Health Care Professionals

MedsCheck

Frequently Asked Questions: MedsCheck Follow-up


What is the MedsCheck Follow-Up?

The MedsCheck Follow-Up is an additional medication review for those patients who may benefit from a second MedsCheck during the annual time-frame due to specific situations such as:

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A patient has been discharged from the hospital with new and/or changed medications. The pharmacy records show that the MedsCheck Annual was conducted within the previous six months; can I perform a second MedsCheck?

Yes. A MedsCheck Follow-Up for hospital discharge can be conducted by a pharmacist provided the patient meets the program criteria and agrees to the service. Pharmacists must clearly indicate in their documentation notes that the MedsCheck Follow-up was conducted as a result of a hospital discharge indicating the date the patient was discharged.

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It has been identified that a patient will benefit from a MedsCheck Follow-up due to a hospital discharge. Is there a time limit for the review to take place?

A MedsCheck Follow-up for hospital discharge is conducted within two weeks after a patient is discharged from hospital. Documentation must include the discharge date.

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As a result of the hospital discharge, the patient is not available to attend the pharmacy for the MedsCheck Follow-up. Can I conduct the MedsCheck Follow-up with the patient’s caregiver or agent?

Yes. The MedsCheck Follow-up is an in-person, one-on-one consultation between the pharmacist and the patient. If however, the patient is not able to attend the pharmacy, the pharmacist may conduct the MedsCheckFollow-up with the patient’s caregiver or agent.

Appropriate documentation including pharmacist’s professional notes and consent forms must be in place when conducting a MedsCheck with the patient’s agent or caregiver.

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Can a hospital pharmacist perform a MedsCheck Follow-up due to a hospital discharge?

The MedsCheck Follow-up due to a hospital discharge is provided by a pharmacist at a community pharmacy provided the patient agrees and has completed an annual MedsCheck Patient Acknowledgement of Professional Pharmacy Services form. While many hospitals have accredited community pharmacies on site that can technically provide MedsCheck services, these pharmacies are not necessarily the patient’s preferred pharmacy for professional pharmacy services.

Should the hospital’s on-site accredited community pharmacy offer MedsCheck services to patients the pharmacist must ensure the patient completes an annual MedsCheck Patient Acknowledgement of Professional Pharmacy Services form. Every effort to obtain a copy of the most recent MedsCheck medication review or a patient prescription profile from the other pharmacy is recommended in order to provide optimal service for the patient. If the most recent MedsCheck medication review or the prescription profile is not obtained, this must be noted as part of the documentation. The completed MedsCheck Personal Medication History should not only be shared with the patient and the primary prescriber but it should also be shared with the patient’s primary pharmacy.

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Can a hospital pharmacist perform a MedsCheck within the hospital?

A MedsCheck service is not considered a billable service if it is not conducted by a hospital in-patient staff pharmacist and conducted within the hospital.

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A patient has recently moved to the neighbourhood from another city and plans to attend your pharmacy. On reviewing her copy of the MedsCheck Personal Medication History, you notice that her new physician has made significant changes to her medication regimen. Is it appropriate to conduct a second MedsCheck within the annual time-frame?

Yes. Patients are eligible for a MedsCheck annual review once per year; however a pharmacist may identify reasons for conducting a second review within the annual time-frame. The second review, a MedsCheck Follow-up, may be conducted and documented as a pharmacist’s decision for instances such as a patient’s relocation to your pharmacy, significant changes in a patient’s medication regimen, diet and lifestyle.

If the previous MedsCheck was conducted at another pharmacy, pharmacists must make every effort to obtain a copy of it from the originating pharmacy or from the patient. For audit purposes, the pharmacist’s reason for providing the MedsCheck Follow-up must be documented; a copy of the signed and dated medication list and any supporting documentation is kept on file at the pharmacy in a readily retrievable format.

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A physician has contacted the pharmacy to request that a patient have a MedsCheck with the pharmacist. You notice that the MedsCheck was already conducted within the past year. Can the pharmacist conduct a second MedsCheck within the annual time-frame due to a physician’s request?

Yes. When the pharmacist identifies that the MedsCheck has been performed within the past year, a MedsCheck Follow-Up may be considered provided the patient meets the program criteria and agrees to the service. In addition, the pharmacist must provide the referring practitioner with a copy of the MedsCheckmedication review list.

