By Dr. Oona Hayes
How can we use data to change the way certain services are delivered?
Whether it’s an office schedule where the next available appointment is a few weeks out or filling out insurance forms late at night, I know the clinicians reading this all experience time pressures in our practices. A common complaint from patients is that we don’t spend enough time with them, and yet we are supposed to be available to all patients promptly. It can be downright dispiriting to rush from one encounter to the next. What would it be like if we could slow down for a moment and win back some of our precious time? We can do this with the help of data.
A 2022 study found it would take almost 27 hours/day for a primary care provider (PCP) to meet the needs of a 2500-patient panel. The authors added up the estimated time to deliver recommended preventive care, acute care, and chronic disease management, as well as time for charting and inbox management. The conclusion was that adding team-based care models, especially for preventive health counselling, reduces the burden on primary care providers (PCPs) to a more manageable 9.3 hours/day.
I felt a twinge of validation as I read this study, as it highlights the herculean tasks of family medicine. The ideal patient medical homes (PMHs) provide the same services as the study: comprehensive care across the lifespan encompassing preventive, acute care and management of chronic conditions. This kind of care improves the health of patients and populations and contains costs. While PCPs can’t provide all this care independently, especially for larger panel sizes, team-based care promises to help. Practice and community-level health data can inform PMH and Primary Care Network team composition.
Practice-level data gleaned from our EMR or HDC Discover application gives us an overview of the strengths and vulnerabilities of our practice population. For example, smoking rates are higher in some areas of the province, increasing the risk of cardiovascular and respiratory diseases and certain cancers, while other regions experience lower smoking rates. This knowledge could influence the prioritization of preventive services in our practices. Systems like HDC generate measures that identify Populations of Focus (PoF), which allows us to take a more macro view of our practice.
We can optimize the quality of care for individual patients with clinical decision support tools activated in many EMR systems by the diagnostic codes on the patient’s problem list. Using these tools, we can off-load part of the cognitive burden of ensuring evidence-based care.
We can use data to change the way certain services are delivered. We have traditionally provided care in one-on-one appointments, but switching to group medical appointments may be a way to gain back time. I’ve heard of family physicians providing group medical visits for patient education around lifestyle and dietary advice for managing metabolic syndrome. Skills for self-management of anxiety and low mood are delivered in a group format with the CBT Skills course. What does your data tell you about where your time is going? Do you have many patients with one condition? If so, can you test out a group medical visit or link to another team member to lighten the load?
HDC Clinical Services Managers can help PCPs wanting to dive into their data in more detail and better understand their practices. If additional time is needed to create a QI project, the Practice Support Program (PSP) coaches can help support a QI Facilitation Cycle.
As frontline providers, we are best suited to determine how to use health data at a local level. We know our practice and the staff who work alongside us. We bring context to the data and insights gleaned from HDC Discover. PCPs reading this may need more time to dig into the data. Are you curious of how data could give you back time?
Contact me at oona.hayes@hdcbc.ca to explore more!