Wendy Wolfson is a contributing author for Medical Economics.
Your primary care practice team may not be as efficient as it could be, particularly for patients with complex, chronic health needs
Primary care practices can become more efficient by training “dream teams” of various professionals such as physician assistants and nurses to extend physician capacity. “There are a lot of routine needs that don’t necessarily require a physician,” says Edward Salsberg, MPH, a research instructor at The George Washington School of Nursing.
Salsberg says the needs of the chronically ill and elderly will continue to stress the healthcare system and go beyond what can be provided by physicians.
“Bringing in an inter-professional team structure can allow physicians to practice at what they do best,” says Janis M. Orlowski, MD, MACP, chief healthcare officer, Association of American Medical Colleges (AAMC).
Integrating professionals such as nutritionists, occupational therapists and social workers on the team can improve patients’ health and ability to function and can enable more efficient delivery of preventive care that helps keep patients healthy and out of the hospital.
Investing in shared electronic health records and data analytics can help segment patients, assign resources and design customer experiences that enable primary care practices to maintain continuous engagement at various care touch points, rather than interacting with patients on sporadic visits.
Technology can help practices leverage team members more effectively, extend the primary physician’s “virtual” team and foster more seamless interactions with specialists.
Orlowski cites a $7 million AAMC initiative sponsored by the Center for Medicaid & Medicare Innovation (CMMI) for electronic health record-based consults and referrals that connect primary care physicians to specialists, who can view patients’ medical records, specify tests, triage a patient visit or quickly reply to physician questions.
By streamlining workflow, this program enables primary care doctors to care for a larger number of complex patients and make referrals to specialists when they are truly needed.
A team structure can help operationally in other ways. According to PwC Health Research, a major source of inefficiency in primary care practices is that physicians have to spend more than a third of their time and significant resources on administration.
Andy Lazris, MD, a Maryland-based solo primary care physician, has successfully built and trained team of nurse practitioners who care for a patient panel of 2,000 patients, 75% of whom are geriatric patients with complex medical needs.
So Lazris joined an accountable care organization, which provides his practice with administrative guidance and additional resources.
“That’s a great feeling after having to go at this alone for so many years,” Lazris says.