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Expanding primary care capacity by reducing inefficiency
Date:11/11/2013

-40 million more primary care visits available each year without a single additional provider.

Shipman, through his association with the Association of American Medical Colleges, and Sinsky, through hers with the American Board of Internal Medicine Foundation, suggest solutions to the "remarkable inefficiency" in primary care. The authors conducted nationwide site visits, contacted leaders of innovative primary care practices across the country and reviewed the literature.

The authors highlight several opportunities to improve efficiency in primary care through examples currently in use, albeit in a minority of settings:

  • Teamwork Conservatively, research suggests that other staff members could perform tasks that consume 15 percent of the time physicians spend on patient care outside of visits. Enlisting health coaches, medical assistants or nurses to aid with documentation of office visits enables more time for physicians interact with patients, rather than keyboards and computer monitors. These team members could also review care plans, and provide preventive counseling and other standardized aspects of care.

  • Redesigned work flow Redesigned work spaces that co-locate physicians with the rest of the health care team throughout the day facilitates "real time" communication, and can save a physician 30 minutes each day. Evidence in some systems has shown that simple reconfigurations, such as putting a printer in every examination room or placing large monitors in work areas to continuously show patient visit status, can save 20 or minutes daily for a physician.

  • Technology While electronic records increase efficiency in information retrieval, it has increased inefficiencies in data entry, such as visit notes, billing information, test results. The authors quantify the time wasted daily due to this interface "through which all care must pass." On the positive side, software programs that triage pat
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Contact: Annmarie Christensen
annmarie.christensen@dartmouth.edu
603-653-0897
Dartmouth-Hitchcock Medical Center
Source:Eurekalert

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