01-03E - Introduction to Healthcare and Public Health in the US - Unit 03 - Delivering Healthcare Part 2 - Lecture E

Introduction to Healthcare and Public Health in the US

Delivering Healthcare (Part 2)

Lecture e

This material (Comp1_Unit3e) was developed by Oregon Health and Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number

IU24OC000015.

Delivering Healthcare (Part 2)Objectives

• Describe the organization of clinical healthcare delivery in the outpatient setting, and the organization of outpatient healthcare (Lectures a-c)

• Describe the organization of ancillary healthcare delivery in the outpatient setting (Lecture d)

• Discuss the role of different healthcare providers, with an emphasis on the delivery of care in an interdisciplinary setting (Lecture e)

2Health IT Workforce Curriculum

Version 3.0/Spring 2012

Introduction to Healthcare and Public Health in the USDelivering Healthcare (part 2)

Lecture e

Organization of Primary Care Clinics

• Organization of primary care clinics usually revolves around two axes

• The provider – physician, nurse practitioner, or physician

assistant• The patient




Lecture e

The Patient Experience

• The Front Office– Receptionist – often the first point of contact

for the patient– Scheduler – makes appointments for patients– Greeter – some larger clinics have personnel

who can help patients find the appropriate areas for their care




Lecture e


• The Front Office– Patient Navigator – helps patients navigate

the complex maze of medical care– Clinic Manager – administrator for the office,

responsible for clinic activities. • May have additional personnel to help administer

the clinic




Lecture e


• The Clinical Team– Medical Assistant – certified healthcare

assistant who performs minor clinical or clerical work

• Usually the first clinical point of contact for patients in outpatient offices

• rooms patients, obtains the vital statistics and chief complaint (in some offices may obtain additional information)




Lecture e


• The Clinical Team– Provider - physicians, nurses, physician

assistants, or nurse practitioners, who address the patient’s clinical issues

• Providers typically have a predetermined schedule of appointments for their day

• However, they don’t spend all their time in direct patient care

• One study suggested face-to-face time for family practice physicians with patients is typically around 55%




Lecture e


• What do physicians do when they are not seeing patients?– Reviewing charts– Fielding telephone calls– Reviewing test results, correspondence– Answering questions from staff about patient care– Consulting with other physicians about patients– Completing forms– Other work




Lecture e


• The patient may also visit with other members of the clinical team– Care management coordinator – helps with

referrals, tests, insurance pre-approvals– Pharmacist – acts as a pharmacological

resource for patients• In some clinics manages medications for chronic

illnesses or dosing protocols for blood thinners such as warfarin




Lecture e


• The Clinical Team– Dietician / Diabetes educator – helps patients

with specific dietary interventions– Social Worker – assists with social issues– Counselor – usually for mental health issues,

also assists with patients’ psychosocial issues• In many communities there is an acute shortage of

mental health services




Lecture e

The Patient Experience• The Back Office

– Triage Nurse – takes phone calls, problem-solves issues for patients, and refers complex issues to the physician

– Back-office Medical Assistants – in some offices Medical Assistants take on multiple roles (telephone triage, referral coordination, point-of-care procedures)




Lecture e

The Patient Experience• The Back Office

– Coders and billers – codes to delineate diagnoses and levels of care are interpreted by billers/coders

– Insurance Specialists / Referral Coordinators – simplify the referrals process for patients

– Housekeeping Services (including disposal of sensitive patient-related information and medical wastes)




Lecture e


• Laboratory and Diagnostic Testing– Patient may meet specialized ancillary staff

such as• radiology and laboratory technicians• nuclear medicine technicians• sonographers

• Other ancillary service providers• physical and occupational therapists• speech therapists• emergency medical technicians and paramedics




Lecture e

Delivering Healthcare (Part 2)Summary – Lecture e

• Discussed the role of different healthcare providers.

• Patient experience includes interdisciplinary team effort

• May include ancillary providers.




Lecture e

Delivering Healthcare (Part 2)Summary – Lecture e

1. Described the organization of clinical healthcare delivery in the outpatient setting, and the organization of outpatient healthcare

2. Described the organization of ancillary healthcare delivery in the outpatient setting

3. Discussed the role of different healthcare providers, with an emphasis on the delivery of care in an interdisciplinary setting




Lecture e

Delivering Healthcare (Part 2)References – Lecture e

ReferencesGottschalk A, Focke SA. Time Spent in Face-to-Face Patient Care and Work Outside the Examination Room. Ann Fam

Med 2005 3: 488-493




Lecture e

Documents

01-03E - Introduction to Healthcare and Public Health in the US - Unit 03 - Delivering Healthcare Part 2 - Lecture E