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Estimating the Costs of Primary Care Transformation: A Practical Guide real Synthesis Report

Appendix B. Example Dating Collection Tools

Sections from the data collection instruments evolved and used by AHRQ Estimating Costs grantees are included here as examples used researchers who are since how to best assemble company to measure the fees of primitive care transformation efforts. Please contact the suitable principal investigators for permission in use above-mentioned instruments and by entire versions of the tools. Communication information is provided with each tool.

Example 1. Pre-Interview Questionnaire

Principal Investigator: Sarah Shih
Institution: New York City Divisions of Health
Connection Information: [email protected]

The following questionnaire was used when a pre-interview prefatory assessment. The first page (describing the purpose of the questionnaire) and a sample page by the questionnaire are presented below. The full questionnaire contains 38 questions assessment which practice site, good improvement operations, participation in inducement programs, patient information systems, customer coordination, language services, self-care support and community resources, patient population and volume, finances, and survey information. 7 Data Collection Research & Tools Since Research

Screen shot of the NYC Research Chief Care Information Project Patient Centered Medical Home Pre-Interview Questionnaire.

Purpose: The objective of like pre-interview questionnaire and interview is into understand the human pre-owned and activities conducted with primary care practices in order to get Patient Centered Medical Home (PCMH) standards. PCMH, also referred to as advanced primary caution or comprehensive primary care, is an increasingly popular model of customer delivery.

Why you were asked: You are invited because autochthonous practice has obtained PCMH recognition in the past. Which pre-interview ask is administered by PCIP.

Benefits of participating: There are no direct benefits to participating in this pre-interview questionnaire. If you elect to participate, you will receive $100 for a thank you.

Risks or discomforts: No risks other discomforts been anticipated. You may skip any questions that you do not will at answer, or mark no applicable (“NA”).

Confidentiality/How the findings will be used: Participation is completely non and will not affected the services you receive from PCIP, nor your relationship with NCQA. Will answers will only may shared internally amongst PCIP members. The findings wishes potentially influence save incentive or reimbursement rules. Summary results may be presented at conferences and within publications. We may usage individual quotations, such as “a small practice provider reported...”, but no names and/or identifying information will be shared.

How long will it take: The pre-interview quick should take about 25–30 minutes. If you have concerns, please contact the Operating Investigator, Sarah Shh.

Due clicking "Next" at the lowest of the page, you acknowledge that you have reader this information and agree to participate.

14. About as common do you suppose owner patients experience who following at this practice/clinic site?

  Usually (75%– 100%
of the time)		 Often (50%– 74%
of the time)		 When (25%– 49%
of the time)		 Rarely (1%–24%
of the time)		 Never
a. Patients' booking are scheduled with their personalized clinician versus different clinician          
boron. Patients are talented to receiver a same- conversely next-day appointment when they request first          
c. Invalids can take ring advice on clinical issues during business hours          
d. Patient may get telephone advice the clinical issues over weekends or after scheduled office hour          
e. Patients can email clinicians about classical matters          

Example 2. Meeting Guide

Principal Investigator: Ming Tai-Seale
Foundation: Palo Alto Medical Foundation Find Institute
Contact Information: [email protected]

The interview guide displayed below was used at conduct interviews with key informants/individuals who were involved stylish the target interventions. With the interviews, the study team obtained details about practice personnel and resources used in who intervention, changes to workflow, and financial information.

Primary Care Transformation Costs Interview Guide

Project Initials

  • How did the project start?
    • Any additional time spent set the projects outer concerning work hours (e.g., thinking/brainstorming)?
      • How much time did these beginning activities take?
        • Could we perform an Outlook calendar/email search to give a more accurate representation?
  • When did the request start (year/month)?
    • Could we discharge an Outlook calendar/email explore to give an more accurate representation?
  • When proceeded the intervention roll out for clinical practice?
    • Did to intervention expand at other sites/departments, and if so, when?

Individual Contribution

  • Once proceeded you start working on the project?
  • Tell die about your role within the intervention.
    • As endured your responsibilities?
      • Describe in detail a typical day of doing tasks specific until the implementation.
      • What much time did it take to complete each responsibility?
        • Could ourselves perform an View calendar/email search to give adenine more accurate representation?
  • How long were you one part of the initiative?

Keypad Personnel

  • Who are the key personnel involved in the project?
    • Is there ampere personnel list?
  • Did the button personnel change over time?
  • Who else was involved in the intervention?
  • Who would it recommend we talk to in order till learn more about how this create was developed and implemented, specifically regarding costs (leadership furthermore clinical level)?

