Providers are still working from a schedule that assumes there’s a mixture of easy and complicated appointments. With the easy stuff often being handled outside of clinic, Providers are attempting to provide a high quality of care to increasingly complex patients and still fit it all into the same block of time.

We don't have any simple visits anymore in Primary Care. We've gone so much to Electronic Visits and Phone Visits and doctors on the phone (KP Now) to the Virtual Medical Center who's also doing the same kind of thing. So all that comes in the door during the day is complex, sick people

Family Medicine Physician, LAMC

A physician is trained to disambiguate complex problems and figure out things that a machine can't.

Surgeon, Orange County

The concept of having an ailment, going to a doctor, getting a treatment - that's largely been replaced by having 6 or 7 ailments, on top of questions about something they saw on television or something their friend talked to them about

Family Medicine Physician, Baldwin Hills

• HMW provide holistic care coordination for those who need it most?
• HMW evolve our automated and support systems for physicians to allow for variety of practice?
• HMW create a staffing model that shifts chronic complex conditions into new specialty care practice?
• HMW collect more useful data about our complex member's health to understand when they need support?
• HMW acknowledge the shifting work of in-clinic care? new staffing? new roles? new protocols?

Primary Care is designed to be the gatekeeper of most care experiences for members. In order to do what’s best for the patient, PCPs are frequently working beyond their scope and comfort level and placing the burden of responsibility on themselves in an attempt to control patient outcomes. Inconsistent care team support is made worse by the lack of reliable feedback channels between PCPs and care team leadership.

There's no consistent feedback loop back to the nurse manager. Where is the opportunity for the nurse manager to sit down and say, "What's working, what's not working, where are the gaps?" There isn't that time at all.

Family Medicine Physician, Baldwin Hills

Medicine should be a team sport – we are not leveraging the group of individuals to its maximum

Family Medicine Physician, Colorado

I think our team works as efficiently as it can, but sometimes is it you've maximized efficiency and is there some other thing to be looking at? Is it a volume problem? Sometimes I think we keep looking at the individual as the problem rather than the system as the problem

Family Medicine Physician, Pasadena

• HMW distribute the burden of responsibility away from Physicians?
• HMW improve the feedback loop between doctors and care team?
• HMW engage patients to become a part of their PCP's care team?
• HMW reimagine Primary Care not being the front-door of care.
• HMW celebrate PCPs being the face of KP?

PCP’s are trained to make quick and responsible decisions based on the information available, yet they are frequently delayed or impaired by a lack of available data or a member’s misunderstanding of the purpose of their visit. With many appointment types still defaulting to “Physical,” or “Annual Wellness,” members have unrealistic expectations of what will occur in their visit. We should strive to arm both new and existing members with education about the importance of sharing health data and questions prior to visits in order to experience the best care possible.

If we were queued up with patient's concerns prior to their visit, I'd be able to see 40 patients in a day

Family Medicine Physician, Colorado

It's not just 1 problem, they come in with 14 problems. Patient expectations need to be set and nobody wants to set that because it's a Customer Service business now. So how can a doctor address 6 problems in basically 15 minutes?

Family Medicine Physician, Pasadena

If patients were educated to know what is seen for a physical, why you would go to urgent care, what's an ER appointment, what's a telephone appointment? They have 15 problems during a telephone appointment - I think patients just don't know - it's not their fault, they're just not given the education.

Family Medicine Physician, Pasadena

• HMW onboard new members in a more efficient way?
• HMW collect the pertinent details of a new member's history outside of a Primary Care visit?
• HMW extend the appointment before and after
• HMW set everyone up for success before the appointment?
• HMW teach members to be advocates for themselves within the KP system?

Over the past 2 decades the volume of new requirements placed on physicians from multiple directions has strained their ability to practice quality medicine. New expectations from PMGs, the Federal Government, patients, and the software itself have squeezed our PCPs from all sides, leaving many to reduce their committment to KP, their families, or themselves.

I cannot believe the rock the primary care docs are required to lift every day. It's insane - the documentation, screening metrics, prescription refills, emails, diagnosis refresh. They're pulled back from direct patient care to doing this other stuff, with no incentive.

Family Medicine Physician, MAS

Whenever you get pulled away from your WHY that’s when you’re much more at risk for getting burned out. Because you’re spending a lot of time doing something that you don’t have much interest in

Physician and Author, San Francisco

The problem with HealthConnect is its relentlessness - all the time it keeps coming. It's like Whack-A-Mole; it just keeps coming up - if you're the type of person that relaxes when everything is "whacked," you're never relaxed.

Family Medicine Physician, Baldwin Hills

• HMW acknowledge and value the new workstreams created by new technology?
• HMW make the least intuitive parts of documentation a breeze?
• HMW prototype new sustainable systems of care before operationalizing unintentional hazards?