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Q: How do you empanel patients for residency programs?

A: Patients should be empaneled to Residents just as they would to faculty PCPs. A great example is from the University of Colorado Denver:
“The resident teaching clinic, AF Williams Family Health Center, has empaneled more than 90% of its 9,500 patients to a primary care clinician. Patients who have not been seen for 36 months are dropped from panels. Patients are empaneled to both faculty physicians and residents; targets for resident-panel size are, for R1, 75; R2, 200; and R3, 400. The empanelment process optimizes balance in patient complexity. R1s are assigned panels with a variety of medical diagnoses and patient ages to ensure a breadth of learning opportunities. The empanelment process, which never stops, addresses the reassignment of patients when R3s leave and makes judgments about which patients are transferred to incoming R1s versus other residents or faculty (see Chapter 12: Building Block 9 for more on resident transitions). Panel sizes are assessed yearly, and the empanelment process is reviewed regularly by the practice manager and discussed with the management team.” (From “High-Functioning Primary Care Residency Clinics Building Blocks for Providing Excellent Care and Training,” available at https://www.aamc.org/download/474510/data/aamc-ucsfprimarycareresidencyinnovationreport.pdf)

Q: How are practices measuring continuity and what are good targets?

A: In general, high performing clinics around the country with excellent panel definitions and management are connecting patients with their team at least 90% of the time. These sites are connecting patients with their PCPs for their visits 70%-90% of the time even with part-time providers.

Q: Any ideas for incentives for teams that are motivated and making progress?

A: A great read on the science of incentives is “Drive” by Daniel Pink.

Q: Who can I contact for technical assistance on implementing Team Based Care at my practice?

Answer: Send us an email to hctransformation@jsi.com

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