Getting Out From Under Paperwork
Instead of relying on yourself or staff to make changes, some providers are looking to vendors to help out.
Healthcare providers spend about 40 minutes every workday tracking paperwork and staring at their computers, but there are ways to cut down on this so they can spend more time with patients.
Shari Erickson, vice president of governmental and regulatory affairs for the American College of Physicians in Philadelphia, said staff can be a great help in reducing the burden of paperwork on a physician. One way is through anticipation of visits. By using team huddles to plan for the next day, providers can better be prepared for patients' clinical needs.
Advanced calls are also effective for some offices. Having a staff member call patients before a visit helps everyone on the team be more efficient and prepared. By finding out what patients want out of the visit, practices can reduce the number of “door knob” questions doctors get as they leave the room.
“If you can reach out in advance, some of that documentation can take place then, or you can prepare for what is needed in advance,” she said.
Registered nurses can also take part in paperwork preparation in the initial part of the visit. This can help physicians spend less time at the end of the day doing documentation.
Erickson also recommends allowing the opportunity for innovation among staff. One practice she worked with, for example, had a receptionist who interrupted physicians throughout the day to get signatures that should have already been completed. She was allowed to do a Plan-Do-Study-Act (PDSA) test to create a solution to the problem. A PDSA cycle consists of creating a test, trying it on a small scale, analyzing the results, and either sticking with it or refining based on lessons learned.
“It takes a little practice to learn how to do it, but if you give everyone the authority to do a PDSA … it can really improve efficiencies in the workflows and make documentation get done more efficiently,” she said.
Sourcing it out
Instead of relying on yourself or staff to make changes, some providers are looking to vendors to help out. Some options include things like services that complete tasks like handling release of information requests or medical form completion. These can be helpful, depending upon your patient population, Erickson said.
If many patients are older and need prior authorization for things like motorized scooters or other equipment, outsourcing might be a good idea. “There is a cost associated with this, but it may be offset by the increase of efficiency of other staff,” she said. “Outsourcing some of that probably costs less than having staff do it because you have overhead for them.”
Another option for outsourcing some of the workload is by using scribes, which are akin to paralegals for lawyers. Scribes can look at charts of incoming patients in advance to order tests. They can reach out to patients to make sure they have everything needed for an appointment. A scribe can sit in the room and document patient visits and do follow-ups like scheduling a foot exam for a diabetic patient.
“Across the country physicians are angry and upset and at their wits end,” said Michael Murphy, MD, CEO of ScribeAmerica. “Data is what is driving policy and holding people accountable, but at some point you have to give a little and say patient care is being impacted.”
Murphy said scribes can take over more than 80% of physicians' ancillary duties. The cost of a scribe is approximately $160 for a full day. Urology practices that use his scribes now see 4 to 8 more patients a day because of increased efficiency.
“They can help focus more attention on the clinical side and less on the paperwork,” Murphy said. “The key is to have everyone working at the top of their license or abilities.”