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    The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders about the most common check-in method for in-person visits this year. The majority (71%) responded “front desk,” while 17% said “phone,” 7% stated “online/portal,” and 5% answered “kiosk.”

    The poll was conducted Aug. 4, 2020, with 722 applicable responses.

    COVID-19 facility changes: The basics

    As outlined in MGMA’s COVID-19 Recovery Center resources and discussed in the MGMA Member Community, medical facilities have adopted a variety of new procedures and protocols to mitigate potential coronavirus exposure and meet social distancing requirements, including:

    • Temperature checks and triage questionnaire for every person who enters a facility, including employees, delivery workers, patients, visitors, etc. Some practices also have a specific policy for rescheduling if a temperature check prompts an individual to be denied entry.
    • Plexiglas separators at the front desk and in administrative offices, along with mandatory mask requirements for employees and patients
    • Social distancing markers near check-in and checkout to promote social distancing
    • No visitors allowed with a patient unless the patient is a minor or an underlying medical condition prevents the patient from coming alone
    • Restructured scheduling to reduce patient wait times
    • Scheduled cleanings to disinfect all areas of the office multiple times a day [This is especially important if your practice has touchscreen kiosks. The Centers for Disease Control and Prevention (CDC) has guidance on cleaning and disinfecting surfaces in your facility.]
    • One-time use of pens until disinfected (e.g., a patient uses it and puts it in a "dirty" pile or keeps it; staff and other patients never touch until sanitized via spray)
    • Cleaning of credit card terminal after each use.
    The importance of patient flow

    In many cases, practices will need to shift away from their traditional philosophy on scheduling to update the flow of people throughout the practice space. MGMA consultant Adrienne Lloyd, MHA, FACHE, chief administrative officer, Duke Eye Center, Duke Medical Center, says that the traditional batches of patients who would come into a practice and sit in the waiting area were a product of scheduling models that focused mostly on reducing wait times for providers between patients.

    Now, the focus should shift to a “pull” model of appointments that’s more patient friendly, so that patients can go directly to areas for upstream work that needs to be done prior to visiting with a provider (e.g., imaging, workup, lab draws) and move along to see a provider thereafter. This approach helps to avoid patient bottlenecks in the facility, which helps maintain social distancing protocols. 

    Wait times

    Prior to the COVID-19 pandemic, patient total wait times — which include time spent in the wait area as well as in the exam room waiting to see a provider — ranged from 20 to 25 minutes, according to MGMA DataDive Practice Operations

    New data in the forthcoming 2020 MGMA DataDive Practice Operations show that practices in various specialties saw increases in wait-area wait times in 2019:

    With changes such as those recommended by Lloyd and MGMA members, the entire nature of wait times has changed for the duration of the pandemic. How much those changes become permanent fixtures of practice operations remains to be seen, but they hold promise on delivering a more patient-centered experience, according to market researcher Rob Klein, founder and CEO, Klein & Partners. 

    “I’ve always told clients that a waiting room is a brand experience failure,” Klein said in a recent webinar. “Out of this difficult time, good things are starting to happen in terms of becoming more patient-centric. … Making things customer-centric is critical.”

    Action steps

    Lloyd says that medical practice leaders have specific areas they can address for long-term facility updates:

    • Patient flow can be improved by providing a mobile check-in to limit the need for an indoor waiting area. This could be as simple as having patients call when they arrive and instructing them to wait outside until staff can alert them via text or other messaging when a room and/or provider is ready.
    • Spaghetti mapping of a practice can help evaluate the facility floor plan and how the patients and staff flow from entryways all the way through to exam rooms, imaging areas and labs. 
    • Finding the highest volume visit types and diagnoses can also help practice leaders move or relocate services. “If you’re doing imaging or lab testing really frequently … that might be an area where you want to pull some of those services more to the front of your clinic so that you can get those patients in and out” quickly, Lloyd said.
    The role of virtual connections

    Regardless of how much telehealth a medical practice is offering, Lloyd notes that there are strategic considerations for connecting with patients digitally. Prior to any type of visit, it can be helpful to build out questionnaires in a patient portal to get patients to supply information to the provider before a visit to help build out his or her chart.

    It’s “almost like you’re doing an interview” and having them attest to issues going on in their overall care, Lloyd said. This is especially helpful for providers having difficulty making the transition to virtual visits and working with patients to disclose certain issues. 

    MGMA Stat

    Would you like to join our polling panel to voice your opinion on important practice management topics? MGMA Stat is a national poll that addresses practice management issues, the impact of new legislation and related topics. Participation is open to all healthcare leaders. Results of other polls and information on how to participate in MGMA Stat are available at:

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