Implementing pre-visit lab testing in your practice can save you time and money, enhance the patient experience and prevent no-shows. Get answers to your questions about this efficient method of managing patient care.
Pre-visit lab testing involves ordering patient lab tests for completion before upcoming appointments. This gives physicians the opportunity to discuss results with patients at their visits, eliminating the need to review results later and call patients to explain results and coordinate follow-up care.
For clinics implementing this system, it’s working. Ben Crocker, MD, a primary care physician in Boston, instituted pre-visit lab testing in 2012. Dr. Crocker’s practice saw dramatic results, including:
- 89 percent fewer phone calls to the practice
- 85 percent fewer letters sent to patients
- 61 percent fewer revisits resulting from abnormal test results
- 21 percent fewer lab tests ordered overall
All told, instituting pre-visit lab testing saved the practice about $25 per visit in physician and staff time.
A free online module in the AMA’s STEPS Forward collection offers everything you need to know to start pre-visit lab testing in your practice. If you’re interested, but you have questions, get your answers below.
- Will this require hiring additional staff? No—it actually requires less staff time. For example, without a pre-visit lab process in place, the patient sent for a lab test after the visit may need to call for results. The receptionist or call center fields the call and passes the message to the nurse, who discusses the matter with the physician. The physician must then review the chart for clinical details and communicate back to the nursing staff about next steps. The nurse then tries to contact the patient, which may require multiple attempts. These steps all can be avoided with pre-visit lab testing.
- If I schedule patients for appointments up to one year in advance, won’t there be a lot of patients who need to reschedule, either because of their schedule or the physician’s? Will there be a lot of no-shows? Many practices find that scheduling one year or more in advance saves staff time. Some patients will have to call to reschedule later, but this is less work than a system that requires all patients to call to schedule their next visit. Experience suggests that pre-visit lab testing, especially when coupled with an automated reminder, will decrease the rate of no-shows.
- Will patients remember to come in for a lab test and their appointment if scheduled three, six or even 12 months in advance? Many scheduling systems include automated reminder functions. When setting up the next appointment, the patient can choose to receive a reminder via email, text message, phone call or letter.
- What if a patient doesn’t come in for their lab appointment? The staff can call the patient, inviting them to come in for the test they missed and, when appropriate, remind them of their upcoming appointment with the physician. This phone call can serve as a safeguard to reduce no-shows for office visits and can alert staff to the occasional situation in which a patient has moved or is not planning to keep their appointment, allowing you to open up that time slot.
- Can this same system be used for other tests? Yes, the same processes can be used for X-rays and other diagnostic tests. For example, by scheduling a mammogram or follow-up chest X-ray to occur before the patient’s next appointment, it is less likely the patient will miss the test or that your practice will overlook the results.
- What if the patient’s pre-visit lab testing yields an abnormal result? Practice teams generally handle abnormal results according to established protocols and by reviewing abnormal results with the physician. For example, if a patient has a newly elevated blood sugar result, the practice team will discuss with the physician, who may choose to order additional tests prior to the appointment. This provides the opportunity to advance the clinical evaluation prior to the appointment.
The module includes information about how to get support for intervention implementation, and it offers continuing medical education credit. More than 25 modules are expected to be available the AMA’s STEPS Forward collection by the end of the year.
If you’re interested in more ways you can save time and money in your practice through pre-visit planning, visit AMA Wire®.
