By Joe Benardello, co-founder, chief strategy and marketing officer, IKS Health.
Joe Benardello
Ambulatory care organizations throughout the United States are facing a new reality in the wake of the COVID-19 pandemic. Practice managers must face declining visit volumes, up to 70 percent in many instances, while simultaneously predicting and planning for pent up demand.
More than half of primary care organizations have had to furlough a substantial percentage of their staff and are posing the question of whether or not those employees will be willing or able to return if and when there is a need. With more questions than answers, how do practice managers make strategic decisions for the immediate and long-term health and stability of their organizations? Here are four considerations for leaders in this position.
Identify Where Work Must Happen and Contract for Variable Cost Support
By asking ourselves, what is that work that only doctors can do, ask the same of nurses, and ask the same of front office teams, we can streamline our organizational efficiencies. By job function, identifying which critical tasks each role must complete then enables us to look at where these jobs best sit by both job title and location.
From there, when work is not tied to a specific space, how do you keep the cost as low as possible and make that cost variable while ensuring business continuity and increased performance. Now that organizations have had to embrace a wider work from home policy, can you reduce hard costs like rent and utilities in administrative offices by retaining a remote team or vendor partner.
This can also enable you to variablize your overhead as you can more quickly scale up and down in response to the predicted waves or economic contractions that may occur in the months ahead. For organizations that have already downsized, finding a partner might allow you to reduce cost without bringing staff back on. This allows you to ensure the same standard of care while finding other avenues you can potentially reduce costs in the immediate crisis and permanently as visit volumes resume.
By Shane Peng, MD, chief clinical services and innovations Officer, IKS Health.
Shane Peng, MD
“Not enough time with my provider” or “my doctor isn’t listening to me” are among the top five complaints of today’s patients—and those frustrations haven’t changed much over time. Providers feel these pressures more than ever as they are pushed to provide quality care and patient engagement for less cost, while adding to their clinical documentation requirements with less time to do it.
These and other demands have driven providers to find more streamlined, digital solutions to help them save time, while government regulations (MIPS) and health plan providers have made mandates further increasing clinical documentation and reporting requirements.
These factors have led to the challenges of the last decade as stakeholders attempt to find ways to ease charting and administrative tasks during the patient appointment and unlock physician time. The federal government and commercial payers even offered mandates to encourage providers to onboard new technology aimed at optimizing performance.
Unfortunately, these technologies have not had the effect everyone had hoped for, and in fact, have sometimes amplified physician burdens rather than reducing them. Charting in an EHR can sometimes be time-consuming, difficult, and distracting, particularly when tackled during the constraints of the visit. This has led to physician frustration and stress, and worse, errors, as time pressures mount and they are asked to speed documentation while maintaining accuracy and making the appointment more patient-centered.
To lessen the strain, many providers opt to complete documentation after the appointment, often after normal business hours. However, this can quickly burnout physicians as they work a full day seeing patients and then spend their free time finishing up charts. Most physicians report an additional two hours of documentation time per work day. This can unfortunately also lead to more mistakes because the physician is documenting based on the memory of the encounter, which is inherently flawed in terms of accuracy and comprehensiveness.
It’s clear: “The way we’ve always done it” isn’t working
Although organizations appreciate the need to free physician time and smooth the documentation process, they frequently struggle to determine the best ways to realize change. It can be tempting to fall back on traditional methods like ramping up provider training or tweaking the EHR adding customized templates to hopefully streamline workflow.
However, organizations are beginning to see that these conventional tactics aren’t overly effective, and they need to approach the problem from a different angle. Entities must find means to remove the burden from physicians while still ensuring precise and thorough documentation that supports better patient care, stronger quality reporting and tighter reimbursement.
