Diabetic visit workflow processes in primary care practices

Diabetic visit workflow processes in primary care practices engaged in quality measures data reporting: A qualitative analysis by SNOCAP USA Tiffany Noelle Martin Brown, Ph. D. W. Perry Dickinson, M. D. Murray Cote, Ph. D. Tiffany Radcliff, Ph. D. Pete Smith, M. D. David R. West, Ph. D. University of Colorado Denver Department of Family Medicine Statement of the Problem Diabetes-specific Visit Work Flow Process Little data is available to help small to medium primary care practices determine what it takes to participate in quality measures data collection and reporting on a day-to-day basis. This study lays out the additional work processes encompassed in a diabetes-specific medical encounter when engaging in quality measures data collection and reporting. Sample 6 primary care practices in Colorado Methods Interviews and observations of: Practice Staff Practice Managers Clinician Champion Quality Improvement Coaches Conclusions • The majority of diabetes QI work occurs outside the encounter. • Practices must be able to identify their diabetic patients before the patient arrives. • Data related to quality measures must be documented during the visit. • Quality measures must be put in a format which is accessible for future QI activities (i. e. recall) • Much of the diabetes data management work is carried out by Medical Assistants. • Technologies, such as registries, are a critical part of the diabetes QI process, but are currently difficult to incorporate into workflow. • Due to technological issues, some of this work includes double data entry for EHR users. Recommendations • It is important to engage in diabetes quality data collection as part of the workflow in real time, where the information is entered synchronous to the medical encounter. • People in multiple roles in the practice need to be involved in the process. This work was funded through an AHRQ PBRN Task Order, Understanding the Direct and Indirect Costs of Quality Measurement Data Collection and Reporting in Primary Care Practice