The current primary care process can be seen as a series of steps which are initiated as an acute episode (e.g. athletic injury) or chronic disease management (e.g. follow visit to manage high blood pressure.) The steps in the process include:

1. Patient calls clinic to make appointment
2. Drives to clinic, park and walk to clinic waiting area
3. Checks in at desk (name, conditions, insurance changes)
4. Completes current medications and history form
5. Enters exam room
6. Nurse collects data (blood pressure, weight etc.) and current issues and history
7. Physician Enters and conducts examination
8. Physician completes treatment plan, advises patient, order drugs as needed, complete documentation in Electronic Health Record
9. Patient is provided with printed visit summary and plan and exits

Concerns about this current process include

• Much of patient time is spent in non value-added activities
• There is no direct system for follow up between clinic visits
• There is no system to collect useful clinical data between visits
• There is no accessible opportunity for patients to monitor their own progress toward meeting clinical goals

1. Read the case and think about your primary care encounters (pros and cons). You can also query family and friends on their experiences. Is your experience simlar to the process described above?