6 Reasons Primary Care Providers Should Revamp Inefficient Program Design
For most patients, primary care is still the gateway to the healthcare system. Whether they’re family medicine, internal medicine, pediatrics, or geriatrics specialists, the role of primary care clinicians is critical — they deliver preventive care, alert patients who need to see a specialist, and provide long-term chronic Care Management. So it’s critical that they leverage efficient program design in order to optimize their Care Management and promote wellness for the primary care patients who need them most.
According to new data published on June 26 by the Association of American Medical Colleges (AAMC), the U.S. could see an estimated shortage of between 21,400 and 55,200 primary care physicians by 2033. That’s why the federal government is providing support for these preventive care providers to help narrow the pay gap between them and specialty healthcare providers.
Most primary care physicians are solo practitioners or work in practices with 10 or fewer family medicine physicians — so in addition to being a principal healthcare provider, they’re the head of a small business facing the same challenges that other small business owners face, such as managing revenue and productivity. Revamping inefficient program design can help primary care providers alleviate these challenges, providing comprehensive care for chronic diseases. When patients get more checkups in a doctor’s office, they can help prevent emergency room visits.
How primary care affects the entire healthcare industry
According to Grandview Research, the primary care market was valued at $283 billion in 2019 and is expected to grow 4.7% annually from 2020 to 2027. Primary care providers are in demand to strengthen regional and national primary care because they can help curb hospitalization rates and pharmaceutical prescriptions while managing chronic conditions for patients who are becoming more engaged in the care.
Primary care physicians who practice internal medicine, family medicine, pediatrics, and geriatrics excel at early detection of chronic conditions and can provide immediate treatment or quick specialist referrals in the primary care setting. Patients also rely on their Primary Care team to teach them about preventive care and general wellness.
Ongoing healthcare coverage reforms are already reenergizing the primary care infrastructure and revamping the primary care payment and delivery model. The comprehensive care provided and long-term relationships promoted by primary care physicians (PCPs) improve the quality and consistency of healthcare to achieve better patient outcomes.
Primary care doctors are credited for lowering overall Medicare spending, which enhances the entire healthcare system. Researchers and legislators are realizing that it is the primary care provider who can promote the current value-based healthcare payment model, so they continually propose initiatives to empower primary care physicians, nurse practitioners, and physician assistants to spend more time with patients — not with their computers.
The Centers for Medicare & Medicaid Services (CMS) created the Comprehensive Primary Care Plus (CPC+) and Primary Care First models — innovative payment models that enhance primary care delivery. Now, Primary Care teams can prioritize provider-patient relationships, chronic disease management, preventive care, and ultimately, patient outcomes.
Types of primary care providers and their program design needs
A study published by Brookings.edu found that access to primary care is associated with improved value and better outcomes than specialist-based care. Primary care providers are segmented into:
- Family physician and geriatrics: These primary care providers make up the front line of healthcare for patients with all kinds of social determinants in both urban and rural America. One in every five office visits is made to a family physician — that’s 192 million visits per year.
- General practice (GP): These primary care providers serve similar patients as family physicians, but they are not trained in other subspecialties. All primary care providers can treat and manage chronic medical conditions and know which specialists to refer patients to when necessary.
- General internal medicine (IM): These primary care providers make up 34.5% of the primary care pool, and they help curb hospital healthcare and emergency room costs by monitoring for and detecting early-stage dysfunctions.
- General pediatrics: These primary care providers diagnose, treat, and help prevent diseases and injuries in children while referring patients to specialists only when needed. There were 27,550 general pediatricians in the U.S. in 2020.
What program design needs do all of these primary care providers share? Digital Healthcare Research, which produces health IT planning, design, and implementation toolkits for Primary Care teams, found that the key to the successful implementation of primary care health IT is to recognize its impact on the workflows of both clinicians and administrators. Once implemented, efficient health IT can provide information that helps your Primary Care team reorganize and streamline your workflow so you can spend more time with patients. What risks does inefficient program design pose for Primary Care teams?
Plans and program design affect everything from patient progress and retention to the cost-effectiveness of Care teams. If your new program design is inefficient, your Care teams will spend more time on administrative tasks, less time fostering patient relationships, and less time helping patients achieve program goals. Patients may slip through the cracks, lost in a mess of data as primary care managers jump from an email to a spreadsheet to a CRM to try to keep track of patients.
