Integrated Care News by CFHA

MAY 1, 2025

Bridging the 17‑Year Research–Practice Gap Implementation scientists estimate that it takes about seventeen years for new evidence to become routine care (Rubin, 2023). Reclaiming Time and Attention Primary care professionals may log more than eleven hours a day, over half of it in the electronic health record (Menchaca, 2025).

Patient-Centered 130

Patient-Centered Integrated Care Primary Care Healthcare Professional 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: Evaluate implementation of an electronic scoring system (Elders Risk Assessment—ERA) to detect and an adapted risk-factor checklist (Checklist for Early Recognition and Treatment of Acute IllNess in Family Medicine – CERTAIN-FM) to assess older patients at high risk of critical illness in a primary care setting.

Illness 130

Illness Electronics Primary Care Nurse Practitioner 130

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design/Analysis: This cross-sectional study was conducted from September 2022 to April 2023. Setting/Dataset: 121,570 registered patients over 18 years of age with an email address available in their electronic medical record. Setting: 104 PHC clinics across Quebec, Canada.

Healthcare 130

Healthcare Clinic Chronic Condition Finance 130

Annals of Family Medicine

NOVEMBER 20, 2024

Search strategy developed for six medical databases (2000-March 2023), key terms of ID, pain, analgesia, medication. Measures: Varied by study design; self/carer-report or electronic health records (EHR). Study Design and Analysis: Systematic review (PROSPERO CRD42023415051). Narrative synthesis of findings.

Management 130

Management Medical Healthcare Professional Chronic Condition 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Electronic health record (EHR) order preference lists and order sets potentially improve efficiency but have limited utility in complex primary care settings. Beginning of Phase 2 (rapid implementation), 630 xOrders were released with an additional 253 xOrders added between 9/26/2021 and 6/24/2023.

Primary Care 130

Primary Care Nurse Practitioner Finance Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Reviews were identified through a search of scientific electronic databases: MEDLINE, CINAHL, PsycInfo, AMED, Healthcare Administration Database, ABI/INFORM Collection, Cochrane Database of Systematic Reviews, Epistemonikos, and Scopus. Results: Thirteen reviews published in English from 2010 to 2023 were included.

Finance 130

Finance Community Consulting Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Patient portals (PPs) are online healthcare platforms enabling patients access their electronic health records and offering different features to help patients manage their care such as viewing and entering health information, and permitting asynchronous communication between patients and their providers.

Patients 130

Patients Primary Care Appointment Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: In response to a call initiated by CIHR in 2023, inviting patient, public, and community participation, the Patient Council of the Canadian Primary Care Research Network (CPCRN) responded with a Report on March 25, 2024. Results: The Pan-Canadian Patient Council met electronically to co-analyze and interpret the themes.

Patients 130

Patients Community Primary Care Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Study design and analysis: A retrospective matched cohort study using data from more than 70 Dutch general practices collected from 2015 until 2023. Setting or Dataset: The Academic GP Developing Network Database (AHON), containing data from the electronic patient file of more than 460,000 patients was used for analysis.

General Practice 130

General Practice GP Management Patients 130

Family Medicine Initiative

APRIL 9, 2024

The study was terminated early because benefits were already significantly visible by October 2023. million electronic health records in the USA showed a lower risk for suicidal thoughts in those taking semaglutide than in those taking other weight loss medications. semaglutide 1.0 mg or placebo in 2019. 17 An analysis of 1.8

Diabetes 130

Diabetes Patients Medical DO 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: Electronic health record data from 541 community-based clinics across 17 states in the OCHIN network from 01/01/2019-5/31/2023. In the months following the PHE declaration >50% were telehealth, leveling to 25% at the end of the study period (March 2022-May 2023).

Primary Care 130

Primary Care Screening Telehealth Community 130

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design: We performed a scoping review searching three electronic databases. Dataset: We systematically searched PubMed, Embase (Ovid), and IEEE Xplore on August 4, 2023. Population studied: We included studies reporting results on the development, evaluation, and implementation of DTs for clinical decision-making.

Clinic 130

Clinic Electronics Screening Physicals 130

Annals of Family Medicine

NOVEMBER 20, 2024

Population Studied: Individuals identified through electronic medical record (EMR) periodic surveillance with either diagnosed with HCV and either not engaged in treatment or not completed treatment, as well as those needing additional testing (SVR or high-risk re-testing).

Behavioral Health Services 130

Behavioral Health Services Primary Care Patients Healthcare 130

Annals of Family Medicine

NOVEMBER 20, 2024

It includes modifications to the EpicTM electronic medical record (EMR) for guidance on treatment alternatives, support for provider-patient communication and goal setting, billing and coding support, and a new visit type called a Weight Prioritized Visit (WPV).

Primary Care 130

Primary Care Management Electronics Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

This analysis was part of a larger implementation study called PATHWEIGH, which provides a toolset embedded in the EpicTM electronic health record and other supportive services to help practices provide weight management to their patients. We utilized AI tools in the qualitative software program Atlas.ti

Primary Care 130

Primary Care Electronics Provider Management 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting: Providers across six Northern California clinic sites surveyed over an 8-week period (March 21-May 16, 2023). Population Studied: 87 primary care providers, including family physicians, internists, nurse practitioners, and physician assistants.

Telemedicine 130

Telemedicine Primary Care Provider Nurse Practitioner 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting/Dataset Data were extracted from the electronic health records at a Family Medicine practice in Philadelphia, PA. Population Studied Inclusion criteria were ages 16-45 with a DME performed between 2018 and 2023.

DO 130

DO Family Medicine Complication Families 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: Practice facilitators recorded activities in an Electronic Practice Record (EPR) in REDCap. Results: Practices received 407 in-person and 37 virtual PF visits from Feb 2022 to Aug 2023. Study Design and Analysis: 3-stage, modified step-wedge design. Descriptive statistics were used to summarize PF activities.

Management 130

Management Primary Care Electronics Healthcare 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: 1) Demonstrate the feasibility of collecting data from prescription drug monitoring programs (PDMPs) for population health reporting, 2) analyze trends in PDMP and electronic health record patient data relative to CDC guidelines and 3) identify use of patient-centered measures for pain management in primary care.

Patients 130

Patients Patient-Centered Primary Care Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: Electronic Health Record data from 599 CHCs in 11 states on the Accelerating Data Value Across a National Community Health Center Network clinical research network. Unwinding of Medicaid continuous enrollment in the last months of 2023 may damper the effect of this eligibility expansion.

Community 130

Community Insurance Healthcare Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

Dataset: Electronic medical records (EMR) from an 8-hospital health system in Southeast Michigan. Population Studied: Patients 50-80 years old without lung cancer eligible for LCS from April 1, 2021, to December 31, 2023. Study Design: Retrospective cohort study.

Screening 130

Screening Insurance Electronics Healthcare 130

GeriPal

APRIL 6, 2023

Alex Practice-PC Program Information: UCSF’s Practice-PC program is now accepting applications for the 2023-2024 year. LaVera: I trained at UCSF in family medicine. Thanks to my son Kai for playing the guitar part in 5/4 with strange chords on Riverman by Nick Drake! You started off as a physician, right? LaVera: Yes.

IT 99

IT Patient-Centered Families Family 99