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A physician has referred a patient for a MedsCheck Follow-Up, can the pharmacist take this as a verbal request?

Yes, the MedsCheck referral from the physician or nurse practitioner may be in writing or as a verbal request. The written referral may be provided to the patient or faxed to the pharmacy. The verbal referral is transcribed and signed by the pharmacist.

For both written and verbal referrals, the information should be documented with the prescriber’s name, patient’s name and date of referral. For audit purposes, the referral documentation must be maintained on file at the pharmacy with a copy of the signed and dated MedsCheck record.

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Is it mandatory to forward a copy of the patient’s MedsCheck Personal Medication Record to another party?

Pharmacists must share the MedsCheck Personal Medication Record with the patient’s primary physician. A pharmacist may identify situations when the MedsCheck medication record ought to be forwarded to other physicians (specialists), to another pharmacist / pharmacy, to the hospital for planned admissions or emergency use, or other primary health-care professionals who interact with the patient.

Building positive communication channels between the pharmacy and the other health-care professionals will add value to the communication process and fosters seamless care. It is advisable that the pharmacist ensure that the patient is aware that the medication review is being forwarded to the other party and that this action is documented on the pharmacy copy and professional notes.

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As a pharmacist, do I require patient consent to request the MedsCheck medication record from another pharmacy?

Best practice is that pharmacists ensure the patient is part of the discussion in obtaining and sharing MedsCheck medication review records. It is considered implied consent for a pharmacist to request any MedsCheck medication review record from another pharmacist or health information custodian. The Personal Health Information and Protection Act (PHIPA) provides for disclosure without expressed consent under certain circumstances such as when the disclosure relates to providing health care programs and services.

Any such transaction should be documented by both pharmacists including the reason for the request. Pharmacists must make every effort to obtain the previous MedsCheck medication record either from the patient or the other pharmacy when conducting a MedsCheck Follow-up in the situations when the previous MedsCheck was performed elsewhere.

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How many MedsCheck Follow-up services can the pharmacist perform per patient in one year?

There is no limit to the number of MedsCheck Follow-up services that a pharmacist can perform per patient in the annual time-frame. The criteria for the MedsCheck Follow-up must be identified as part of the claims process with the appropriate documentation and reason. The four criteria for the MedsCheck Follow-up result from:

Note: a MedsCheck that is conducted for the purpose of drug monitoring (for example warfarin INR (international normalized ratio) levels) is not considered within the program criteria of any MedsCheck.

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A patient happens to mention to the pharmacy technician that she will be entering the hospital for surgery next month. What action should the pharmacy initiate regarding MedsCheck?

When pharmacy staff is alerted to patients undergoing planned hospital admissions, they should schedule a MedsCheck with the patient and / or review when the last MedsCheck was conducted to ensure there is a current MedsCheck for the patient.

Patient’s entering the hospital for a planned admission should be reminded of the importance of carrying the MedsCheck medication review list with them to the hospital and be made aware that medications may change upon discharge. The patient should be enlightened on either providing the hospital admitting staff with the MedsCheck or referring them to the pharmacy for the copy.

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The area hospital has contacted the pharmacy for a patient’s MedsCheck due to a scheduled hospital visit. As a pharmacist, am I obligated to provide the MedsCheck medication review list to the hospital and do I require the patient’s consent?

Community pharmacists should provide the hospital staff with a current MedsCheck medication review list. It is considered implied consent for a health information custodian to request the original MedsCheck from the pharmacist. It is advisable that the pharmacist ensures that the patient is aware that the medication review is being forwarded to the other party and that this action is documented on the pharmacy copy.

The MedsCheck is a complete medication review that includes current prescription medications, over the counter and herbal medicines. If the pharmacist observes that the MedsCheck on file is no longer current, it is not recommended to forward it to the hospital as being the current medication list. Instead a current patient profile can be sent. If time permits, a MedsCheck Follow-Up may be conducted with the patient and the subsequent medication list forwarded to the hospital with the date of the MedsCheck indicated; following this process, the pharmacist may claim for reimbursement of the MedsCheck Follow-Up.

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For More Information

To learn more about MedsCheck talk to your Pharmacist or contact ServiceOntario, INFOline 1-866-255-6701 or TTY 1-800-387-5559