Francis, MD – Primary Care Physician


Direct Engager

Clinical Role

Primary Care Physician

Strength of Evidence

Strength of Evidence Rating 5 out of 5


Human Factors Engineering (HFE), Office of Health Informatics, Veterans Health Administration

Francis, MD – Primary Care Physician




Dr. Francis is trying to keep her work-life balance while handling the stress of a busy job on the frontlines of the VHA.

Early 40s, married                          


Intermediate tech skills             

Direct Engager

My Relationships

In the diagram above, individuals that are darker, larger and closer to Francis are more important to her than individuals that are smaller, lighter and farther away.

“I want to provide my patients with what they need as quickly as possible, but while also showing each and every one that they are my priority”

My Job

  • PCP, 6 years
  • Full-time, CBOC-based clinician with a panel of 1,280 Veterans
  • 100% Outpatient Clinic averaging 18 patient appointments a day

My Devices & Technology Skills

  • Several desktops in several locations (work computers)
  • MacBook Pro with latest OS (Personal Computer)
  • Mobile phone: iPhone 6 – iOS 9 (smart phone)
  • iPad Mini 4 (Tablet)
  • FitBit Charge HR (fitness tracker)

Barriers & Enablers to Patient-Centered Care (PCC)

  • Lack of sufficient scheduled time for documentation tasks
  • Lack of adequate resources to manage walk-ins
  • Policies creating work without a clinical need


  • In person (patients and co-workers)
  • Electronic Notes & Orders via CPRS
  • Electronic Instant Messaging
  • VA Email (co-workers, HIT tech support)
  • Phone, Voicemail Systems & Pagers (patients, co-workers, non-VA providers)
  • Fax (patients & non-VA providers)
  • Overhead Paging System

My Pain Points & Motivators

  • Administrative burdens related to CPRS
  • CPRS alert management and fatigue
  • An EHR that is designed around her personal visit style
  • Filtered alerts, showing only those that may require her action
  • Biometric authentication
  • Full integration of MHV Secure Messaging

My Narrative

Dr. Francis is a primary care provider at a Community Based Outpatient Clinic (CBOC). She has been with the VA about six years. Her day is packed solid with appointments and she sees almost 20 Veterans per day from all different service eras.

Dr. Francis is supposed to have a dedicated Nurse, Tech and half-time Admin Clerk on the PACT, but shares each between 3 other PCPs. This is very difficult because it requires that she spend more time doing non-clinical tasks when she would much rather spend more time with Veterans and keep her clinical knowledge up to date with the ever changing pace of modern medicine. She often feels like she has to focus on processing tasks instead of focusing on the health outcomes of her patients. 

Dr. Francis is married with an active 9 year old daughter. Despite her dedication to Veterans, she experiences fleeting thoughts of contacting a colleague who stated there is an opening in her practice with better work/home balance and compensation. She regularly misses her daughter’s soccer games and her relationship with her husband is suffering as well. She knows that the private practice position would require interruptions of her home life that she doesn’t experience with the VA. But, she may seriously consider a career change soon if things do not improve.

My Components of Health and Proactive Well-being

This describes Francis’ relative health and well-being attitudes. 

In the diagram above, the relative width of the three outer bands and the
relative size and brightness of the eight inner circles represent their importance to Francis.

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