Improving Patient Access and Patient-Clinician Continuity through Panel Redesign

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Project Details -
Completed

Primary care practices need to balance the timeliness of care delivery with continuity of care so that appointment schedules allow patients to see their primary physician whenever possible. Timeliness and continuity are intrinsically tied to the makeup of a provider's patient population, or "physician-patient panel." Using patient appointment data, physician panel sizes, and case mix from primary care databases, the project team investigated how group practices can dynamically manage physician panels to improve timeliness of access and continuity. The team developed a quantitative decision support system to help clinicians, practice managers, and health systems answer the following questions:

  • How should patient panel composition be altered over time to best match patient demand with physician supply?
  • How should practices best match patient and physician preferences, while simultaneously considering the influence of panel size and case mix on patient access?
  • How many additional new patients can be empanelled without adversely affecting the goals of timely access and continuity?

In developing the system, the team constructed a general modeling framework for managing physician panels in a group practice and utilized systems engineering to model the system over time. The model incorporated specific features, such as patient and physician preferences, changes in scheduling regimens, group visits, and changes in the supply and demand dynamics of a practice. The models indicated optimized physician-patient panels increased physician capacity and may create an opportunity to mitigate physician shortages.