Abstract:

This paper presents the results of an extensive review of the literature to identify the metrics that are useful in benchmarking family care practices consisting of family care, internal medicine or pediatric physicians.

The following categories of benchmarking metrics have been identified:
1) clinic facilities,
2) physician productivity,
3) patient waiting and service times,
4) patient scheduling,
5) patient portal usage,
6) patient satisfaction,
7) common diagnoses,
8) staffing levels and
9) financials.

Specific metrics have been identified for each category of benchmarking. For example, a physician productivity metric is the average number of visits/day, week and year. Several patient waiting and service time metrics are the average patient wait to see a physician and average time physician spends with a patient. Several patient scheduling metrics are percent no shows, why no shows miss appointments and how to reduce no shows. A patient portal usage metric is the reason patients use a portal. A patient satisfaction metric is patient suggestions for improving office visits. Several financial metrics are physician charges/month; collections; adjustments; accounts receivable; and total expenses, staffing expenses, supply expenses, net income and physician compensation as percentage of collections. A family care practice can compare its practice against best practices by selecting one or all of the specific benchmarking metrics. In most family care practices nurses play an important role in the overall day-to-day operations. Nurses interface with patients, talk to patients on the telephone, answers patient billing questions and are active in the supervision of office staff. As a result, nurses are acutely aware of the effectiveness and efficiency of the family care practice. The College of Nursing at the University of Alabama in Huntsville introduces it undergraduate and graduate students to the concepts of benchmarking and benchmarking metrics, how to collect benchmarking data, and how to conduct a benchmarking study. Included in this paper is a description of the steps in benchmarking, a description of the specific metrics for each category, nurse training in benchmarking and conclusions. Several conclusion of this project are as follows. Benchmarking is an effective tool to identify where a healthcare organization is performing against its peers and where it needs improvement. This information is then used to identify opportunities for improvement. Technology is becoming a driving force in patient expectations of healthcare encounters.

This is most evident in patient desire:
1) for online appointment scheduling,
2) for automated appointment confirmation and reminders and
3) for online patient portal access.

Twenty-three percent of patients have already had a video chat with their physician and an additional 57% are willing to try. The Covid19 pandemic will probably result in a faster acceptance of virtual care. Patients want to pay on-line. Seventy-nine percent of patients receive paper medical bills; however, only 21% want to pay by check. Virtual care is the wave of the future, including the monitoring of patients with wearable's devices, email consultations and virtual visits. Many healthcare surveys and studies have reported widely different values for the benchmark metric standards; consequently, in these instances it is difficult to benchmark a physician practice against standards.

Keywords:

Benchmarking, metrics, family care practices, nurse training.