Transcript LTC Workshop March 2014

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LTC – Helpful Tools
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To be covered
 How
to document monthly LTC contact
 LTC reports for those patients requiring
contact, re-assessment or new
prescriptions
 How to generate email and txt reminders
for LTC patients
 Documenting contact with prescribers
 Creating your own medication
management plan template or modifying
an existing one
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LTC Documentation
Document interactions with LTC patients at
least monthly (particularly if they are being
dispensed to three monthly)
 On Toniq make one LTC note (F5 in the
patient diary) and keep adding to it or
add notes to the “notes and additional
comments” section on the agreed MMP
(LTC4)
 On LOTS document on the events audit
(eg face to face meeting, phoned and
talked to patient). Add comments
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Medico packs
 Although
many patients
on medico packs are
eligible for LTC some are not
(eg using a pack for
convenience rather than
compliance issues)
A pack delivered by a delivery person every
week or month does not count as a contact
For LTC
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Contact and Documentation
Contact with LTC patients and
documentation can be done when first
receiving the prescription at the front
counter if your pharmacy has the
dispensing program accessible from here
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Contact and Documentation
Ways to alert the checking pharmacist that
a patient is LTC
 An
“L” or an “LTC” on the 3rd part label
(if your site does not have this set up
contact LOTS or Toniq)
 A sundry label can be set up to be printed
out after each prescription saying eg “ LTC
patient, discuss medication”
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Sundry labels on Toniq
 First
make a Sundry label and name it eg
“LTC”
 Then on each patient go to F2 (edit
patient), then go to the third page (F11,
F11), put the sundry label name in (LTC)
and choose the LTC sundry label you
have created
 Then tick required filters, ie prompt at end
of visit, always for repeats only, always for
originals only
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Hospital discharge
prescriptions
 Document
all hospital medical
discharge prescriptions for LTC
or potential LTC patients,
related to that patients long
term condition
Each hospital admission in the year scores 5
points in the LTC evaluation and could
make a non-eligible patient eligible.
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LTC Reports
The monthly LTC service fee will not be paid
 unless the patient is reassessed once
every 12 months and the LTC registration
updated to reflect the last assessment
date
 there has been a dispensing within the last
120 days
Monthly documented contact is required as
part of the LTC service
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LTC Reports on Toniq
 To
do a report on when re-assessment is
due from the main menu go to 3 (reports),
then 4 (patient reports), then 7 (LTC
patient summary).
 From this screen you can put in the dates
that the review is due from (eg what
reviews are due in the next month)
 From this screen you can also do a report
filtering for patients who haven’t had a
dispensing for eg 30 or 100 days (picking
up those patients requiring contact/a
prescription to stay in the service)
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LTC reports on Toniq
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LTC Reports on LOTS
The last contact report accessed through
the LTC manager (shown below) shows
when:
 Reassessment is required (within 14 days)
 Scripts due within 14 days and
 Contact required in 5 days time
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LTC Reports on LOTS
Each section on the last contact report can
be sorted by clicking on the relevant header
LOTS recommend that pharmacists use the
last contact report by clicking on “ Action
Required by” to sort from the most urgent to
the least urgent and do the “Action
required”
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Reminders for LTC patients
With the patients permission reminders can
be given for eg
 Repeats or owed medication to be
picked up
 Prescriptions to be brought in
 Agreed medication management
planning to be done
Text and Email messaging will need to be set
up with Toniq/LOTS
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Reminders for LTC patients Toniq
 From
the main menu go to 9 (other), 2
(bulk edit patients), then F11 (Next page),
fill in LTC as at the current date and the
required “ review due by”, then F11, F11,
F11, F12. From this report create a
contact list using the F9 key (contact
clients) and name the list
 Multiple clients can then given an email or
txted reminder
 Txt or email reminders can also be made
from the repeats due/owings reports
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Reminders for LTC patients LOTS
 Go
to the last contact report with LOTS.
