves a Medical Practitioner referring a patient to a pharmacist that has undergone a specific credentialling program to be Accredited to perform comprehensive medication reviews with patients in their homes.

Who would be IDEAL patients to consider referring to South West Medication Reviews for a Home Medicines Review (HMR)?

Essentially, any patients receiving pharmacotherapy / disease state management that you feel are not achieving agreed therapeutic goals for any reason. Some great examples may include:

1. Recent hospital admission – for example, an exacerbation of COPD or heart failure.
2. Failing to attain therapeutic goals such as blood pressure targets, glycaemic targets.
3. Recent or recurrent falls.
4. New diagnosis of a chronic condition that typically requires long-term or multiple medications.
5. New to your Practice – use me to do some of the initial work relating to obtaining history from them.
6. Unexplained abnormal pathology results or symptoms that you might attribute to a medication.
7. Suboptimal health literacy, suboptimal motivation to manage their health, fear of medications, difficulty using therapeutic devices (e.g. inhalers) or requiring education for other reasons.
8. Seeing multiple practitioners and concerns of fragmentation of medical information.
9. Support / education of carers that have needed to increase their “caring” role secondary to decline in the patient’s health and function.

So what happens when I refer a patient for a Home Medicines Review (HMR) to South West Medication Reviews?

The referral will be received by either the Individual Accredited Pharmacist that you and the patient have agreed upon to provide the service. Alternatively, the referral can be sent to the Community Pharmacy of the patient’s preference, and they will arrange for an Accredited Pharmacist to review the patient.

Upon receipt of the referral, I will contact the patient / carer within two weeks to introduce myself, explain the process, obtain any consent that I feel is required, and arrange a day / time that suits both patient and myself to visit.

I spend approximately one-hour in the patient’s home with them and their carer. I will perform an accurate / update medication reconciliation, assess compliance, assess the patient’s self-management needs, assess and educate on the correct use of medication-related devices (inhalers, spacers, topical or injectable medications, and monitoring aids such as blood glucose monitors), and goals of their pharmacotherapy.

Once the home visit is completed, I return to my home-office to write a letter back to the Referrer – typically, I return this to the Referrer within 48 hours of seeing the patient. If I identify any concerns with the patient that might impact on their well-being prior to the patient returning to their Doctor, I call the practice and speak either to a Doctor or Practice Nurse to discuss the issues.

Upon receipt of the letter (report) from myself, your practice staff are instructed to recall the patient for a dedicated appointment to discuss the findings and any further actions required. The GP can claim MBS Item 900 for this consultation, assuming they’ve fulfilled the requirements laid out in the Medicare Benefits Schedule.

General Practitioners and their staff should refer to MBS Online (Medicare Benefits Schedule) for full information under MBS Item 900.

So HOW do I refer a patient to South West Medication Reviews for a Home Medicines Review (HMR)?

My suggestion is to keep is simple. There is no formal requirement for the format of a written referral.

A simple letter from a Referrer with patient demographics (including residential address, current phone number, and Medicare Number), date, reason for referral, referral information (including provider number & contact details) will suffice – you could easily use a template similar to a referral to a Specialist – I will obtain further information from your Practice Nurse / Practice Staff as required. Provided the patient provides me with consent, I gather as much information as possible from MyHealthRecord using my PRODA access.

This is my recommended proforma for HMR referrals if you wish to get your Practice Manager / IT support to set it up. Click the here for a sample referral template developed in Microsoft Word that Practice Staff can utilise to setup as a standard document in your Practice software.

As of 9th August, 2023, I am now set up to receive referrals via Secure Electronic Document Delivery via HealthLink using my recipient address “swmedrev”.

In the interim, referrals may be posted to me addressed as follows:

​PRIVATE & CONFIDENTIAL

Matt Pettit

South West Medication Reviews

PO Box 7099,

Eaton WA 6232, Australia

Let’s dispel a few of the myths, concerns and controversies surrounding HMRs that I’ve encountered.

Doctor: I don’t need a pharmacist to tell me about drug interactions or how to manage chronic diseases or my patients! (Yes, I’ve had that said to my face).

I’m here to support your practice as a medical practitioner, support the patient in their journey to self-manage their chronic condition, and hopefully make your consultations for more time-efficient by ensuring you have current information about the patient. I never have, and never would, contradict or criticize another health professional to their patient.

Nothing in my report / letter is reproduced from commercial software (in fact, it is uncommon that I find a drug interaction of significance that warrants commenting upon!).

My letters are written in a non-judgmental manner; no content in my letter is intended to “teach” you anything. It is simply reporting findings from the home visit, and the compiling of information from various sources, including the patient.

I like the idea of referring for HMRs however, I just don’t have time.

As I’ve alluded to above, a referral to me does not need to be elaborate – it shouldn’t take any longer than a Specialist referral. Ultimately, over the course of 3-4 appointments with the patient, it is my hope this makes future consultations easier and more efficient as you should have up-to-date, reliable and concise information on the pharmacotherapy of the patient. If the patient’s clinical status / issues change considerably, a repeat HMR can be requested by a referral assuming there is a clear clinical need, as determined by their Medical Practitioner.

In my HMR report, I fill out the Medication Management Plan on your behalf – for efficiency, you can type straight into my letter to meet your documentation requirements under MBS Item 900 (see my Sample Report below).

How much money does a pharmacist make out of this process?

As of 7th August, 2023, the payment to a pharmacist via PPA for this service is $222.77.

This service takes me around 3-hours per patient / per HMR (sometimes more). I hope to work for around $70 per hour doing this process.

Reference: Home Medicines Review – Pharmacy Programs Administrator (ppaonline.com.au)

Who can refer to me to perform a Home Medicines Review (HMR)?

At the time of accessing the HMR Program Rules here on 5th August 2023,

 What does your HMR Report look like?

Here is a de-identified real-life report with some information removed to ensure patient confidentiality is maintained.

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