Sprandio says he tackled the process of standardizing workflows by prioritizing what was most important.
The telephone triage system for managing predictable and common symptoms was a work in progress for 15 years. Now, it is centralized in one practice location, and has netted some real success in reducing ER visits by helping patients manage symptoms at home. In 2006, 77.2% of all symptom related calls were managed at home. By 2012, that percentage grew to 85%, with only 4.1% getting referred to the ER.
Part of the success of the triage system is due to engaging patients in their care early and often. At Sprandio's practice, it begins with telling the patient on the first visit that CMOH is always the first point of contact.
"If they think they might have a symptom, whether it's on a potential symptom list or not, they call us," he says. "This is said multiple times by three sets of people: the orientation folks, the nursing staff, and the physicians."
CMOH also orders every test so patients do not have to worry about scheduling or tracking it to completion.