• Use telephone contact, initiated either by the clinic or the patient, to check up on patient status in lieu of an appointment.
• For patients who may need a follow-up appointment, develop a system where the nurse checks in with the patient by phone two weeks prior to when the follow-up appointment would have occurred. If the patient’s condition warrants a visit, the appointment can be scheduled at that time. Otherwise, an additional follow-up contact with the patient can be made by phone.
• Create an alternative way for patients to refill medications (e.g., pharmacy clinic) or receive lab results (e.g., nurse calls patients with results).
• Physicians can conduct telephone consults with patients. These consults can be pre-scheduled, or planned at the end or beginning of each day.
• Nurses can staff telephone advice lines. If home care is appropriate, nurse interaction with a patient can save a visit to the provider. This requires that nurses use approved advice guidelines and follow protocols for some basic health problems such as UTI, suspected strep, etc.  See Optimize the Care Team for more information.
• Email, telemedicine, and Internet communication between physicians or nurses and patients can be used to manage patients with chronic conditions such as diabetes, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF).
• Nurse clinics can be used to manage patients with chronic conditions such as hypertension and diabetes, and for certain procedures such as sigmoidoscopies and stress tests.
• Group visits in which several patients meet together with a provider and/or the care team can be conducted. Group visits are an effective method not only for reducing demand but also for providing increased continuity of care and a supportive social network for patients. In a group visit, the physician might meet briefly with the group, but the patient receives all the services of a traditional visit by utilizing other members of the care team.

Group Visit Starter Kit

Group Visits 101