Team-based care: an expanded medical assistant role – enhanced rooming and visit assistance

Harper, Peter; Riper, Kristi Van; Ramer, Timothy J; Slattengren, Andrew H.; Adam, Pita; Smithson, Angela; Wicks, Cherilyn; Martin, Casey S; Wootten, Michael R; Carlson, Steve A.; Miller, Elizabeth; Fallert, Christopher J.

doi:10.1080/13561820.2018.1538107

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…Over the past 2 decades MA roles have evolved to team-based care in order to provide high quality, cost effective, and patient-centered care. 4 , 30 , 31 A growing body of evidence demonstrates that a team-based approach to primary care can improve patient, provider, and staff satisfaction. 32 - 35 Because MA scope of practice is largely defined by adequate training and supervision, MAs with sufficient training are well-positioned to take on complex patient care functions such as care coordination and panel management.…”

Section: Discussionmentioning

confidence: 99%

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Transforming Interprofessional Roles During Virtual Health Care: The Evolving Role of the Medical Assistant, in Relationship to National Health Profession Competency Standards

Rokicki-Parashar

Phadke

Brown‐Johnson

et al. 2021

J Prim Care Community Health

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Introduction: Medical assistants (MAs) were once limited to obtaining vital signs and office work. Now, MAs are foundational to team-based care, interacting with patients, systems, and teams in many ways. The transition to Virtual Health during the COVID-19 pandemic resulted in a further rapid and unique shift of MA roles and responsibilities. We sought to understand the impact of this shift and to place their new roles in the context of national professional competency standards. Methods: In this qualitative, grounded theory study we conducted semi-structured interviews with 24 MAs at 10 primary care sites at a major academic medical center on their experiences during the shift from in-person to virtual care. MAs were selected by convenience sample. Coding was done in Dedoose version 8.335. Consensus-based inductive and deductive approaches were used for interview analysis. Identified MA roles were compared to national MA, Institute of Medicine, physician, and nursing professional competency domains. Results: Three main themes emerged: Role Apprehension, Role Expansion, and Adaptability/Professionalism. Nine key roles emerged in the context of virtual visits: direct patient care (pre-visit and physical care), panel management, health systems ambassador, care coordination, patient flow coordination, scribing, quality improvement, and technology support. While some prior MA roles were limited by the virtual care shift, the majority translated directly or expanded in virtual care. Identified roles aligned better with Institute of Medicine, physician, and nursing professional competencies, than current national MA curricula. Conclusions: The transition to Virtual Health decreased MA’s direct clinical work and expanded other roles within interprofessional care, notably quality improvement and technology support. Comparison of the current MA roles with national training program competencies identified new leadership and teamwork competencies which could be expanded during MA training to better support MA roles on inter-professional teams.

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Section: Discussionmentioning

confidence: 99%

“…

BackgroundIn most health systems, medical assistants (MA) are foundational members of team based care [1][2][3][4] supporting patients and clinicians. Medical assisting is one of the fastest growing occupations in the United States, with over 725 000 jobs in 2019.

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mentioning

confidence: 99%

Transforming Interprofessional Roles During Virtual Health Care: The Evolving Role of the Medical Assistant, in Relationship to National Health Profession Competency Standards

Rokicki-Parashar

Phadke

Brown‐Johnson

et al. 2021

J Prim Care Community Health

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“…Although medical assistant is a general term for several professionals with different medical skills and training, MAs are usually part of a GP's staff [15]. The former role of MAs in physicians' offices was focused on administrative tasks and the provision of isolated clinical measures under the direct supervision of physicians [38]. Currently, MAs are qualified to visit patients at home and manage different tasks, for example, monitoring a patient's health status, taking blood samples, or supervising and adjusting the intake of prescribed medication.…”

Section: Multi-actor Approaches In Modern Health Carementioning

confidence: 99%

Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-Based Primary Care: Mixed Methods Study

