THE AMBULATORY ENTERPRISE:

Transcription

1 THE AMBULATORY ENTERPRISE: SEVEN TIPS THAT WILL HELP YOU RUN A SMOOTH CLINIC Robert H. Hopkins, Jr., MD, FACP, FAAP Director, Division of General Internal Medicine

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3 WELCOME TO UAMS!! A M B U L A T O R Y O P E R A T I O N S A R E : S I M P L E B U T C O M P L E X P A T I E N T F O C U S E D B U T C A N B E I M P R O V E D C H A N G E R A T E I S V A R I A B L E

4 #1 KNOW YOUR PEOPLE Medical Director + Department/Division Director Approve clinic sessions Review and approve clinic templates Department/Division Administrator Set up your template with your director/administrator Interface with Clinic/Appt. Center Oversee scheduling in areas where central scheduling is not utilized Access/Appt. Center [UH, VA, ACH: Separate] Communication with these people is critical!!!! Some Departments do not use central access center UH Policies: Insurance; Template formats; Hospital Follow ups

5 #1 KNOW YOUR PEOPLE (CONT D) Clinic Manager: Build and maintain a good relationship Learn the policies already set in place Staffing, Rooms, Clinic metrics E-Billing and Encounter Forms Nurses: Communicate with them about your preferences Facilitate effective/efficient patient check-in Facilitate overbooks Patient questions/triage Interface with other clinics/services

6 #2 KNOW MCPG (FACULTY GROUP PRACTICE) The UAMS operating division that administers the business aspects of physician services, including billing, payment CUMG Serves in this role for ACH-based services Encounter Forms and Coding Encounter forms may be paper or [E-bill] within EMR now With UConnect [Epic] implementation [beginning 8/2013] all providers will be responsible for e-billing for ambulatory + inpatient services. Risk Management (deals with problems) Best to let them know about potential problems rather than finding out too late..

7 #3: LEARN THE COMPUTER SYSTEMS CENTRICITY [Current Ambulatory EMR] Not all clinical areas using EMR to its capability To be replaced by UConnect [Epic] in Initial clinics go LIVE with UConnect 8/1/2013 ALL Clinicians will use this system if UAMS. Advantages Communication between docs Review/sign-off ~all clinical data [minimize miss potential] Legible notes/orders Organized, [reasonably] user friendly Disadvantages Typing vs. Dictating Current IP and OP systems communicate but don t integrate IT glitches can always occur

8 #4: KNOW YOUR CLINIC POLICIES No shows Late patients Time allotted to each patient visit Rules for canceling your clinic Minimum of 4-6 weeks notice except emergency Some departments have more stringent requirements Administrative dashboard [EIS] Data on many clinic metrics Reviewed routinely by administration, Dean, department and divison leadership. Use for assessment of practice and to drive improvement

9 #5: FGP COMPLIANCE Learn [keep up with] changes in billing/coding Check with your administrator re: specialty-specific tools Please teach your learners how important/complicated this is and can be! Routine audits Initial audit in first quarter, annually and random I recommend you review your results, ask for a sit down if you have concerns Better to know and fix than to be tracked down for problems later

10 #6: STUDENT/RESIDENT EDUCATION Most clinics serve insured and underprivileged Institutional policy on fees/payment for services Review specific clinic policies with your administrator The majority of us are on an educator track We teach students, residents, fellows, [other learners] You should know the rules for documentation of services w/ learners What/how much of learner note you can refer to What is required in a teaching physician statement Does your practice qualify for a primary care exemption?

11 MAKE THE MOST OF TEACHING MOMENTS.. We are all pressed by multiple demands on time REMEMBER we are here because we have a passion for education, clinical care and/or research. Few of us are trained educators Remember to reach our learners: Smile!! Many teaching strategies: Ask pertinent questions [without pimping ] and wrap with knowledge pearls Pick one teaching point from each patient encounter One Minute Preceptor Share your clinical dilemma Provide feedback sandwiches to learners

12 #7: GET INVOLVED There are ALWAYS opportunities for improvement! Consider involvement with standing committees Clinical Coordinating Committee Medication Policy Committee Professional Standards Committee Participate in Quality Improvement Champion an issue, work with your clinical team! PDSA Cycles Avoid the temptation to use its not my problem - make positive changes!! Faculty Senate EPIC development in your specialty area Others

13 OVERALL. Introduce yourself Consider volunteering for outreach- Publicize what you bring to UAMS and Arkansas Get involved in UAMS and Central AR community Ask questions Be proactive for positive change Knowledge is POWER!

14 SHAMELESS PLUG PRIMARY UAMS UAMS Center for Primary Care Collaboration of 3 on-campus primary care disciplines- our physicians are happy to provide professional comprehensive primary care for you and your families in one of 5 [on and off campus] clinics: UAMS Internal Medicine South [Ages 16+] UAMS Internal Medicine West [Ages 16+] UAMS Internal Medicine North [Ages 16+] UAMS Family Medical Center [All ages] Incl. Student Health Center, Employee Health, Employee Walk In Clinic UAMS Center on Aging [ages 65 and older] ACH Pediatric Clinics Skilled Pediatricians who provide comprehensive Pediatric primary care General Pediatrics Clinic [Birth to 18] Adolescent Clinic [Ages 14-20]

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