I am trying to get a better grasp on the concept of patient centered medical home, and from everything I read seems counter intuitive to how I run a practice on a daily basis.
Again, I am going to quote my father in law, the business savvy farmer who despite the crushing external elements of unpredictable markets and weather has not only survived but excelled.
“If you have one hired man, you have one good man, you have two hired men, you have half a man, you have three hired men you have no one working for you.”
From my 21 years of observation and experience this quote has an element of truth that can be translated into how, with the technology, I have not only adapted this principle, but am a firm believer in this work model in a small office setting.
I have found that one trusted employee, my nurse, can manage the intersecting efflux and influx of patient centered data/information quite well, and much better than multiple employees.
My nurse, at her fingertips, manages the telephone, schedule, e-faxes, EHR, portal, and scanner at her dual monitored, not single monitored computer.
However, and this is where my father in law’s principle pans out. My nurse and I have adapted, evolved to where we have designated roles and co manage the Updox inbox and Amazing Charts EHR, and it is a bit of a dance or give and take for peak maximum efficiency.
I call it the tripod or 3 legged milk stool phenomena with our set up, but as long as my EHR inbox, my nurse’s EHR inbox and our co managed Updox inbox is relatively empty, then the work is getting done effectively and quickly, and we both can check on any 3 of these in boxes electronically instantaneously anytime throughout the day and give one another the humanistic “hey, get your stuff signed, so I can e-fax it to this office” to get it done.
If I add any other variable or employee to this mix there is an exponential diminished efficiency, and added cost to running an office.
So with the newfangled technology and old fashioned wit of a wheat farmer, my idea of a patient centered medical home is working extremely well for me, but not necessarily following the current definition as I understand it to be, but I am willing to learn.