Knop¹,

Mueller²,

Niehaves³

2021

J Med Internet Res

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Background Owing to the shortage of medical professionals, as well as demographic and structural challenges, new care models have emerged to find innovative solutions to counter medical undersupply. Team-based primary care using medical delegation appears to be a promising approach to address these challenges; however, it demands efficient communication structures and mechanisms to reinsure patients and caregivers receive a delegated, treatment-related task. Digital health care technologies hold the potential to render these novel processes effective and demand driven. Objective The goal of this study is to recreate the daily work routines of general practitioners (GPs) and medical assistants (MAs) to explore promising approaches for the digital moderation of delegation processes and to deepen the understanding of subjective and perceptual factors that influence their technology assessment and use. Methods We conducted a combination of 19 individual and group interviews with 12 GPs and 14 MAs, seeking to identify relevant technologies for delegation purposes as well as stakeholders’ perceptions of their effectiveness. Furthermore, a web-based survey was conducted asking the interviewees to order identified technologies based on their assessed applicability in multi-actor patient care. Interview data were analyzed using a three-fold inductive coding procedure. Multidimensional scaling was applied to analyze and visualize the survey data, leading to a triangulation of the results. Results Our results suggest that digital mediation of delegation underlies complex, reciprocal processes and biases that need to be identified and analyzed to improve the development and distribution of innovative technologies and to improve our understanding of technology use in team-based primary care. Nevertheless, medical delegation enhanced by digital technologies, such as video consultations, portable electrocardiograms, or telemedical stethoscopes, can counteract current challenges in primary care because of its unique ability to ensure both personal, patient-centered care for patients and create efficient and needs-based treatment processes. Conclusions Technology-mediated delegation appears to be a promising approach to implement innovative, case-sensitive, and cost-effective ways to treat patients within the paradigm of primary care. The relevance of such innovative approaches increases with the tremendous need for differentiated and effective care, such as during the ongoing COVID-19 pandemic. For the successful and sustainable adoption of innovative technologies, MAs represent essential team members. In their role as mediators between GPs and patients, MAs are potentially able to counteract patients’ resistance toward using innovative technology and compensate for patients’ limited access to technology and care facilities.

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“…MAs conduct medical history intake, including the patients' smoking history and status prior to the appointment with the provider. While studies suggest that MAs can help improve care and access to diagnostic tests for colorectal and breast cancer, [43][44][45][46][47] no studies have evaluated the benefit of educating MAs about LCS or exploring their role in LCS.…”

Section: Introductionmentioning

confidence: 99%

A Lung Cancer Screening Education Program Impacts both Referral Rates and Provider and Medical Assistant Knowledge at Two Federally Qualified Health Centers

Akhtar

Sosa

Castro

et al. 2022

Clinical Lung Cancer

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Low LCS referrals at FQHCs may worsen NSCLC disparities in marginalized populations. We implemented a program at two FQHCs that provided LCS education to 57 providers and MAs. After the program, there was a significant increase in both LCS referrals as well as provider and MA ability to identify eligible LCS participants at FQHCs. Background: Federally Qualified Health Centers (FQHCs) serve minority and low-socioeconomic populations and provide care to high-risk smokers. These centers frequently exper ience barr iers, including low provider and medical assistant (MA) knowledge around lung cancer screening (LCS). Subsequent low LCS referral rates by providers at FQHCs limit utilization of LCS in eligible, high-risk, underserved patients. Methods: Providers and MAs from two FQHCs participated in a LCS educational session. A pre-educational survey was administered at the start of the session and a post-educational survey at the end. The intervention included a presentation with education around non-small cell lung cancer, LCS, tobacco cessation, and shared-decision making. Both surveys were used to evaluate changes in provider and MA ability to determine eligible patients for LCS. The Pearson's Chi-squared test with Yates' continuity correction was used to measure the impact. Results: A total of 29 providers and 28 MAs enrolled in the study from two FQHCs. There was an improvement, P < .009 and P < .015 respectively, in provider and MA confidence in identifying patients for LCS. Additionally, one year prior to the program, 9 low-dose computed tomography (LDCTs) were ordered at one of the FQHCs and 0 at the other. After the program, over 100 LDCTs were ordered at each FQHC. Conclusions: A targeted LCS educational program improves provider and MAs' ability to identify eligible LCS patients and is associated with an increase in the number of patients referred to LDCT at FQHCs.

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Team-based care: an expanded medical assistant role – enhanced rooming and visit assistance

Cited by 9 publications

References 30 publications

Transforming Interprofessional Roles During Virtual Health Care: The Evolving Role of the Medical Assistant, in Relationship to National Health Profession Competency Standards

Transforming Interprofessional Roles During Virtual Health Care: The Evolving Role of the Medical Assistant, in Relationship to National Health Profession Competency Standards

Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-Based Primary Care: Mixed Methods Study

A Lung Cancer Screening Education Program Impacts both Referral Rates and Provider and Medical Assistant Knowledge at Two Federally Qualified Health Centers

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