May 8, 2019
Is your office running as efficiently as it could be? Does clinic start on time? Is the staff able to get all of their daily work completed without getting overwhelmed each day?
If you can answer “no” to one or more of those questions, here are four underused workflow techniques that will improve operational efficiency.
1. Patient portal usage.
Practices that encourage patients to complete their paperwork via a patient portal in advance of the appointment experience shorter wait times, higher patient satisfaction and higher physician satisfaction. The main advantage of using a patient portal is enabling patients to complete their health history online, in advance of the appointment. When set-up properly, this frees up substantial staff time because the medical assistant does not have to manually enter health history; the patient already entered it, so it’s simply imported into the chart.
The result of directing patients to provide their information via the portal is an efficiency boon for the clinic. Patients are ready to be seen when they check in. No more waiting for patients to complete their paperwork.
2. Surgery coordinators.
The most successful surgical practices employ dedicated surgery coordinators who schedule surgery, verify benefits, perform preauthorizations, and collect surgery deposits.
All too often, the surgery coordination process is fragmented. The nurse or medical assistant schedules the surgery, someone else obtains the precertification or prior authorization for surgery, someone else verifies benefits, and yet another person collects a surgical deposit for elective cases.
Surgical practices can achieve greater efficiency in the clinic by consolidating the responsibility for surgery scheduling and precertification into a dedicated position, which we typically refer to as surgery coordinator. An effective surgery coordinator can handle 100 to 125 cases per month, which includes precertification and collection of patient responsibility balances, in addition to precertifying and scheduling tests (MRI, CT, etc.). And as a best practice, surgery coordinators support the clinic rather than an individual surgeon.
3. Clinical teams
The old “secretarial” model whereby each surgeon is paired with one clinical assistant is expensive and inefficient unless there is only one surgeon in the department. Cross-training among the clinical staff so they can work with all providers serves the clinic well, especially when a nurse or medical assistant is unavailable, sick, or on vacation.
To make the transition, first determine the number of clinical staff needed to support each provider. In fact, many providers are more productive and can see more patients when assisted by more than one medical assistant or nurse. Here are two models we’ve successfully implemented in multiple practices and organization types. The one that works best for you will depend on practice needs, preferences, and culture.
– Pair a lead nurse or medical assistant with one provider each for the day, and deploy two to three “floaters” (depending on the number of providers in the office) to work with all providers who see patients in the office that day.
– Pool all the clinical assistants available on a given day and have them equitably work with all the providers.
Having a “nurse on call” each day to handle phone calls for all providers allows calls to be answered for the most part by a live person and allows calls to be returned promptly rather than going to voicemail and then answered in between patients or at the end of the day.
The goal is to equally distribute the workload among clinical assistants and support the providers in the most efficient manner. Frequently with the secretarial model, there are workload inequities among staff based on their providers’ productivity and key man dependency with little to no cross-training to cover another surgeon when a staff member is out sick or out on vacation.
4. Prescription benefit manager.
Most electronic health records have the functionality to query the pharmacy network to identify which prescriptions patients have filled. Instead of asking patients bring all their medications with them in a “brown paper bag,” and having medical assistants spend a lot of time keying in the medications list, the medications are ready and available for review.
This speeds the workflow around patient prep in the exam room. The medical assistant or other clinical staff can ask, “Mr. Jones, are you still taking Coumadin?” and mark the medication as active or inactive on the list, saving considerable time.
Collect information about over-the-counter medications and supplements using the patient portal, or manually keyed in by the medical assistants, both of which help reduce the amount of time needed before the patient is ready to see you.