Table 5. Activities That Required the Greatest Time Investment^* and the Highest Value for Improving Patient Care

	Practice 1 (Pediatrics)	Practice 2 (Pediatrics)	Practice 3 (Pediatrics)	Practice 1 (Family Medicine)
Previsit planning and care coordination processes new work to pre-populate patient charts, prepare for visits, identify overdue or upcoming screening or other tests to recommend)	T^V	T^V		T^V
Defining 3 preventive care services, 3 different chronic care services and identifying patients not recently seen and patients on specific medications	T^V	T^V	T^V	T^V
Writing office policies defining processes to define work flows for following up on laboratory, imaging, and other care processes including drafting agreements with consultants; drafting job descriptions	T^V	T^V	T	T^V
Demonstrating that >50% of patients who request an e-copy of their information receive it within 3 business days	T	T
Establish patient satisfaction survey process	T^V	T^V	T
Starting new office meetings dedicated to quality improvement and working to complete NCQA application requirements		T		T
Creating and processing screenshots to demonstrate existence of required elements	T	T	T	T
Providing after-hours access to care (providing advice to patients electronically, and via phone, demonstrating hat afterhours advice is then incorporated into the patient record)	T	T		T
Workbook preparation and documentation	T	T	T	T
Clinical advice via secure messages during office (via establishment of a patient portal purchased for PCMH work)		T	T

↵* All activities required at least one full working day (8 hours) of staff time to complete. Many activities, especially regarding preparing policy documents, job descriptions, screenshots, documenting chart data into workbooks, and devising plans managing populations, took much longer than 8 hours.
NCQA, National Committee for Quality Assurance; PCMH, patient-centered medical home; T, greatest time investment; T^V, highest value for improving patient care.