Medical Office Inefficiency: The Silent Enemy of Patient Care
Posted by Janna Vienca Cañezal
Efficiency is the crown jewel in most industries, businesses spending millions of dollars to constantly improve. While the healthcare industry is one of the largest service industries in the US, though, it has the highest inefficiency rate, with billions of dollars wasted due to inefficient processes.
Inefficiencies in the Healthcare Industry
Efficiency is the relation between the resources consumed and either intermediate outputs (patient waiting time) or final health outcomes (treatment of health conditions, lives saved, and life-years gained). Although many studies and plenty of improvements have been made to address clinical inefficiency, healthcare industry expenditures still outweigh overall positive patient outcomes. So, where does the disconnect come from? The answer is easy to find but hard to rectify: practices give too little attention to the other side of the practice — the office.
According to a study from the American Academy of Family Physicians, poor human resource management is one of the leading sources of inefficiency. Examples include an unbalanced workload between employees, difficulty adjusting when anyone goes on leave, and poor communication between staff.
The front desk is a bustling center of activity with a whole range tasks needed before checking in or checking out a patient. Poor check-in workflow and unclear delegation, or redundancy of tasks within the check-in process, can cause neglect of the front desk staff's other primary responsibility — taking patient calls.
That leads to long hold times, low rates of return calls, and high call abandonment. Poor call management not only decreases your patient’s satisfaction but also affects your staff’s productivity too. The same study found that having the right number of staff with clearly defined roles was an essential element of having an efficient office.
Unfortunately, these problems aren't new. Back in 2009, Tricia Hern, MD, medical director of Community Group Family Medicine and an award-winning doctor and educator, published a study to improve the efficient and effective delivery of patient-centered care. Hern identified that office efficiency is one of the key component. Complex schedules and transitions in provider assignments create a problem for continuity of patient care. For example, one of the clinics in the study had all part-time providers. That limited the time when the physician and the patient have the same availability for office visits.
Furthermore, when a staff member received phone messages from patients, they were often unclear where the primary physician might be or who is the designated physician in case the primary physician was on vacation. Most of the time, the designated physician is unfamiliar with the patient and does not have access to the patient’s chart. Time-sensitive messages go unanswered if the primary provider is not available. All of these lead to a delay in needed health information to treat a patient. If that sounds familiar, it's because the same case applies to far too many practices today, more than a decade later.
Worst of all, we are feeling the effects more than ever. Estimates from the Association of American Medical Colleges show that there could be a shortage of about 21,000 to 55,000 primary care providers by 2023. With the increasing demand for healthcare providers to fight the ongoing pandemic, that challenge might be even more difficult to overcome. However, Harvard Business Review published an article arguing that the problem with US healthcare is not actually a shortage of doctors, but rather the inefficient use of physician time.
HBR suggests that about 30% of physicians’ time is spent on documentation and other compliance-related activities, much of which can be delegated to NPs and PAs. This leads to a decrease in patient volume and loss of potential revenue.
Technology Can Play A Role
Inefficiencies in a medical office affect your staff’s productivity and your clinic’s financials, leading to a decline in quality patient care. At the root of every single one of these inefficiencies is an improper allocation of resources. The healthcare industry’s greatest strength is the people who provide care for patients in their times of need. With that in mind, it’s worth looking at how managing that resource affects inefficiencies in delivering care.
Assessing current roles and establishing boundaries between responsibilities can be the first step in making a change. Empowering nurses and MAs to play an active role in care lets the physician focus more on tasks that require their level of expertise. Building a care team composed of other clinicians like NPs and PAs ensures continuity of care.
And finally, employing technology to automate delegation and scheduling processes can be one less thing that practice administrators have to think about. It’s worth reaching out to your EHR partner for recommendations and to see what tools they have in place to address those concerns.