1. 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.

2. 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) 2 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. 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 3 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 –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 4 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 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 5 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 –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) 6 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 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% 7 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 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 8 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 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 9 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 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 10 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 –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) 11 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 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) 12 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. 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 13 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 Discussed the role of different healthcare providers. Patient experience includes interdisciplinary team effort May include ancillary providers. 14 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) 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 15 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. 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 16 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture e