Abstract
Accessibility to healthcare is important for patient outcomes and general health of the American population. COVID-19 and insurance have both contributed to how clinics in the United States function as well as patient and provider satisfaction. Primary care clinics struggled with poor communication, long-term complications from COVID-19, and inadequacies for optimization of healthcare. These led to greater inefficiency in patient throughput. Inadequate healthcare is not limited to poor clinic management, insurance also plays a role, uninsured Americans receive poorer health outcome to their insured counterparts (Dillman er al., 2014).
Both the sociotechnical project and the technical project were designed to describe the landscape of healthcare within the United States and improve a small segment of healthcare access. The aim of the technical project, “Optimization of Patient Flow and Process for a Primary Care Clinic During the COVID-19 Pandemic” was to improve patient and provider experience and patient throughput at the University Physicians of Charlottesville (UPC) Suite 2100 clinics. The sociotechnical project sought to explore the role of various groups in the maintaining of private insurance market share and success within the United States as well as the importance of healthcare insurance for patient outcomes.
The technical team did in person observations to understand the general flow through the Suite 2100 clinics (pre-registration, check-in, and rooming) and how different components (physicians, nursing, and front desk staff) operated together to generated qualitative observations. Quantitative data from the University of Virginia Health electronic medical record system, Epic, was also analyzed. This data included cadence reports and scheduling information that was also used to better understand patient flows through the clinic. From both observations
and analysis, the team was able to further analyze the progress of a patients through registration to check out to evaluate statistical significance. These methods allowed the team to model distributions of arrival times, wait times, and other bottlenecks in the patient flow process.
For the sociotechnical research project, private insurance, its market share and its players were analyzed through the Social Construction of Technology (SCOT) STS framework. This included looking at how physicians, professional societies such as the Association of American Physician and Surgeons, and trade associations like the Federation of American Hospitals contribute to securing private insurances market share. The different perspectives on insurance (whether public or private) were also explored through SCOT concept of interpretive flexibility. diachronic closure, another SCOT principle, was used to demonstrate how health insurance is still evolving in the United States through shaping by relevant social groups. This portion of the project also gave way to highlighting the importance of insurance in the United States as it pertains to health of Americans.
Overall, these projects explored healthcare practices and accessibility. On a more general level, through looking at private insurance in the United States, I was able to see the more societal interactions that affect how healthcare is received. I was also able to explore the micro level through analyzing patient throughput at the Suite 2100 clinics, which iterates through potential solutions to inefficiencies within clinic management.
