The Clinical Enterprise: Seven tips that will help you run a smooth clinic

1. The Clinical Enterprise:Seven tips that will help you run a smooth clinic Robert H. Hopkins, Jr., MD, FACP, FAAP Director, Division of General Internal Medicine

3. Welcome to UAMS!! Ambulatory Operations: Simple but complex…- Patient focused but need refinement… Change rate is variable…

4. #1 Know Your People • Medical Director & Department/Divison Director • Appointments/Scheduling • Set up your template with your director/administrator • Department/Division Administrator • Appointments/Scheduling • Set up your template with your director/administrator • Access/Appt. Center [UH, VA, ACH: Separate] • Communication!!!! • Some Departments do not use central access center • Policies: Insurance; Template formats; Hospital Follow ups

5. #1 Know your people (contd) • Clinic Manager: • Learn the policies already set in place • Build and maintain a good relationship • Staffing, Rooms, Clinic metrics • Encounter Forms • Nurses: • Communicate with them about your preferences • Time to check a patient in • Overbooks

6. #2 Know MCPG (Faculty Group Practice) • The UAMS operating division that administers the business aspects of physicianservices, including billing, payment • Encounter Forms and Coding • Encounter forms may be paper or within EMR • This issue likely to be more uniform with Epic implementation [next 12-18 months] • Risk Management (dealing with problems) • Prefer to know about potential problems than to hear ‘to late..’

7. #3: Learn the Computer Systems CENTRICITY [Current Ambulatory EMR] • To be replaced by EPIC [IP/OP] in 2013 • Development beginning now • Not all using EMR to its capability… • Advantages • Communication between docs • Sign off/review all OP data [minimize ‘miss’ potential] • Organized, reasonably user friendly • Disadvantages • Typing vs. Dictating • IP and OP systems communicate but don’t integrate • IT glitches

8. #4: Know your clinic policies • No shows • Late patients • Time allotted to each patient • Rules for canceling your clinic • Administrative dashboard [EIS] • Data on most of these clinic metrics • Reviewed routinely by admin, Dean and Dept/Divison leadership

9. #5: FGP Compliance • Learn [keep up with] changes in billing/coding • Check with your administrator re: specialty-specific tools • Please teach your learners how important/complicated this is and can be! • Routine random audits • Review your results, ask for a sit down if you have concerns…When you screw up, they will find you!

10. #6: Student/Resident Education • Most clinics serve insured and underprivileged • Institutional policy on fees/payment for services • Review specific clinic policies with your administrator • The majority of us are on some ‘educator track’ • Students, residents, fellow, [other learners] • Know rules for documentation of services w/ learners • What/how much of learner note you can refer to… • Teaching physician statements… • Primary care exemptions…

11. Make the Most of Teaching Moments.. • We are all pressed by multiple demands on time • We are here b/c we have a passion for education • Most are not trained educators • Tips • Smile • Pick one teaching point from each patient encounter • One Minute Preceptor • Share your clinical dilemma • Feedback sandwiches…

12. #7: Get Involved • ALWAYS opportunities for improvement! • Committees • Clinical Coordinating Committee • Medication Policy Committee • Professional Standards Committee • Quality Improvement • Faculty Senate • EPIC development in your specialty area • Consider getting involved with reform

13. Overall…. • Introduce yourself • Consider volunteering for outreach- • Publicize what you bring to UAMS and Arkansas • Ask questions • Be proactive Knowledge is POWER!