Summary Statistics on Care by Design Implementation, Patient Satisfaction, Clinician Satisfaction, and Financial Data in 2011
| Variable | Score, Mean (SD) |
|---|---|
| CBD implementationa | |
| Same-day access | 2.22 (0.94) |
| Primary care clinician continuity | 2.62 (0.81) |
| Response to messages | 0.99 (0.46) |
| Abandonment rate | 3.00 (0.47) |
| TSF (% of calls answered within standard) | 2.00 (0.94) |
| Patients signed up for MyChartb | 1.89 (1.14) |
| Use X-filec | 2.53 (1.16) |
| Physical template | 1.97 (1.20) |
| Best Practice Alerts | 0.78 (0.59) |
| Standardized examination rooms | 3.28 (0.74) |
| Efficient visit | 2.71 (0.73) |
| Huddles | 2.29 (1.46) |
| Blood drawn in room | 2.98 (1.56) |
| Continuity of MA in visit | 3.27 (0.61) |
| MA engagement in visit | 2.38 (0.62) |
| Documentation of patient communication needs | 1.92 (1.27) |
| Presence of advance directives | 0.08 (0.13) |
| Depression screening | 0.24 (0.24) |
| List of community resources | 2.53 (1.35) |
| Efficient communication among team | 3.75 (0.29) |
| Registries | 0.37 (0.77) |
| Labs done prior to visit | 2.03 (0.64) |
| After-Visit Summary given | 0.77 (0.70) |
| Medication reconciliation | 2.55 (0.58) |
| Procedure/consult notes available at follow-up visit | 3.57 (0.44) |
| Care plan documented | 0.12 (0.17) |
| Progress on care plan documented | 0.34 (0.24) |
| Contact patients after hospital discharge | 0.03 (0.07) |
| Overall scores | |
| Planned care | 1.08 (0.21) |
| Care team | 2.41 (0.36) |
| Access | 2.12 (0.30) |
| Implementation | 1.94 (0.20) |
| Quality measures | |
| Patients prescribed antiplatelet therapy | 0.78 (0.05) |
| Patients prescribed drug therapy for LDL-C | 0.87 (0.03) |
| Patients with prior MI who were prescribed β-blocker | 0.72 (0.06) |
| Lipid profile | 0.63 (0.08) |
| CAD patients with LDL-C <100 mg/dL | 0.65 (0.06) |
| Patients who have LVSD and/or diabetes and were prescribed ACE inhibitor/ARB | 0.86 (0.06) |
| HbA1c testing | 0.78 (0.05) |
| HbA1c <9% | 0.59 (0.05) |
| Blood pressure <140/80 mm Hg | 0.56 (0.05) |
| LDL-C testing | 0.70 (0.04) |
| Diabetic patients with LDL-C <100 mg/dL | 0.36 (0.06) |
| Urine protein testing | 0.86 (0.02) |
| Eye examination | 0.14 (0.07) |
| Foot examination | 0.48 (0.10) |
| Patients who had LVF assessment ever | 0.63 (0.13) |
| Patients who were provided HF education in past year | 0.08 (0.06) |
| Patients with AF who were prescribed warfarin | 0.91 (0.08) |
| Breast cancer screening | 0.46 (0.08) |
| Colon cancer screening | 0.46 (0.08) |
| Patients aged ≥50 y who received influenza vaccination during Sep-Feb | 0.35 (0.04) |
| Pneumonia vaccination | 0.77 (0.05) |
| Patient satisfactiond | |
| Wait time in clinic | 0.49 (0.10) |
| Friendliness/courtesy of the clinician | 0.83 (0.05) |
| Explanations the clinician gave you about your problem or condition | 0.79 (0.05) |
| Information the clinician gave you about medications | 0.77 (0.03) |
| Follow-up instructions | 0.75 (0.03) |
| Amount of time the clinician spent with you | 0.75 (0.05) |
| Likelihood to recommend | 0.80 (0.04) |
| Overall satisfaction | 0.71 (0.05) |
| Clinician satisfactiond | |
| Morale of your group | 0.16 (0.18) |
| Quality of care dimension (questions 14–18) | 0.39 (0.14) |
| Quality of care you are able to provide | 0.45 (0.23) |
| Time spent working dimension (questions 20–24) | 0.16 (0.14) |
| Time you work | 0.13 (0.14) |
| Time you spend with patient | 0.16 (0.11) |
| Volume of patient load is reasonable | 0.17 (0.18) |
| Patient interaction dimension (questions 26–29) | 0.35 (0.10) |
| Relationship with patients | 0.79 (0.14) |
| Continuity of care you are able to provide | 0.38 (0.26) |
| Relationships with staff dimension (questions 40–43) | 0.27 (0.14) |
| Nonphysicians in my practice carry out clinical instructions | 0.18 (0.14) |
| Not enough support staff | 0.19 (0.16) |
| Using EHR has improved my practice | 0.61 (0.21) |
| Overall satisfaction with practice | 0.27 (0.22) |
| Financial/productivity, $e | |
| Net revenue/visit | 147.27 (10.53) |
| Clinician cost/visit | 64.04 (20.18) |
| Clinician cost/WRVU | 45.39 (14.35) |
| Staff cost/visit | 64.51 (11.14) |
| Net revenue/WRVU | 104.17 (4.61) |
| Staff cost/WRVU | 45.86 (8.11) |
| Staff cost/clinician FTE | 240,965.50 (52,506.46) |
| WRVU/clinician FTE | 5,525.50 (1,526.03) |
| Visits/clinician FTE | 3,856.80 (974.90) |
ACE=angiotensin-converting enzyme; AF=atrial fibrillation; ARB = angiotensin receptor blocker; CAD = coronary artery disease; CBD = Care by Design; EHR = electronic health record; FTE = full-time equivalent; HbA1c=hemoglobin A1c; HF = heart failure; LDL-C = low-density lipoprotein cholesterol; LVF = left ventricular function; LVSD = left ventricular systolic dysfunction; MA = medical assistant; MI = myocardial infarction; TSF = telephone service factor; WRVU = work relative value units.
Notes: Denominators for the quality measures varied by measure and ranged from 233 to 20,143. Completed patient satisfaction questionnaires were returned by 2,051 unique patients in 2011 on the basis of visit date. The clinician satisfaction questionnaire was completed by 51 unique clinicians in 2011.
↵a Implementation scores range from 0 to 4, with higher scores indicating greater degree of implementation.
↵b A patient portal in the EHR.
↵c A patient history template in the EHR.
↵d Patient and clinician satisfaction scores range from 0 to 1, with higher scores indicating greater satisfaction.
↵e Dollars in 2011.