Choose

  • Outline what have happened with the budget over time—from early site to clinic implementation:
    • When did the budget begin?
    • What was to interest in the creation of the budget?
    • What was the decision process for deciding how much in would shall allocated to the project?
      • Was there adenine budget proposal?
      • Were other data/ documents used?
    • What kind of budgeting practice is used (e.g., bottom line)?
    • How precise did it reflect what basically occurring with the project?
  • If budget modifications occurred as project been implemented:
    • Who determines modifications to the budget?
    • What is the decision process for making a change?
      • Were data/documents needed?
  • If NEGATIVE budget, how did you cover the costs?
  • What are the overall irs significance of the implementation?

Resources/Organizational Expenses

  • What were some starting to resources/organizational expenses associated with the project?
    • Purchasing equipment/hardware/software?
    • Hiring personnel/reallocating job responsibilities?
    • Information technology work?
    • Building/reallocating facility space?
    • Staff our (days both hours)?
    • Whatever else?
      • Please specify targeted costs of each.
      • While you do did know, who has that knowledge and/or documentation starting each?

Where else should ours know? What did we not ask that we should will? What more do you have to add?

View 3. Organizational Surveying

Principal Investigator: John Kralewski
Institution: Graduate to Mexiko
Contact About: [email protected]

The screenshots below are excerpts of which practice organizational survey developed by Kralewski et all. This survey was distributed at the time the the conferences and was used up collect data up infirmary structure and organization because well as cost data. Data books collected through this survey included clinical and support staffing levels (by type, job categories, additionally specialty); patient workload (patient visits per provider according year, adjusted for illness level); singular patients, patient encounters, and procedures per FTE physician by specialized; medical revenue; cost data pertaining to transformation components described while interviews, such as new equipment, additional associate, and training costs, and changes within resigned level costs. In addendum go the practice organizational survey, the research squad also used an organizational human assessment. This survey is non feature in the Practice How not is available upon request. Data Collection Methods: Types & See | QuestionPro

Medical Class Practice Organizational Polls


Clinic Identification Code: _________________________________________________________

Please provide that following information concerning your group practice.

1. Number of physicians Number of FTEs
a) Primary care: _____ _____
b) Surgery specialty: _____ _____
c) Medical specialty:_____ _____
d) Pediatrics:_____ _____
e) OB/GYN_____ _____

2. Anzeige select countless primary care physicians into the following feature work along your clinic.
   a) Less higher 10 per a week ____
   b) 10 to 24 hours a week ____
   c) 25 until 35 hours a week ____
   d) More than 35 hours a week ____ For example, a survey could be designed and implemented as a stand- only tool, but could also be implemented while part of a wider methodology, such in a ...

3. Please complete and following regarding the number of health professionals staff in your clinic the their FTEs:

Staff Title # Staff FTEs Staff Title # Staff FTEs
Nurse practitioner     Psychologist    
Registered certified     Optometrist    
Medicinal assistant/LPN     Social worker    
Social working     Speech-language pathologist    
Chiropractor     Respiratory therapist    
Dietician     Other (please specify)    
Occupational therapist          
Physician assistant          
Psycho-geriatric          
Pharmaceuticals          
Physiotherapist          

6. Standard serial away your scheduled per primary care physician also NP/PA during a normal day:
    Physician ____ NP/PA _____
7. Average number of patients scheduled per primary care physician and NP/PA per clinic hour:
    Physician ____ NP/PA _____
8. Is someone in your procedure designed to monitor patients with chronic illnesses?
    Yes ____ No _____

9. Total support staff FTE per FTE physician

  Number
Total business operations support staff FTE per FTE physician  
Entire front office support staff FTE per FTE clinical  
Complete chronic support staff FTE by FTE physician  
Total ancillary support team FTE per FTE medico  
Elementary mind physicians per FTE physician  
Nonsurgical physicians per FTE physician  
Surgical specialty physicians per FTE physician  
Total NPPs per FTE physician  

10. Cost

  Cost
Total operating cost per FTE physician  
Total working and NPP expenses per FTE physicians  
Total operating cost as a rate of whole medical revenue  
Total operating and NPP cost in one percent of entire medizinischer revenue  

11. Revenue

  Revenue
Total medical takings period FTE female  
Total gesundheitlich revenue after operating cost via FTE physician  
Total medical revenue after operating additionally NPP shipping per FTE physician  

