And they’re doing it in a landscape that’s increasingly hostile to them, with one researcher noting, “people in the US are confused about the primary care specialties, skeptical about their claim to deliver comprehensive care, and unable to associate primary care with science or technology.” That’s, of course, on top of “a lack of respect in academic circles, administrative burdens, and inflexible appointment schedules and brief visits that satisfy neither patient nor provider.”
There’s clearly no one perfect way to address all the factors that contribute to the inability of primary care clinicians and their staffs to fully satisfy patients and themselves in the delivery of care. But as systemic concerns – like healthcare models that incentivize sick care versus wellness – get sorted out, there is a clear way to alleviate the burden on these teams and adopt a well-rounded, ‘whole person’ care approach that substantially improves both care and outcomes. It’s with the right technology.
Instead, imagine a world in which the right technology ensures patients are streamlined into the right programs that ensure staff members take care of some of the details, reserving clinician time for when it has the greatest patient impact. This same technology could reduce administrative tasks with simplified data entry and note-taking. With time saved, clinicians can then reinvest some in patients, strengthening the doctor/patient relationship through unhurried listening and personal focus.
Leverage (the entire) team
Technology can help by ensuring a team approach to care management is the norm. That means everyone uses one platform to keep up to speed, on the same page, and allocate tasks to those who are most appropriate to do them. It also means being able to pick up right where another team member left off. Practically, what’s nice about this model is that physicians are only called on to do what only they’re uniquely trained to do, like interpret tests, diagnose and prescribe. Others on the team can counsel, remind, set up new appointments, follow up on specialist appointments, set up check-ins, devise nutrition plans, etc.
Research from UCSF bears this out: “As much as 77 percent of a doctor’s time spent on preventive services, however, could be safely delegated to non clinician care-team members, the UCSF researchers proposed. And another 47 percent of the hours a doctor devotes to patients managing common chronic conditions, they calculated, could be shifted to other personnel — registered nurses, pharmacists, health educators and medical assistants — aided by health information technology and working under standing physician orders.”
Decrease the burden of patient advocacy
Primary care physicians today are responsible for a panel size of patients that is, on average, between 1,200 and 1,900. Although this is an improvement over decades past, it’s still a staggering number of patients that’s probably unreasonable for any one clinician to take on. It’s logical to assume that the patients who have the most urgent needs – or the loudest voices – are the ones who rise to the top of a primary care clinic’s “to do” list. It also means that patients who have questions, concerns, or simply need to keep on top of health conditions must adopt a “squeaky wheel” posture. This forced advocacy can result in feeling tired, overwhelmed, and disheartened by a perceived lack of caring on the part of their PCP (when, in fact, nothing could be further from the truth).
A technology platform that enables care teams to keep in touch in a synchronous, asynchronous, and even automated fashion – with reminders, appointment scheduling, test results, and the like – can make lightweight communication much simpler to achieve on a regular and reassuring cadence. It can also make actually connecting for necessary personal conversations with patients substantially easier (and aligned with their preferences of text, email, phone call or video conference).
Surface information faster
If primary care clinicians and their team members have such large panels of patients, the potential for dropping the ball gets higher. Things naturally get missed. Connections might not get made in the optimal time frame. There’s a greater likelihood that patient outcomes will decline.
But technology can once again step in here. A platform that unites all team members in a single view of the patient can also be tailored to provide real-time alerts – based on the parameters unique to the clinician’s office and designed by the physician herself. The more technology can reliably connect the dots for the team, the less things fall through the cracks. Imagine, for example, being able to fine-tune your technology so that the instant certain test results come in, you can be alerted if the numbers are off. That automatically allows for faster evaluation and response times, which can only help improve patient outcomes.
It’s about surfacing the most important nuggets of what really matters, and reducing the noise so that providers don’t have to spend time looking for information, but rather spending more face to face time with their patient.
More effective data sharing
One time suck is the need to create and share notes with regularity and consistency foremost in mind. Not only that, clinician notes must be high quality to do any good. If they aren’t formatted consistently, comprehensive enough to ensure everyone knows what they need to, and aren’t passed to team members on a predictable cadence, it’s ineffective. Care team members will struggle to find the information they need in a timely way, which introduces unnecessary friction and frustration. Once again, patient outcomes can suffer in that liminal space where the clinician thinks they’ve been clear and the care team members work to decipher their meaning. What’s worse is that many of the traditional EHRs are ostensibly set up to help make this process faster but endless drop-downs and clunky interfaces end up slowing the process down versus speeding it up.
A technology platform that strikes the right balance of enough charting support to be comprehensive and organized can pull valuable double duty. It decreases the burden of charting for the clinician while also guiding information and workflow so it’s instantly understandable by every care team partner. And it can connect EHRs, care management, labs, electronic prescriptions and more, freeing up time from record-keeping and monitoring to spend with actual patients.
Ultimately, technology holds the real promise of alleviating the burden of primary care on multiple fronts – whether it’s separating signal from the noise to surface the right patient information exactly when it’s needed to enabling asynchronous but sincere communication that keeps patients tightly connected and cared for. At a time Boomers and Millennials are aging and requiring more care, when traditional healthcare models seem irretrievably broken, but before new models can be fully adopted, technology is the one advantage PCPs can seize immediately – to help their patients and themselves.
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