The study identified these ways to improve efficiency:
- Teamwork and delegation, because research suggests that staff could perform tasks that consume 15% of the time physicians spend on patient care outside of visits.
- Redesigned work flow that co-locates physicians with the rest of the healthcare team throughout the day and facilitates "real-time" communication, which can save a physician 30 minutes each day.
- Acknowledging the double-edge of technology, including the "time sink" that can be created for physicians entering patient data in electronic medical records, while also seeing efficiencies created by software programs that triage patients and guide treatment decisions and don't require an office visit, which can improve care quality and reduce the burden on physicians' time.
- Re-examining policies ranging from having a computer automatically sign out a user for security reasons, requiring users to sign in recurrently, to limitations in non-clinicians' ability to assist in routine, protocol-driven care.
In a phone interview, Shipman discussed the study and some of the themes that emerged from it. The following is an edited transcript of that conversation.
HLM: Has primary care workflow always been inefficient, or has it gotten worse because of the increased demands and because the practice of medicine has gotten more complicated?
Shipman: It's some of both. There has been an element of inefficiency that hasn't been highly prioritized in medicine. This goes beyond primary care but is certainly relevant for primary care. Because both demographic demands and recognition of the unsustainability of the rising cost of healthcare have become more prominent the focus on where to root out inefficiency becomes more prevalent.