THE ENLIGHTENED OFFICE

This equation yields more than one sum

Techs who screen patients and scribe for doctors? They catapult the patient experience, and more.

By Cynthia Matossian, MD

This month’s column concerns the following equation:

Efficiency + accuracy = an excellent patient experience.

Two scientific-based accomplishments that, when correctly executed, produce a measurable response.

This response ultimately yields a dynamic practice with a growing bottom line.

I learned the importance of this equation decades ago. I was searching for a way to stay focused on my patients during their examination while simultaneously recording my findings and observations.

I didn’t want a machine; I wanted the recorder to be a human being. I realized for the practice to become more efficient, help in two areas was needed: Someone to screen the patient by asking vital questions and perform valuable diagnostic testing and someone to scribe during the patient–physician encounter.

We made the decision to train our more junior technicians to screen patients and then our more senior technicians to scribe.

ASKING QUESTIONS …..

Both roles, when fulfilled successfully, provide high levels of efficiency that serve the patient, physician and practice.

A simple example: A patient in another practice could tell a technician that she is seeing black shadows. A technician, who is not educated in screening patients, will record, “Patient is seeing a black shadow.”

…. AND GETTING ANSWERS

But our techs are trained to ask additional, more sophisticated follow-up questions such as: is it in one eye or both, does it move, is it in the center of the vision? If the shadow is in the center, for example, our trained techs will know to use an Amsler Grid to check for possible maculopathy. Then, they ask the physician whether the patient’s eyes should be dilated.

Our technicians know how to assess the depth of the anterior chamber. This way, when the physician enters the exam room, there is a more complete history to help with the diagnosis and the additional steps such as Amsler Grid testing and pupil dilation to make the entire encounter more efficient for patient and physician.

Because of their training, our technicians can ask more targeted questions, eliciting the types of answers that help physicians.

SCRIBE TRAINING

Once the junior technicians have gained significant levels of experience, they begin following a senior technician to learn how to scribe.

Scribes act as the physicians’ recorder. Every word is entered into the patient’s electronic medical record. To me, the benefit is remarkable: As I speak with and listen to the patient, my eyes make contact with the patient — they are not on a keyboard. And the patient knows it.

When we are finished speaking, the scribe is finished typing. Often, the scribes review the information stated by the physician once the physician leaves the exam room for added reinforcement.

Our patients view our highly trained technicians as educated, polished professionals. Our staff attrition rate is low; our patient count is up.

It’s a simple math equation with satisfying results: Efficiency + accuracy = an excellent patient experience. OM

Cynthia Matossian, MD, FACS, is the founder of Matossian Eye Associates. Her email is cmatossian@matossianeye.com