Rethinking the Role of ACPs in Cardiology

Is the right person performing the right tasks at the right time in your cardiology practice?  Advanced care practitioners (ACPs), such as physician assistants (PAs) and nurse practitioners (NPs), have long supported the delivery of cardiac care.  In many physician practices and hospitals, however, ACPs are simply not being leveraged as effectively as they could be.  Instead, lingering assumptions about the role of ACPs and long-held practice models are restricting their true capacity to improve productivity and enhance patient access.  The use of PAs and NPs is not new or novel, yet ACPs continue to be untapped resources for improving the delivery of cardiac care.

ACP Utilization and Responsibilities

The employment of ACPs has grown over the past 5 years; however, increased employment does not necessarily reflect optimal usage.  There is often an opportunity to safely increase the scope of work for PAs and NPs, from providing follow-up care for more complex patients to administering stress tests and even diagnostic cardiac catheterizations (primarily in select academic settings).  Various studies confirm this, including a Duke University study showing that trained and supervised PAs performed diagnostic caths on par with cardiology fellows.

Care Teams

Emphasizing the benefits of a “care team” approach may be helpful for those of you who may experience difficulty in “selling” a visit with a PA/NP to patients.  Care teams are assigned a panel of patients who will always see one of the team providers, allowing for more efficient follow-up scheduling and a greater sense of continuity.  As the initial operational challenges of team practice are identified and addressed, the teams are often able to handle a panel size greater than would have been possible as independent providers, increasing patient access.

Shared Visits

Many high-performing cardiology practices use “shared visits” or “double schedules” as another way to increase the integration of ACPs into their practices.  In these types of appointments, the PA/NP gathers the majority of information from the patient and conducts most of the appointment, with a brief visit from the physician at the end.  One of our clients remarked that this approach allowed physicians and ACPs to see up to a combined 35 to 38 patients in a day.  Shared visits can also help improve patient satisfaction, as patients may prefer a timely appointment with an ACP and brief visit with their physician over lengthy waits for a physician-only visit.

Optimize Your Resources

Becoming more effective, efficient, and cost-conscious requires physicians and physician practices to think innovatively about care delivery; but that doesn’t necessarily mean reinventing the wheel.  With ACPs continuing to be available but underutilized resources, it’s time to rethink their involvement in advancing care, not just supporting it.

This post is adapted from a column that originally appeared in the October 2014 issue of CardioSource WorldNews, a publication of the American College of Cardiology.

This entry was posted in Cardiology, Performance Improvement, Physician Strategy, Practice Management and tagged , , , , by Jason Peterson. Bookmark the permalink.

About Jason Peterson

Jason’s extensive project management, healthcare operations, and information technology (IT) experience enables him to take a holistic approach in addressing issues from physician compensation mechanisms to information systems integration. At ECG, Jason has worked on a variety of engagements, including strategic business planning, physician/hospital alignment development, physician compensation planning, managed care contract analysis, and provider-based billing implementation. Before transitioning to the Healthcare – Northwest practice, Jason worked in ECG’s Healthcare IT practice, implementing electronic health record (EHR), practice management, and patient portal systems. Prior to joining ECG, Jason worked as a Quality and Operational Improvement Consultant for Kaiser Permanente and as a System Engineer for a healthcare IT vendor, managing interface implementation and device integration projects. Jason has master’s degrees in business administration and health services administration from the University of Washington and a bachelor of science degree in biomedical engineering with a minor in economics from Washington University in St. Louis.

One thought on “Rethinking the Role of ACPs in Cardiology

  1. Pingback: Becoming a High-Performing Cardiology Practice | ECG Management Consultants, Inc.

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