Assessment administration can consume hours each week—time that could be spent with patients. The solution isn't skipping assessments (they're clinically valuable and often required for billing). The solution is making them dramatically more efficient.
1. Move assessments before appointments
Having patients complete measures during session time is the biggest workflow inefficiency. Every minute a patient spends filling out a PHQ-9 in your office is a minute you're not providing clinical care.
Send assessments electronically 24-48 hours before appointments. Patients complete them on their own time, and results are ready when you walk into the session. This saves 5-10 minutes per session and actually improves data quality—patients aren't rushed and have time to consider their responses carefully.
Some patients won't complete them beforehand. Have a backup process: tablet completion in the waiting room, or paper forms. The goal is reducing routine in-session administration, not eliminating it entirely. Completion rates typically run 70-85% when systems are well-designed and patients understand the purpose.
2. Automate scoring completely
Manual scoring consumes more time than you'd think. A PHQ-9 has nine items scored 0-3—simple addition, but multiply by dozens of patients, add occasional scoring errors that need correction, and you've spent significant time on arithmetic.
Use assessment tools that score automatically. The patient clicks "submit" and the total appears instantly, along with severity interpretation and comparison to previous scores. This saves 1-2 minutes per assessment and eliminates scoring errors entirely. Automatic scoring supports CPT 96127 billing just as manual scoring does—you're still responsible for clinical interpretation; the automation handles the arithmetic.
3. Use templates for documentation
Assessment results need documentation in clinical notes. Writing this from scratch for each patient wastes time and creates inconsistency.
Create templates that pull assessment data directly into progress notes. A good template includes: assessment administered ("PHQ-9 completed electronically prior to session"), score with interpretation ("Score: 14, indicating moderate depression"), clinical significance ("5-point improvement from last month"), and clinical action ("Continue current treatment plan. Reassess in 4 weeks").
Many EHRs support dynamic fields that populate from assessment data. If yours doesn't, even a static template with blanks saves time over free-text documentation. This can cut 3-5 minutes per note.
Templates should support documentation, not replace clinical thinking. The interpretation and action sections require your judgment—automation handles data transfer; you handle clinical reasoning.
4. Use tiered screening
Not every patient needs a comprehensive battery at every visit. Efficient assessment means matching depth to clinical need.
Implement brief screeners like the PHQ-2 and GAD-2 for routine monitoring—they take about 30 seconds each. Reserve full assessments like the PHQ-9 and GAD-7 for positive screens, new patients, and clinically indicated situations.
A typical workflow: patient receives PHQ-2 and GAD-2 before session. Both score below threshold? Brief check-in documented, move to clinical content. One scores positive? The full measure automatically sends, with results available within minutes for same-session use.
Brief screeners have high sensitivity—they catch most cases. What they may miss on specificity (occasional false positives) is acceptable because positive screens trigger further assessment anyway.
5. Batch administrative work
Some assessment tasks can't be fully automated: reviewing unusual results, following up on concerning responses, configuring new patient schedules. Handling these throughout the day fragments your attention.
Designate specific times for assessment administration. Beginning of day: review overnight completions, note concerning scores. Between sessions: quick check for new results. End of day: follow up on non-completions, review trends for tomorrow's patients.
Many tasks don't require clinician involvement—sending surveys, monitoring completion rates, following up with non-completers. If you have support staff, delegate these. Your time should focus on clinical interpretation and care.
What this looks like in practice
Here's an efficient workflow: 24 hours before the appointment, the system sends PHQ-2 and GAD-2 to the patient. Patient completes them on their phone (one minute). PHQ-2 scores 4, triggering automatic PHQ-9 delivery. Patient completes it (two minutes). Results are ready for clinician review.
Session prep takes two minutes: review dashboard, note PHQ-9 = 14 (down from 18 last month), check that item 9 shows no self-harm concerns. Session starts with context established: "I see your depression score improved this month. How have you been feeling?" Documentation takes one minute with the template auto-populated.
Total clinician time on assessment: 3-4 minutes. Compare to the old workflow: patient fills out paper form (5 minutes of session time), clinician scores manually (2 minutes), documents from scratch (5 minutes). That's 12+ minutes, much of it during the session itself.
Start with one change
Pick the highest-impact opportunity for your practice. If patients complete assessments in session, start with pre-appointment delivery. If you score manually, implement automatic scoring. If documentation is tedious, create templates. If assessments feel excessive, implement tiered screening. If administrative tasks fragment your day, establish batch processing times.
One improvement creates time for the next.