Table 2

Problems and Innovations

Unplanned visits with overfull agendasPrevisit planning
Preappointment laboratory tests
Inadequate support to meet the patient demand for careSharing the carea
 Expanded nurse or medical assistant rooming protocol
 Standing orders
 Extended responsibility for health coaching, care coordination, and integrated behavioral health to nonphysician members of the team
 Team responsibility for panel management
Great amounts of time spent documenting and complying with administrative and regulatory requirementsScribing
Assistant order entry
Standardized prescription renewal
Computerized technology that pushes more work to the physicianIn-box management
Verbal messaging
Teams that function poorly and complicate rather than simplify the workImproving team communication through
 Regular team meetings
Improving team functioning
 Systems planning
 Work flow mapping
  • a These roles require 2- or 3-to-1 clinical support per physician.