In 2017, the flagship multispecialty practice of Oregon Medical Group, moved into its new digs—a 46,000 square foot redesigned medical office building. Practice leaders and the 30-odd clinicians in six different specialties were committed to a coordinated patient experience. They wanted to ensure that patients could move smoothly between sequential visits with different care providers—on the same day. To this end, the group invested in a centralized check-in process. However, the spacious physical plant was a significant obstacle to a smooth, efficient patient flow, even with centralized check-in.
I spoke with two leaders of the group, Chief Executive Officer Karen Weiner, MD, MMM, and Chief Operating Officer Eve Riley, MSN, MHA, about the innovative solution the practice is using to address this challenge: self-rooming using real-time location system (RTLS) technology.
At a recent conference I attended, Christine Sinsky, MD, Vice President of Professional Satisfaction at the American Medical Association, presented data on various time savers that physician practices have tested to streamline clinical processes.
One example she described was pre-visit lab testing. She asserted that the strategy saves time and money. It sounded intriguing. I’ve seen how cluttered processes and time-consuming workarounds can really make you frazzled and sap the joy out of patient care.
As I listened to her presentation, I found myself wondering, “How does it actually work? Does it involve additional needle sticks? How do they get labs done fast enough for the results to be ready at exam time? Do they hold tubes of blood for add-on orders?”
For years I wondered why despite being a confirmed urbanite, I love camping. Then I realized that camping gives me full permission to improvise—to make creative use of the limited materials I have to get the job done. Hence, shirt tails are fair game for wiping coffee grounds out of measuring spoons.
Similarly, I am inspired by people and groups that use the resources we have at our disposal in health care in creative new ways. Like the first explorers, these folks are testing approaches to provide care that are more effective than the status quo. Given the escalating health care costs, we need to be looking for ways to make the available financial resources work better for us. And, studies have shown that health care delivery includes a lot of wasted time, resources, and supplies, due in part to use of higher-priced services with no health benefits over less-expensive alternatives.
At a recent meeting on patient safety, I heard about a novel way of using a previously untapped resource—emergency medical technicians (EMTs), those courageous first responders to 911 calls. I followed up with Matt Zavadsky, MS-HSA, NREMT, who is the chief strategic integration officer at MedStar Mobile Healthcare, which provides emergency medical services (EMS) in the Fort Worth, Texas area, to learn more about it. Here’s what he told me.
For decades EMS units have been paid only to respond to emergency calls and transport people to the hospital. If they were to transport a person who needed less intense care to a lower acuity setting, like a walk in center or a clinic, they would not be paid—representing overuse of higher-priced services. In addition, EMTs, especially those based in fire departments, often spend a substantial portion of their shift waiting for emergency calls—representing underutilized human resources.