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Three Keys to Improved Medical Practice Workflow Redesign

New consumer-oriented service delivery sites such as retail clinics and virtual visits are popping up to fill voids in access to care. In order to successfully compete in the future, medical groups must evaluate the way they currently operate with a critical focus on managing patient access through the promotion of consumer-oriented services and efficient workflows. One way of competing in this new market is to increase access without adding locations or providers by improving the efficiency of existing locations and providers. Redesigned workflows place the patient at the center of the care model, with the goal of improving patient engagement and access to care. This results in a better patient experience and improved clinical outcomes at reduced cost.

1. Identify Care Model and Care Team

One of the key attributes in workflow redesign is to identify the care model and care team needed to ensure that providers and staff are practicing at the top of their license or skill set. This might mean transferring work from providers to clinical staff or from clinical staff to front office staff. It also entails identifying the most valuable use of all staff time. This may be achieved through effective use of technology while engaging patients through the use of patient portals, email, text messaging, and home monitoring.

2. Utilize Process Flow Mapping

Another attribute is to utilize process flow mapping to create a picture of the current-state workflows and identify areas of potential waste or bottlenecks. Once current-state workflows are mapped, utilize a team of providers and staff to create a vision for the future (or ideal state). Work as a team to eliminate as much waste as possible to move towards the future state. Establish performance targets for the ideal state and measure baseline performance to gauge progress. Conduct cycle time studies as part of the redesign effort as an effective measure of wait time (value-added vs. non-value added time). Test the redesign efforts and compare results to established targets and continue to modify until goals are achieved.

3. Optimize Technology to Meet Clinical Care Needs

Finally, ensure providers and staff are effectively trained on the practice management (“PM”) and electronic health record (“EHR”) systems and that the technology is fully optimized to meet clinical care needs. Spend time shadowing providers to evaluate how the system is used in practice and what changes can be easily made to better accommodate workflows. Make sure a local resource may be contacted with questions or advice as well as dedicated site-specific subject matter experts (“SMEs”) for immediate troubleshooting. Create a continuous learning environment, through the use of webinars, on-site educational sessions, and shadowing to increase provider/staff adoption of the technology, and reduce rework or general frustration due to a lack of training or appropriate optimization of the system.

Workflow redesign efforts, if successfully implemented, can significantly decrease non-value added time by allowing for increased time with patients and increased access to care. Improving operational efficiencies and optimizing electronic systems also increases provider and staff satisfaction thereby supporting a patient-centered environment.

Medical Practice Workflow Redesign, The Camden Group,

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