Date: 30 May 2018
As our health system strains to cope with increasing numbers of Australians suffering from multiple chronic health conditions, it is clear that ‘collaboration’ and ‘integration’ are essential elements of efficient, patient-focused health service delivery.
The cost and complexity of modern health care mean it is no longer feasible or desirable for health professionals – be they doctors, pharmacists or allied health providers – to operate alone in a siloed system of care.
In order for our health system to deliver cost-effective health outcomes, it must be underpinned by an integrated approach where all health professionals have a genuine commitment to working collaboratively with each other in the delivery of patient care, supported by the best available tools and systems.
Models of care and health funding should support and reward collaborative, whole-of-patient approaches and discourage approaches where health providers continue to operate as ‘care islands’, fragmenting and duplicating care and not sharing knowledge and information.
It is vital that community pharmacies embrace collaborative care and integrate with the broader health system or they risk being seen as merely transacting medicine supply but superfluous to patient care.
Thankfully two significant initiatives, on the cusp of rolling out, provide a timely opportunity for community pharmacies to position themselves as an integral part of the preferred collaborative health care model.
The first is the Health Care Homes trials. These trials in 10 Primary Health Networks are GP led and are focussed on the coordinated care of patients who have complex and chronic health care needs. Under the Health Care Homes trials, medical practices and Aboriginal Community Controlled Health Services (ACCHS) are funded to coordinate the development and delivery of shared care plans for these high need patients working with other health care providers.
As part of the Pharmacy Compact, negotiated with Health Minister Hunt in 2017, community pharmacies will, for the first time, be funded to collaborate with GP practices and ACCHS in addressing the ongoing medication-related support needs of patients in the Health Care Homes trials.
Eligible Health Care Homes’ patients will benefit from patient-centred, coordinated medication management services delivered by their community pharmacy of choice in conjunction with their Health Care Home, including an initial reconciliation of their medications and development of a collaborative Medication Management Plan. This will be supported by regular follow-up reviews by the community pharmacy to maximise continuity of care and improved chronic disease management.
Community pharmacy and the GP or ACCHS-led Health Care Homes care team will work together to deliver the Medication Management Plan, to ensure that the patient’s medication goals are achieved and to support their patients in change management and lifestyle approaches. Importantly, the Medication Management Plan and its delivery will be tailored to the individual patient’s needs and preferences and will enable pharmacies to take a personalised approach to medication support working in coordination with the patient’s broader care team.
The Health Care Homes trial will link to a second major initiative that, over time, will drive improved collaboration and integration in our health system, namely the My Health Record. Each of the Health Care Homes trial patients will have My Health Records and health professionals participating in the trials, including community pharmacies, will be strongly encouraged to upload Health Care Homes-related information, such as shared care plans and medication management plans, to the health record.
More broadly, the My Health Record provides a step-change opportunity to integrate community pharmacies with the rest of the health system. Until now, from an IT perspective, community pharmacies have largely operated in a vacuum with little visibility of their patients’ interactions with other health care providers (or with other pharmacies). Equally the clinical support that is regularly provided by community pharmacists and which is recorded electronically in pharmacy dispensing systems and services platforms, such as GuildCare, has remained largely invisible to the broader health system.
Over time, the My Health Record will play a key role in overcoming these IT siloes. In the more immediate term, with virtually all Australians likely to have a health record by the end of this year under the opt-out regime, community pharmacies will have access to the recent MBS and PBS records of their patients as well as increasingly being able to access hospital discharge summaries, the results of pathology and radiology tests, and patient vaccination and allergy-related information.
At the same time, the Guild is working closely with the Australian Digital Health Agency to enable pharmacies to register for and activate the My Health Record and to maximise the level of recording on the health record system of the clinical work of community pharmacists – in areas such as medication support, medicines reconciliation and vaccinations – providing visibility for other health care providers.
By proactively embracing and helping drive collaborative health care reforms like the Health Care Homes and the My Health Record, community pharmacies will clearly demonstrate their inherent value to the wider health system and that their role is crucial in achieving the best health outcomes for patients.
Contact: The Guild