Streamlining Patient Visits

HEALTHCARE DELIVERY has become increasingly complex in the past couple of decades. According to Metaspire Consulting, a management consulting and coaching firm that offers process improvement consulting and training for companies in healthcare, “In the United States, the healthcare system is troubled by skyrocketing costs. In turn, the lack of affordability threatens the health, wellness and productivity for far too many.”¹ The need, then, to deliver an efficient and effective healthcare delivery process is more important than ever. Following are some methods to help streamline patient visits.

Map the Patient Process

Process mapping, also known as patient journey mapping, outlines all of the patient touch points during each stage of the care journey. Practice Fusion, a cloud-based ambulatory electronic health records (EHR) platform in the U.S., suggests three ways to improve patient flow:²

1) Establish practice buy-in. Patient flow is a group staff effort. Therefore, to make staff understand the importance of improving patient flow, as well as the benefits for patients and staff such as getting home on time and generating higher income, need to be shared.

2) Chart flow. First, the bottlenecks to the patient care process need to be identified, and their underlying causes need to be understood. Flow mapping starts this process. Ideally, volunteers will visit the office as patients who take detailed notes about their appointments. The true purpose of these visits isn’t shared with staff. Then, how much time each segment of the visit takes should be measured and charted, paying special attention to waiting times. The total time it takes from arrival to departure should be recorded, and these times should continue to be tracked to better understand the dynamics of the practice and identify the largest opportunities to improve patient flow.

3) Address bottlenecks. Once bottlenecks are identified, adjustments to the processes can be made. Practice Fusion has found the sources of most common bottlenecks are visit planning and office architecture. For instance, in many cases, critical tests or required documentation may be missing after a patient has already arrived for an appointment. To prevent this, it should be determined that all necessary information is available in patient charts the day prior to the appointment and, failing this, the appointment should be rescheduled. Providers and support staff can also review their schedules together to identify how to make a day run more smoothly. In addition, office layout is critical for optimal patient flow. For instance, the receptionist should be near the entrance and should be able to view the entire room; exam rooms should be in close proximity to the waiting area; patient traffic flow should move sequentially throughout a visit; and extra exam rooms should be available to handle patients during high demand.

The goal of process mapping is to deliver the same level of medical care to every patient, every time. Ultimately, mapping the patient journey accomplishes three things: improved outcomes for each patient, enhanced patient experience and reduced costs.

Improve Scheduling

The appointment process can also be streamlined to help the office run efficiently, manage a steady flow of patients and increase the number of patients seen in a day. Spectrio, a company that helps create positive, memorable and informative patient experiences, suggests six steps to refine the process:³

1) Offer multiple scheduling options. These can include online scheduling via the provider’s website or patient portals, as well as in-office appointment kiosks. Yet, even with the rise in digital platforms, offices must still manage incoming calls. And, if multiple appointments need to be scheduled, they should be arranged during a single call.

2) Send scheduling and intake emails. Help patients to remember appointments by sending welcome and reminder emails three to five days before and on the day of the appointment. These emails should detail copies of the forms and paperwork patients will need to have upon arrival. Also, patients need to be advised about what they need to bring to the appointment such as insurance cards, health records, etc.

3) Create clear scheduling policies. Scheduling policies allow the office to stick to appointment times and avoid gaps. Policies should include penalties for late arrivals and last-minute cancellations. And, patients should be told about the policies when they schedule and via appointment reminders.

4) Keep staff on the same page. One or two people should be trained to act as primary schedulers, and a standardized scheduling system that includes policies for appointment durations, provider availability and emergency appointment requests should be used. It can also help to use digital signage to keep track of patients’ status (waiting, in exam room, with doctor, etc.).

5) Minimize waiting times. Appointments should not be double-booked, they should be scheduled according to anticipated appointment time, and time should be left for emergency appointments.

6) Make it easier on providers. Overbooking and overworking providers can be avoided by grouping similar patients or appointment times, scheduling downtime and factoring in providers’ out-of-office time.

Leverage Technology

Technology can enable physicians to sit down with patients during an office visit to concentrate on their specific issues and needs, instead of focusing on using technology. While there are many ways to use technology, following are five ideas offered by IntakeQ, a company that emphasizes making a healthcare organization’s intake process as smooth as possible:⁴

1) Adopt an EHR system. EHRs, available at every computer station, rid the office of paper, filing cabinets and time spent filing, sorting and searching for documents.

2) Install a terminal in a convenient area of the office. The terminal should have access to EHRs and a telephone so staff don’t have to walk to offices. Alternatively, providers can utilize a tablet with access to the practice’s electronic recordkeeping software so they can access and input information on the go.

3) Standardize and make employee processes available on a computer. For example, if an exam room is supposed to be set up in a specific way, a checklist can be created for the team to follow and electronically initial when the job has been completed.

4) Send patient appointment reminders automatically with software. Reminders can be sent by email, text message or prerecorded phone calls.

5) Don’t tolerate inadequate devices or outdated software. New tools will require an investment, but they usually quickly pay for themselves in recovered time.

Streamlining Generates a Competitive Advantage

By streamlining patient office visits, physicians are both able to see more patients, which impacts the bottom line, and spend more time with patients, which results in higher quality care. Providers who can demonstrate they care about their patients’ time, convenience and mobility by providing healthcare on patients’ terms will enjoy a competitive advantage over those who don’t.