Transcript comp1_unit3e_lecture_slides

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)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
2
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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
3
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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
4
The Patient Experience
• 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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
5
The Patient Experience
• 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)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
6
The Patient Experience
• 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%
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
7
The Patient Experience
• 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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
8
The Patient Experience
• 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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
9
The Patient Experience
• 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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
10
The Patient Experience
• The Back Office
– Triage Nurse – takes phone calls, problemsolves 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)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
11
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)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
12
The Patient Experience
• 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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
13
Delivering Healthcare (Part 2)
Summary – Lecture e
• Discussed the role of different healthcare
providers.
• Patient experience includes interdisciplinary
team effort
• May include ancillary providers.
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
14
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
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
15
Delivering Healthcare (Part 2)
References – Lecture e
References
Gottschalk A, Focke SA. Time Spent in Face-to-Face Patient Care and Work Outside the Examination Room. Ann Fam
Med 2005 3: 488-493
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Delivering Healthcare (part 2)
Lecture e
16