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.
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
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
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

4
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

5
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)
6
Lecture e
The Clinical Team
Provider - physicians, nurses, physician
assistants, or nurse practitioners, who
address the patients clinical issues
Providers typically have a predetermined schedule
of appointments for their day
However, they dont 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
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
8
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
9
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
10
Lecture e
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
Lecture e
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
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

13
Lecture e
Summary Lecture e
Discussed the role of different healthcare
providers.
Patient experience includes interdisciplinary
team effort
May include ancillary providers.
14
Lecture e
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
Lecture e
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
Lecture e

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

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