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Compass Rose for Generating Community-based Referrals via Epic: Best Practices and Lessons Learned [Social determinants and vulnerable populations]

Annals of Family Medicine

A Compass Rose episode was automatically generated in the patient’s medical record in Epic if patients indicated that they had at least one of the four social risk factors on the screening tool. Results: Between January 2024 and March 2024, the pilot sites generated 861 Compass Rose episodes.

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Transitional Care Management care team impact on no-show rates to hospital discharge appointments [Patient education/adherence]

Annals of Family Medicine

Context: The Transitional Care Management (TCM) clinic visit is a uniquely billed visit type to review a recently discharged patient’s hospital course, reconcile medications, and continue ongoing workup. Referrals were not placed for patients being discharged to another facility or who already had an outside primary care provider.

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Association of Tobacco Assessment and Cessation Assistance with Social Determinants of Health Risk in Primary Care [Smoking cessation]

Annals of Family Medicine

Setting or Dataset: Electronic health record data from 11 community-based clinics within a safety-net system in the Midwest from 07/01/2021-3/31/2024. Referral to counseling (7.5% overall) and provision of tobacco cessation medications (3.5% overall) were very low and did not significantly differ by level of SDOH risk.

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Q&A: Physicians Weigh Improvements in MASLD Treatment Against Gaps in Assessment Strategies

Physician's Weekly

This is a well-done and concise summary of where we are in 2024 in trying to tackle the immense public health problem of MASLD.” They also nicely summarize drugs in development for MASLD and how various medications work in different ways to benefit the liver. Referral to a weight management center can help.

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Combating Food Insecurity in Minnesota

Minnesota Academy of Family Physicians

The Minnesota Academy of Family Physicians (MAFP) adopted a resolution (policy guidance) in 2024 related to addressing food insecurity in Minnesota. An excerpt follows: 2024-04. M Health Fairview’s Fair Table program ensures convenient access to food during medical appointments.

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Coming Soon: Logansport Memorial Pain Management Center

Logansport Memorial Hospital

Logansport Memorial Hospital is pleased to announce the opening of a new pain management center on April 1, 2024. Our team of providers utilizes an interdisciplinary model of care, including physical therapy, neurology, primary care, medical imaging, and other areas to address patient well-being from multiple perspectives.

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The Physicians Foundation Announces New Recipient in Leadership Award Program, Recognized for Addressing Drivers of Health

The Physicians Foundation

is honored for his transformative work, connecting patients with primary care and critical health resources BOSTON, August 15, 2024 – The Physicians Foundation is proud to announce Jubril Oyeyemi, M.D., His dedication to this cause should serve as an inspiration to the entire medical community.” Jubril Oyeyemi, M.D., As the U.S.