Rethinking primary care visits: how much can be eliminated, delegated or performed outside of the face-to-face visit?

Journal of Evaluation in Clinical Practice
Mary PelakSteven C Marcus

Abstract

Office visits represent the core component of primary care practice, but little is known about what percentage of primary care provider (PCP) visit time could be suitable for reassignment to another medical home team member or to a non-face-to-face modality (e.g. secure messaging) in order to optimize face-to-face PCP visit time. We videotaped 121 PCP office visits at four Veterans Health Administration Medical Centers and divided visits into discrete activity segments. Two physicians reviewed each visit recording and provided independent clinical judgments regarding which segments might be suitable for reassignment. We examined the activity category distribution of visit time rated as needing face-to-face time with a PCP. Reviewers judged 53% of the 5398 minutes of rated visit time as suitable for reassignment to another team member or modality. The percentage of time rated as needing face-to-face PCP care varied greatly by activity category, from a high of 73.9% (for examining patients) to a low of 16.2% (for medication review). Rater agreement regarding tasks' suitability for reassignment varied across activity categories. These data offer an example of how face-to-face PCP visit time might be optimized as practices seek to ...Continue Reading

References

Apr 1, 1992·JAMA : the Journal of the American Medical Association·J WassonH G Welch
May 10, 2006·Archives of Internal Medicine·Anthony G StaresinicDenise Walbrandt Pigarelli
Apr 3, 2007·Implementation Science : IS·Sylvia J HysongFrank I Moore
May 5, 2010·Health Affairs·David Margolius, Thomas Bodenheimer
May 5, 2010·Health Affairs·Benjamin J Chesluk, Eric S Holmboe
Jul 8, 2010·Health Affairs·Yi Yvonne ZhouTerhilda Garrido
Sep 8, 2011·BMJ Quality & Safety·Tosha B WetterneckBen-Tzion Karsh
Oct 19, 2011·Journal of General Internal Medicine·John C FortneyPeter J Kaboli
Mar 14, 2012·Annals of Family Medicine·George W SabaThomas Bodenheimer
Apr 24, 2012·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Josie SolomonKarl Atkin
Jul 7, 2012·Patient Education and Counseling·Sherri L LaVelaFrances M Weaver
Sep 12, 2012·Annals of Family Medicine·Justin AltschulerKevin Grumbach
Feb 15, 2013·Population Health Management·Debora Goetz GoldbergMary C Carver
Nov 6, 2013·Health Affairs·Scott A Shipman, Christine A Sinsky

❮ Previous
Next ❯

Citations

Sep 19, 2015·Healthcare : the Journal of Delivery Science and Innovation·Samuel T EdwardsElizabeth M Yano
Jan 9, 2018·Primary Health Care Research & Development·Hemalatha MuruganChristopher J Wong
Oct 20, 2020·The Journal of Nursing Administration·Bonnie J WakefieldGreg L Stewart
Aug 24, 2021·Journal of Medical Internet Research·Dawn Heisey-GroveJonathan P DeShazo

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

JEMS : a Journal of Emergency Medical Services
Jon Studnek, Antonio R Fernandez
Continuum : an Interdisciplinary Journal on Continuity of Care
M J Silberstein
Journal of the American Board of Family Medicine : JABFM
Brian ArndtJessica Schumacher
International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
Christine E BredfeldtMark H Snyder
© 2022 Meta ULC. All rights reserved