Poor program design creates the following risks for both patients and Care teams:
While Primary Care teams have benefited tremendously from digital health programs, the rise of health tech and telehealth has introduced a new problem — alert fatigue. Patients and staff don’t necessarily need an alert for every program element — only those that directly affect the patient’s progress. These overused alerts result in
Primary Care teams becoming desensitized to their warning signals, making these tools virtually useless.
Primary care plans and programs can be designed to trigger alerts only when clinicians need to take action based on care plan objectives. Programs that alert care managers to every little change can ultimately frustrate clinicians and negatively impact patient outcomes. By using alerts sparingly, primary care providers will know when they should take immediate action on behalf of their patients.
Although data is critical for hands-on primary care providers who must communicate with patients regularly, too much data can impede care when it’s irrelevant or inappropriate. As studies published in The Hospitalist have demonstrated, the detailed ongoing data that digital health tools allow Primary Care teams to collect from patients’ daily lives can be overwhelming and doesn’t always translate into improved patient conditions.
Researchers have found that increased data-gathering capabilities can impede evidence-based practice. Unless Primary Care teams have a way to filter out unnecessary data, primary care clinicians and administrators will continue to find themselves overloaded with information. This overload can result in primary care managers losing track of data prioritization and overlooking information that’s critical for the patient’s care.
In their program development phase, Primary Care teams would define what data they need so they can customize data collection. By selectively gathering data, primary care managers put only useful, actionable information at their fingertips. They save time when they won’t have to manually sort through loads of information to find the patient data they need to act on.
Lack of automation
Care Management tools that don’t allow for automation can decrease ROI. If primary care managers have to manually complete every task and remember which patient they need to interact with and what channel to use, they’ll inevitably lose sight of patients who need intervention and engagement.
Primary care managers are more likely to execute successful care plans when they don’t spend time on activities that could be automated. Program designers should automate repetitive processes and tasks. For example, primary care managers can send patients automated survey messages each week to monitor biometrics or pain levels. Then, when a patient takes action, they can send automated texts about next steps in their care journey.
Primary care managers shouldn’t be spending the majority of their day doing manual tasks. They need time to interact with patients and support health journeys. Often, they spend more time than necessary on administrative tasks. Usually, that’s because they’re relying on disparate tools like spreadsheets, emails, phone calls, and CRM or EHR systems that have not been integrated.
When Primary Care teams implement health tech programs, they should integrate all their tools so care managers only need to use one system while all other tools get updated in real-time. This will prevent wasting critical resources like data-gathering capabilities, time, and clinician labor — all of which should be channeled into critical cases and high-touch patients who actively seek interaction and coaching for various reasons. Expending primary care resources efficiently means segmenting patients based on need, health education level, condition severity, and self-care ability.
Interactions with Primary Care teams that are too long or too frequent can overwhelm a patient — instead of feeling supported, they may end up feeling more distant from their care team. When primary care managers follow ambitious coaching call agendas, patients may get very little opportunity to express how they’re feeling and explain what they’re already doing. This person-to-person connection is vital for keeping primary patients engaged and motivated in their wellness goals.
Primary Care teams should plan the right amount of interactions based on a patient’s behavior. For instance, patients may not be adhering to the care plan that could benefit from a reminder or nudge. Instead of overwhelming a patient with information, primary care clinicians should leave time during coaching calls for opinions and a determination of which self-care strategy steps have already been taken.
Another risk of inefficient primary Care Management program design is that it can lead Primary Care teams to focus on the wrong patients at the wrong time. For instance, if health tech tools don’t help teams pinpoint patients who need the most support, care managers may end up scheduling calls or interactions with patients who don’t need immediate assistance and ignore those who do.
To prevent unnecessary calls, efficient Primary Care teams leverage clinically proven assessments to monitor the patient’s health status. For example, if a set of patients indicates that their pain has improved, the care manager can correctly conclude that the patients don’t require immediate intervention and put them on a “check-in” list for a later call.
Standardize primary care programs for more efficient workflows
As Primary Care teams standardize their programs, they’ll increase efficiency and create consistent quality. Teams can lower the likelihood of negative experiences among patients, giving them confidence and trust in each touchpoint of their care journey.
For primary care administrators, standardization makes it easier to onboard additional Care team members. This means no more standard operating procedure binders and sticky notes. New members can get up to speed with a platform that guides them swiftly through training and standard procedures.
This is what a workflow platform designed specifically for Care Management is geared to do: streamline processes so Primary Care teams can monitor more patients — more efficiently and more profitably. To learn why Welkin is the Care Management program primary care providers prefer, read this blog post.