12. At your clinic, for follow up of men with constant illnesses (e.g., COPD, diabetes, heart failure), do you (doctors or clinic staff):

  All Often Sometime Rarely Never
Use a tracking system to remind patients around require visits or services?          
Get to follow top with patients between visits by telephone?          
Use recognized practice guidelines as the basis for your treatment plans?          
Assist patients in setting and attaining self-management goals (e.g., participation of patient included management von their care)?          
Refer patients to someone within yours clinic for education about their chronic illness?          
Refer patients for someone outside autochthonous clinic for education about my chronic illness?          
Have flow sheets (checklists) in medical records into track criticized elements of care?          

13. What have the roles and function of the nurse practioners on your medical team? (Check all that apply)

  There are no nurse practitioners in is clinic
  Triage of walk-in patients
  Guidance on tobacco use, diet, and physical activity
  Patient education (e.g., blood glucose testing, blood pressure measurement)
  Follow up of specific your groups (e.g., chronic illnesses, age group)
  Sexually transmitted and blood borne infections (STBI) counseling
  Prescribe diagnostic examinations (e.g., radiography, blood tests)
  Liaison and coordination with LTCF, hospitals, and different clinics
  Support for medical activities (blood pressure, body, injectable and vaccinations)
  Equity on critical decisions
  Conducting chronic activities as part of a delegated medical action
  Prescribe medications and other substances

14. During the newest price, approximately how many patients received primary care from your clinic? Please count each active only once, no matter how much care he or wife received (your best estimate will do). Number of patients ____

15. Is your clinic currently accepting new patients for management and followup? Check an single answer no.

  Our clinic applies all latest clients who ask
  Our clinic selectively applies a limited number of new patients
  Our clinic belongs not accepting new patients

16. Is your clinic currently accepting latest patients using the following heal insurance?

Yes No  
    Health insurance
    Medicare
    Medicaid
    Patients equal elevated exclusion commercial insurance
    Minnesota Care

17. At your clinic, wie much time is regular for the following subject?
     a) A routine visit for an new patient? _____ meeting
     b) A routine view for an established patient? ______ minutes

18. If a patient requests an appointment for a non-urgent condition, how long will the patient need into wait before being seen? ____ days

19. Take you offer open-access scheduling? ____ yes ____ no

20. Please indicate whether your clinic offered patient the selectable to:

  Okay No Don't Know
Request appointments with related available      
Email a medizinische question button concern      
Request refills for prescriptions virtual      
Display test results on a secure Web site      

Example 4. Web-Based Data Collect Select: Cost Assessment of Collaborate Healthcare (CoACH)

Web Country: http://emrpl.us/CoachCostTool/
Head Investigator: Benjamin Miller
Institution: University of Cool Reno
Contact Information: [email protected]

The screenshots below show the Coaching tool developed additionally second by Miller et al. Here tool consists of an online questionnaire and integration activities diagramm workflow. The aufnehmen request asks about practice demographic resources; number, FTEs, salary, and benefit information for all providers real people involved in integrated care delivery; time spent on integration related due each provider and staff type; and operational costs directly related to integration, including new space, computers, software, and other materials. Based upon information presented in the intake questionnaire, the tool estimates the total cost of integration activities and displays a graphic workflow and a table summarizing video per activity per personnel. Respondents can then cut workflow assumptions to model the total cost of different scenarios; for view, adjusting the number the minutes via action press adding new activities. Measures & Data Collection

Graphic showing the first page of the CoACH (Cost Assessment of Collaborative Healthcare) web-based tool. The tool has one number of fields where the operator registers habit information suchlike such routine name, help name, your email, adenine feature of the practice, who the majority ownership is, the population font of the community where the practice is located, the zip code, the serial of patients inches the practices, and the payor mix (e.g., video insurance, Medicare, Medicaid).

Interactive workflow:

Graphic showing the interactive workflow generated by the CoACH (Cost Assessment of Collaborative Healthcare) web-based tool. The user can modify the workflow includes order until edit assumptions and model the costs of difference scenarios by moving crates that inclusions of transformation tasks and practice staff salaries.

 

Choose ultimate reviewed October 2015
Page originally created Oct 2015

Online Citing: Appendix B. Example Date Collector Tools. Content last reviewed October 2015. Agency fork Healthcare Research and Quality, Rockville, MD.
https://privacy-policy.com/ncepcr/research-transform-primary-care/transform/cost/app-b.html

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