Select the button “ Export to Mailing
Labels” at the bottom of the screen
which will take you to the Mailing Labels
screen
 From here bulk text reminders can be sent
by clicking on the button “send text
reminder”
 Individual text reminders can also be sent
from the “ Repeats Due Report”
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Document contact with
prescribers
The CPSA requires that as part of the LTC
service the patient health practitioner be
informed of the patients registration in LTC
and the medication management plan
(MMP) is made available to them
 Document
prescribers
all interactions with LTC patient
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Document contact with
prescribers
Inform prescribers that patients are LTC –
provide a list of LTC patients for that doctor
 Toniq - a list can be generated of the LTC
patients for a specific prescriber. From the
main menu go to 3 (Reports), 4 (Patient
Reports), 8 (LTC patients by prescriber)
 With
eScript if a patient is LTC this will be
able to be seen on Medtech
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Document contact with
prescribers – MMP plans
 Message
from Clinical Partnerships when
the service started was that GPs did not
want the MMP plans sent to them until
they were in an electronic format
compatible with Medtech.
 However surgeries need to be aware that
the plans are available to them
 If the surgery is not wanting the MMP sent
to them this needs to be documented
 Eventually the MMP will be available from
the CCMS
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Contact with prescribers on
Toniq
 If
you and the surgery you are emailing to
have a secure link each individual LTC
template (eg evaluation, MMP) can be
emailed to the doctor by using the F8 key
(Email note) when viewing the template.
Otherwise for privacy reasons it should not
be emailed.
 Completed templates can also be
printed out and faxed to the doctor.
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Contact with prescribers LOTS
 Again
with a secure link medication
Management plans can be emailed to
the prescriber by clicking on the following
button at the bottom of the MMP
 Completed
assessments/plans can also
be printed out and faxed to the doctor.
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Variations on Medication
Management Plans (MMPs)
A Medication Management Plan must include
the following components (Contractual
Obligations):
 Reconcile medicine as appropriate
 Synchronise when needed
 Choose appropriate dispensing frequency
 Appropriate reminders for individual patients
 Regular screening for adherence
 Minimum of monthly contact
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Making your own Medication
Management plan
As long as you incorporate these
components on Toniq you can write
your own Medication Management
Plan
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Making your own template: Toniq
 From
the main menu, go to 9 (Other)
 Then 4 (Edit note templates)
 Then F3 (add)
 Then F10 (other)
 Then A (Copy from existing template)
 Then choose the template: TQ Patient
Pharmacy header
 Then add to the template, give it a new
name and F12 (accept details)
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Go back into the patient name and
choose that template when doing the
MMP
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Modifying an existing template
While the MMP must be individualised, you
can prepopulate a Toniq template with
those components which are common to
your pharmacy and save it as a new
template
 Eg If you always reconcile every new
prescription with another source
 Eg If for all your patients on packs you put
a reminder sticker on the pack that a new
prescription is required two weeks before it
is due
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Modifying the MMP on Toniq
 From
the main menu, go to 9 (Other)
 Then 4 (Edit note templates)
 Then F3 (add)
 Then F10 (other)
 Then A (Copy from existing template)
 Then choose a template, ie LTC3/LTC4
 Then amend the template, give it a new
name and F12 (accept details)
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Medication Management
Plans on LOTS
The MMP is a living document and must be
kept up-to-date in accordance with each
interaction you have with the patient
 With LOTS for each patient, once you
have done the MMP when you go back
into that patient and load up the MMP ,
the previous one will come up and you
can keep adding to it. The amended
MMP is then saved onto the forms and
files tab for that patient.
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Getting to know your LTC
patient
LTC patients are people that you
know well
 In
the new stage of the contract a
pharmacy will receive $20 more a month
for an LTC patient as compared to a core
patient who is on the same amount of
medication
 What are you doing for your LTC patient
each month for that $20?
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Remembering Birthdays - Toniq
Use the LTC patient
summary which gives
a report of name,
NHI, DOB etc
Alternatively go to patient
Reports, then 3 (patient
mailing list, then filter, tick
“ show birthdate” and
accept details.
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Remembering Birthdays - LOTS
From the LOTS Start Menu
go to reports, then other
reports, then mailing labels.
Sort by “ Customer”, then
tick “ select birthday” in the
right hand column.
Select dates eg for August.
and select “ok”.
When the list comes up double click on the
Column heading “ Birthday”. This sorts the
list in chronological order.
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Summary
 Get
into the habit of documenting
everything you do with LTC patients, eg
conversations, contact with their
prescribers, hospital admissions and
changes in medication/doses with the
reason why
 Do regular (weekly or fortnightly) reports
so reassessment times/contact times are
not missed
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Summary
 Get
to know your patients and prescribers
well and be proactive in finding out how
you can help them
 Individualise medication management
plans both for how your pharmacy likes to
carry them out and also for the individual
patient.