2023, Family Medicine and Referral

Artificial Intelligence in Health Care

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). Annals of Family Medicine , 23(1), 5–6. A personalized AI interaction turned a dietary goal into a recipe my daughter loved. References Menchaca, J.

Patient-Centered

Patient-Centered Integrated Care Primary Care Healthcare Professional

Changes in patterns and referrals of Nova Scotians seeking mental health care through 2-1-1 Referral Service [Health care services, delivery, and financing]

Annals of Family Medicine

NOVEMBER 20, 2024

Context 2-1-1 is a designated phone help line in Canada and the US that provides referrals for individuals to local government and community-based services for a wide variety of needs, including social, health care, and mental health services. 2-1-1 Nova Scotia has operated since 2013 as a nonprofit that offers 24/7 assistance.

Referral

Referral Mental Health Finance Community

Optimizing Medical Legal Partnerships for sustainable public funding through the tele-legal model [Mixed methods research]

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design and Analysis: Tele-legal services were provided by one full time poverty lawyer and paralegal January 2021-June 2023. Setting or Dataset: Clinics: AF Williams Family Medicine, Lowry Internal Medicine; EPIC data; legal records. Intervention/Instrument: Legal-needs screening tool.

Medical

Medical Referral Screening Internal Medicine

Risks and Needs: Lessons Learned from Assessing Patients Willingness to Receive Help for Social Risks in Primary Care [Social determinants and vulnerable populations]

Annals of Family Medicine

NOVEMBER 20, 2024

Context: In May 2023, Mayo Clinic implemented a revised screening tool to assess social determinants of health (SDOH) for its patients. Setting or Dataset: Secondary data on social needs screening and referral generated through Epic. Setting or Dataset: Secondary data on social needs screening and referral generated through Epic.

Primary Care

Primary Care Referral Routine Screenings Patients

Practice patterns of Ontario physicians working in 'boutique' medical clinics [Economic or policy analysis]

Annals of Family Medicine

NOVEMBER 20, 2024

All fee-for-service physicians who billed at least 1 OHIP claim from January 1, 2016 to December 31, 2016 and from January 1, 2023 to December 31, 2023 under their clinic group codes were included. There was a higher rate of referrals to dermatology, surgery, and family practice from boutique clinics.

Clinic

Clinic Referral Primary Care Physician Primary Care

Evaluation of Universal Food Insecurity Screening in the Primary Care Setting [Social determinants and vulnerable populations]

Annals of Family Medicine

NOVEMBER 20, 2024

The American Academy of Pediatrics recommends universal screening; however studies have found inconsistencies in screening of FI, documentation of FI, and referral to appropriate resources. Comparison of FI for paired patients in 2022 and 2023. Enrollment and referrals in food assistance programs.

Primary Care

Primary Care Screening Referral Utilities

Factors associated with patients' experience of access to their primary health care clinic: a multilevel analysis [Health care services, delivery, and financing]

Annals of Family Medicine

NOVEMBER 20, 2024

Between September 2022 and June 2023, online questionnaires were sent to patients attached to a family physician and to PHC professionals and administrative staff. Study Design and Analysis. This cross-sectional study builds on survey data collected in multidisciplinary PHC clinics. Multi-level logistic regression models were fit.

Nurse Practitioner

Nurse Practitioner Clinic Family Physician Finance

Multisector Health Equity Coordination in a Midwestern Primary Care Practice, 2022-2023 [Social determinants and vulnerable populations]

Annals of Family Medicine

NOVEMBER 20, 2024

Multisector coordination is critical for effective screening and referral initiatives. Objective: To assess the function and impact of a new role, a Health Equity Coordinator, on the reach of the social needs screening and referral program. Contact hours included a mix of in-person visits and phone calls.

Primary Care

Primary Care Referral Screening Patient-Centered

Substance Use Disorder Screening in Adolescent Patients in Primary Care: Findings, Challenges, Lessons Learned [Behavioral, psychosocial, and mental illness]

Annals of Family Medicine

NOVEMBER 20, 2024

Setting: Three PC practices that routinely serve adolescents were selected: 2 urban practices (1 Family Medicine [FM] and 1 Pediatric [PED]) and 1 rural combined FM/PED practice. Study period for urban locations: Oct 2–Dec 29, 2023; for the rural location: Nov 1, 2023–Jan 31, 2024.

Primary Care

Primary Care Screening Referral Wellness Visit

Impact of the COVID-19 Era on Preventative Primary Care for Children 0-5 years old: A Scoping Review [Child and adolescent health]

Annals of Family Medicine

NOVEMBER 20, 2024

Restrictions and subsequent adaptions to routine care may have affected a variety of outcomes for young children including growth and development, referral rates and wait times, and the identification and management of developmental delays. Intervention: The COVID era was defined as March 11, 2020-May 11, 2023.

