title: Development of a primary care physician task list to evaluate clinic visit workflow.
abstract: BACKGROUND
  Interventions designed to improve the delivery of primary care, including Patient-Centered Medical Homes and electronic health records, require an understanding of clinical workflow to be successfully implemented. However, there is a lack of tools to describe and study primary care physician workflow. We developed a comprehensive list of primary care physician tasks that occur during a face-to-face patient visit.
  
  
  METHODS
  A validated list of tasks performed by primary care physicians during patient clinic visits was developed from a secondary data analysis of observation data from two studies evaluating primary care workflow. Thirty primary care physicians participated from a convenience sample of 17 internal medicine and family medicine clinics in Wisconsin and Iowa across rural and urban settings and community and academic settings.
  
  
  RESULTS
  The final task list has 12 major tasks, 189 subtasks, and 191 total tasks. The major tasks are: Enter Room, Gather Information from Patient, Review Patient Information, Document Patient Information, Perform, Recommend / Discuss Treatment Options, Look Up, Order, Communicate, Print / Give Patient (advice, instructions), Appointment Wrap-up, and Leave Room. Additional subcodes note use of paper or EHR and the presence of a caregiver or medical student.
  
  
  CONCLUSIONS
  The task list presented here is a tool that will help clinics study their workflows so they can plan for changes that will take place because of EHR implementation and/or transformation to a patient centered medical home.
authors: Division of General Internal Medicine, UW School of Medicine and Public Health, 310 North Midvale Blvd., Madison, WI 53705, USA. tbw@medicine.wisc.edu
authors: Tosha B
authors: TB
authors: Wetterneck
authors: Jamie A
authors: JA
authors: Lapin
authors: Daniel J
authors: DJ
authors: Krueger
authors: G Talley
authors: GT
authors: Holman
authors: John W
authors: JW
authors: Beasley
authors: Ben-Tzion
authors: BT
authors: Karsh
mesh_terms: D057189:Checklist; D006801:Humans; D009819:Office Visits; D058007:Physicians, Primary Care / Q000458:organization & administration / Q000592:standards*; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D013647:Task Performance and Analysis; D014922:Wisconsin; D057188:Workflow