Clinical efficiency for patient-centered care

Donna Crowe is an OB-GYN of Women OB-GYN, a women’s health organization in Tennessee. Read on to learn how athenaOne® helps automate routine work and support more personalized patient care.

Q: What defines your organization’s approach to care?

A: We’re a practice of five physicians and nine advanced practice nurses. And we are very patient-centric from the moment you walk in our door. It’s obvious that we care about setting you at ease, making you feel comfortable ... this may be your worst day, but we’re here to help you on your worst day. This may be your best day, and we’re here to celebrate with you on your best day.

We’re very patient-focused. We take care of our staff so that they can be patient-focused. It’s really being aware of what we bring to the table, what the patients bring to the table, that sets us apart from other practices.

We take care of women from their teen years through menopause to the post-menopausal patient and take care of patients during their reproductive years as well.

Q: How has athenaOne changed the way you focus on patients during the visit?

A: We’ve been on athenaOne since 2018. And it made just a wealth of difference in our ability to focus on our patients. athenaOne – when you spend the time to set it up correctly, individualize it for you – offers you lots of opportunities to make the things that you do with every patient automatic so that when you’re face to face with a patient, you are spending the time concentrating on what’s different about them as opposed to what’s the same.

athenaOne  is taking care of all the things that are the same, so that you are able to spend the time you need in a rushed healthcare environment, present and with the patient, [focused] on what’s different about them, what’s unique and individual. And patients feel that when you are able to spend that time with them, concentrating on what’s important to them while making sure that all of the things that we need to do throughout a woman’s life cycle are being done to all the recommendations of care.

Q: How are you using encounter plans and specialty workflows to standardize care while preserving the personal connection?

A: We use a lot of encounter plans in our practice. We have a robust set of reasons for visit, and those reasons for visit put everything down the line for our staff. The way we have it set up for our particular practice is the HPI, which shows up in the intake for our nurses and medical assistants, is kind of how they need to introduce the visit that’s happening that day.

So it gives them some guidelines [such as] this is what the provider would like for you to share with the patient, be it patient education, things that we might order, things that we might need to know about from them to be able to take care of them on that day. The assessment and plan on the other end of the encounter plan includes diagnoses that go with that particular reason for visit, options for labs and orders, imaging, as well as for some things, medical education, the things that you should say to a patient so that they get all of their questions answered throughout the course of a pregnancy.

We have a reason for visit for every gestational age, and we’ve got it organized so that throughout the pregnancy they’re going to get reminded of their vaccines. They’re going to get reminded to pre-register for the hospital. They’re going to get reminded to choose a pediatrician, all of those things. And we’ll do them repeated times, both through the medical assistant or nurse who’s working the patient up, all the way through to the provider at the end, going in and documenting their portion as well.

And it’s great to have those reminders when you’re looking at a chart before you go in the room. These are the things I need to cover quickly so that I can make sure that all of our recommended things to take good care of an obstetric patient at this gestational age are done. And then I go in the room and have the conversation with them and then answer their questions that they may have: what’s important to you at this visit? What do you need to share with me? What struggles are you having? It gives me the time to do that because all the documentation on the standard things are done.

Q: What does an efficient workflow look like in practice?

A: I think it’s by automating everything that can be automated within the system as reminders, both reminders for following up for abnormal results, following up for patient phone calls after a patient has had a miscarriage. I need to call in and check on her. I want to do all those things. I care about this patient, but I have other patients to care about, and I’m not going to remember that if I just keep it in my brain.

athenaOne has such robust techniques to be able to follow up on your patients, whether it’s an automated patient case going out to them to remind them to schedule something, or it’s a reminder for us to touch base with them ourselves to check on them from psychosocial needs. Or how are you doing? I know you had a hard time with this; is there anything we can do to support you during this process?

And because of all of these things being automated, including through the encounter plans, we’re automating the CPT codes that you should use. I don’t have to scroll through 50 things to know what I need to do for this visit. It’s there. It’s within the encounter plan. I can move on, do my billing. I’m not spending untold amount of time thinking about what’s sort of mundane.

In addition, we use the problem lists. If you have your ICD-10s saved in your problem list when you’re seeing a patient, I can move all of those ICD-10s over as I see the patient and have them populate automatically. I don’t have to go looking for all those codes, I’ve already got them. And because I have those codes saved in their problem list, it reminds me, oh I need to touch on this.

All of those things together help me be more efficient and spend my time where it matters, doing the highest level of my work. We are fastidious about adding things to the problem list. When we get things from other physicians, we’re less likely to miss things. Everybody at the top of the game, everybody’s encouraged to add or to ask. They understand the value of having everything set up just so.

Q: What is the downstream impact for patients when that system is working well?

A: I think for patients, seeing having someone reach out to them to check on them, to make sure they understand what we’ve done at their visit, to make sure that we check in on them and make sure that they are recovering from a surgery, that they are recovering from a loss, that they are doing okay during that postpartum period and don’t have any signs of postpartum depression or anxiety.

They felt cared for. They feel seen, they feel important, and they feel valued as an individual person. And who doesn’t want to be that? That’s important to all of us. I want to make sure that we don’t lose the personal as we work through technology.

Q: What impact has athenaOne had on documentation and provider burden?

A: For me personally, the ability to have the things that I do consistently already in the chart so that I can chart by exception more so than by the rule has been very helpful for efficiency as well as for completeness. I certainly did not document nearly as well when I was on paper.

My documentation is as thorough as my exams are now.

Q: How do you think about AI in healthcare today?

A: I think for a lot of people, they’re afraid that AI is going to lose the personal. And I can certainly understand why creatives would be anxious about AI trying to do what they do. But what I would love to see us harness with AI is to take care of mundane tasks that aren’t important, so that we still are able to concentrate on the humanity with each other, that we’re spending the time we need to holding a hand and crying with people.

There’s so many different platforms out there trying to figure out the process and how to be helpful. I don’t currently use it for patient visits because our encounter plans work so well. I don’t really find a need for it. I think for my advanced practice nurses that do a lot more complicated GYN visits, long menopause counseling, or infertility visits, I think it would be incredibly helpful. I know of other providers who do more GYN-based office and are finding AI helpful in that situation.