Table 1:
Socio-technical characteristics of the 5 participating clinics
| Clinic 1 | Clinic 2 | Clinic 3 | Clinic 4 | Clinic 5 | |
|---|---|---|---|---|---|
| Type of clinic | Internal medicine | Family medicine | Family medicine | Internal medicine | Family medicine |
| Size* | Medium | Small | Small | Medium | Small |
| Location | Midwest | Southeast | Midwest | Midwest | Midwest |
| Years in existence | > 20 years | > 8 years | 1.5 years | > 60 years | 10 years |
| Organizational structure | Final stage of PCMH# | Solo provider supported by clinic manager, MA, receptionist, and billing specialist. | Advanced stage of PCMH implementation | Early stage of PCMH | Early stage of PCMH |
| Clinic staff: | |||||
| Clinic manager | 1 (staff) |
1 (staff) |
1 (RN) |
2 (staff and RN) |
1 (RN) |
| Physicians | 7 (6 FTE) |
1 | 3 | 7 (6 FTE) |
8 (3 FTE) |
| PAs and NPs | 7 | 0 | 0 | 1 | 2 |
| RNs | 6 | 0 | 1 | 11 | 6 |
| LPNs | 2 | 0 | 0 | 0 | 6 |
| MAs | 7 | 1 | 2 | 4 | 2 |
| Schedulers | 7 (shared) | 1 | 3 | 8 (shared) | 3 |
| Other staff | 7 | 1 | 0 | 1 | 5 |
| Patients | ~14,000 | ~4,500 | ~2,500 | ~7,200 | ~5,000 |
| EHR | Epic, implemented in 2001 | Bizmatics Prognosis, implemented in 2005 | Epic, implemented in 2012 | Epic, Implemented in 2012 | Epic, implemented in 2001 |
| Patient portal | Epic MyChart implemented in 2006 | Prognosis patient portal, implemented in 2005 | Epic MyChart implemented in 2012 | Epic MyChart implemented in 2012 | Epic MyChart implemented in 2012 |
| Secure messages received per provider per day | 10-12 | 30-40 (including secure messages and email) | 4-6 | 4-6 | 0-1 |
| Clinicians^ who communicate with % of patients using secure messaging | ~23% | ~18% | ~26% | ~12% | ~10% |
| Staff^ who communicate with % of patients using secure messaging | ~28% | ~18% | ~18% | ~0% | ~0% |
*
A small clinic is defined as a clinic with fewer than 5 full-time equivalent (FTE) physicians; a medium-sized clinic is defined as a clinic with in between 5 and 10 FTE physicians.
#
Patient-centered medical home (PCMH): working in care teams of providers, triage RNs and LPNs or MAs. Schedulers work either in-house or in a scheduling pod.
^
Clinicians: Physicians, advanced practitioners (physician assistants (PAs) and nurse practitioners (NPs)), nurses (registered nurses (RNs) and licensed practice nurses (LPNs)); staff: schedulers, receptionists, medical assistants (MAs) and patient care associates (PCAs).