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)TVTVTV
Defining 3 preventive care services, 3 different chronic care services and identifying patients not recently seen and patients on specific medicationsTVTVTVTV
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 descriptionsTVTVTTV
Demonstrating that >50% of patients who request an e-copy of their information receive it within 3 business daysTT
Establish patient satisfaction survey processTVTVT
Starting new office meetings dedicated to quality improvement and working to complete NCQA application requirementsTT
Creating and processing screenshots to demonstrate existence of required elementsTTTT
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)TTT
Workbook preparation and documentationTTTT
Clinical advice via secure messages during office (via establishment of a patient portal purchased for PCMH work)TT
  • * 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; TV, highest value for improving patient care.