Primary Care

Primary Care Referral Relationship Management

Hepatitis C Micro-elimination Using Patient Navigation In a Regional Healthcare System [Infectious diseases (not respiratory tract)]

Annals of Family Medicine

NOVEMBER 20, 2024

Intervention: Patient navigation program to specialist treatment from primary care with additional referral to behavioral health services. A particular focus was those falling outside of the traditional birth cohort.

Behavioral Health Services

Behavioral Health Services Primary Care Patients Healthcare

The utilization patterns and impact of the Stanford Chronic Pain Self-Management Program in Eastern Ontario, Canada [Pain management]

Annals of Family Medicine

NOVEMBER 20, 2024

Dataset: We used data routinely collected through the CPSMP between December 2017 and May 2023. Anyone suffering from pain could register for the program without needing a referral or formal diagnosis from a health care practitioner. Intervention: The CPSMP is a six-week, peer-led program based on self-efficacy theory.

Management

Management Utilities Referral Individual

A feasibility study of the Illuminate 360o approach for monitoring the implementation of a health system innovation [Mixed methods research]

Annals of Family Medicine

NOVEMBER 20, 2024

Setting: Alberta, Canada from May 2022 to October 2023. Participants provided short reflections about their surgical journey or referral experiences, along with elaborations in quantitative categories. Study Design and Analysis: We used a mixed-method complexity-informed methodology.

Referral

Referral Healthcare Provider Utilities

Beyond the Diagnosis: A Detailed Characterization of Outpatient Palliative Care Patients [Palliative and end-of-life care]

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design Retrospective chart review of patients seen in a palliative care clinic between June 2023 and August 2023. The Supportive Medicine Clinic (SMC) provides palliative care integrated within the divisions of pulmonology and cardiology, operating as a hospital-based outpatient clinic.

Patients

Patients Diagnosis Patient-Centered Utilities

Chronic disease management among people with serious mental illness across rural, small urban, and metropolitan settings [Health care disparities]

Annals of Family Medicine

NOVEMBER 20, 2024

Referral to and/or visit with an ophthalmologist was most common in metropolitan settings, with similarly lower values in small urban and rural. The proportions of people with any diabetes or anti-hypertensive drug were similar across settings, but with some variation in patterns for insulin and non-insulin diabetes drugs.

Chronic Disease Management

Chronic Disease Management Chronic Disease Illness Management

Anatomy of a Healthy Plate- Guest Blogger Rebecca Gray

New South Family Medicine and MedSpa

SEPTEMBER 17, 2019

We follow ALL VACCINATION GUIDELINES set forth by the American Academy of Pediatrics and the American Academy of Family Medicine! Then take a moment to reflect on your unique plate. How closely does your current diet and lifestyle reflect the above plate? What similarities do you notice? Learn more.","robots":"index","keywords":"skin

Referral

Referral DO Family Medicine Primary Care

RCT of Chaplaincy: Lexy Torke, Karen Steinhauser, LaVera Crawley

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. And so helping physicians have more fluency in general spiritual care and how to make referrals to specialists when needed. LaVera: Yes. Absolutely loved it.

IT

IT Patient-Centered Families Family

Primary Care Digest

Artificial Intelligence in Health Care

Changes in patterns and referrals of Nova Scotians seeking mental health care through 2-1-1 Referral Service [Health care services, delivery, and financing]

Trending Sources

Optimizing Medical Legal Partnerships for sustainable public funding through the tele-legal model [Mixed methods research]

Risks and Needs: Lessons Learned from Assessing Patients Willingness to Receive Help for Social Risks in Primary Care [Social determinants and vulnerable populations]

Practice patterns of Ontario physicians working in 'boutique' medical clinics [Economic or policy analysis]

Evaluation of Universal Food Insecurity Screening in the Primary Care Setting [Social determinants and vulnerable populations]

Factors associated with patients' experience of access to their primary health care clinic: a multilevel analysis [Health care services, delivery, and financing]

Multisector Health Equity Coordination in a Midwestern Primary Care Practice, 2022-2023 [Social determinants and vulnerable populations]

Substance Use Disorder Screening in Adolescent Patients in Primary Care: Findings, Challenges, Lessons Learned [Behavioral, psychosocial, and mental illness]

Impact of the COVID-19 Era on Preventative Primary Care for Children 0-5 years old: A Scoping Review [Child and adolescent health]

Hepatitis C Micro-elimination Using Patient Navigation In a Regional Healthcare System [Infectious diseases (not respiratory tract)]

The utilization patterns and impact of the Stanford Chronic Pain Self-Management Program in Eastern Ontario, Canada [Pain management]

A feasibility study of the Illuminate 360o approach for monitoring the implementation of a health system innovation [Mixed methods research]

Beyond the Diagnosis: A Detailed Characterization of Outpatient Palliative Care Patients [Palliative and end-of-life care]

Chronic disease management among people with serious mental illness across rural, small urban, and metropolitan settings [Health care disparities]

Anatomy of a Healthy Plate- Guest Blogger Rebecca Gray

RCT of Chaplaincy: Lexy Torke, Karen Steinhauser, LaVera Crawley

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