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. Population Studied: 13 urban and rural primary care practices located across Mayo Clinic sites in Minnesota, Wisconsin, and Florida.

Primary Care 130

Primary Care Referral Routine Screenings Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

The "Sparkbrook Children’s Zone" (SCZ) is one of the first initiatives in the UK to co-locate GPs, dentists, pharmacists, social care organisations, and community-based services in a collaborative attempt to meet the specific needs and challenges of the local population.

Community 130

Community Integrated Care Finance Family Practice 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Currently, primary care data, community data, and hospital data are not linked in Ontario, resulting in a disconnect in continuity of care. Datasets: Primary care EMR data from the Eastern Ontario Network and acute care, post-acute, and community mental health and addictions data from the Shared Health Integrated Information Portal.

Primary Care 130

Primary Care Electronics Hospital Medical 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Two thirds of diabetes patients complicated with hypertension, and comorbidity increase 4-fold risk of atherosclerotic cardiovascular disease (ASCVD). Setting or Dataset Five electronic systems of community clinic. Study design and analysis This is a multiple-center retrospective real-world cohort study.

Hypertension 130

Hypertension Diabetes Patients Transportation 130

Annals of Family Medicine

NOVEMBER 20, 2024

Both providers and mothers reported limitations in patient understanding and knowledge. However, most mothers reported receiving clear education about their condition during delivery, positive delivery experiences, and helpfulness from the clinical team.

Provider 130

Provider Patients Healthcare Professional Healthcare 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Gender affirming medical care is associated with long term benefits for transgender and non-binary patients but access to such care does not meet the current need. This mismatch is worsened in rural communities. Responses to open-ended questions led to changes in the format for the second cohort.

Education 130

Education Primary Care Provider Community 130

Canadian Family Physician

MARCH 18, 2025

Objective To determine what factors individual physicians in a remote northern Saskatchewan community consider when advising patients on an obstetric delivery location. Setting La Ronge, a remote northern Saskatchewan community. Participants Eleven family physicians providing full-scope care in a remote medical clinic.

Family Physician 52

Family Physician Community Family Families 52

Annals of Family Medicine

NOVEMBER 20, 2024

Extension for Community Healthcare Outcomes (ECHO) is a health professions education model that uses telehealth technology to bridge specialists to community clinicians to disseminate best practices and foster interprofessional collaboration.

Management 130

Management Telehealth Education Community 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Community health services constitute the cornerstone of China's primary healthcare system. Since the recent healthcare reforms, significant strides have been made in the development of community health services across the country.

Healthcare 130

Healthcare Management Finance Chronic Disease 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Project ECHO (Extension for Community Healthcare Outcomes) is a virtually-delivered health professions education model, designed to improve patient care by enhancing primary care capacity in specialty topics.

Primary Care 130

Primary Care Management Diagnose Clinical Practice 130

Integrated Care News by CFHA

MARCH 21, 2025

On January 7, 2025, SAMHSA announced the award of one-year Certified Community Behavioral Health Clinics (CCBHCs) Demonstration planning grants to 14 states and Washington, D.C., Leverage Technology and Data Implement measurement-based care tools that work across both systems to track patient outcomes and demonstrate effectiveness.

Behavioral Health Services 130

Behavioral Health Services Primary Care Integrated Care Mental Health 130

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design and Analysis: In a convergent, mixed methods design, a cross-sectional survey allowed us to assess the concurrent validity of Proactive by comparing its results with those of a clinical examination. Setting: Community-based. Intervention: Proactive consists of 21 items covering nine constructs.

Screening 130

Screening Primary Care Clinic Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The Northern New England CO-OP Practice and Community-Based Research Network (NNE CO-OP PCBRN) conducted an operational survey to gather insights from primary care (PC) practices across Northern New England (NNE). Data analysis included descriptive statistics and qualitative analysis of open-ended responses.

Primary Care 130

Primary Care Telehealth Patient-Centered Community 130

Integrated Care News by CFHA

APRIL 16, 2025

It offers care where people already are: their doctor’s office, their community mental health clinic, their OB/GYN’s exam room. Fund technology that supports behavioral health labs —routine assessments just like bloodwork—to inform care in real time and empower patients. You don’t have to build it from scratch.

Integrated Care 130

Integrated Care Primary Care Mental Health Family Healthcare 130

Sound Physicians

MARCH 12, 2025

With the absence of intensivists on the ground in these community hospitals, the question becomes how to treat these patients where and when they need care. Our tele-ICU program , which is part of our critical care specialty, has brought meaningful and much-needed intensive care to remote communities for the past five years.

Telemedicine 52

Telemedicine Community Hospital Patients 52

Annals of Family Medicine

NOVEMBER 20, 2024

Community-based service learning is a proposed way to develop resident proficiency in core competencies and addressing and exploring social determinants of health. Setting: The Children’s Museum of Southern Minnesota was chosen as there was an existing partnership with Mayo Clinic for community education by healthcare providers.

Community 130

Community Education Family Medicine DO 130

Annals of Family Medicine

NOVEMBER 20, 2024

Little is known about variation in adoption of CCS modalities in federally qualified health centers (FQHCs) in communities where cervical cancer disparities persist. Setting or dataset: Electronic health record data from 25 primary care clinics in 3 FQHCs in Washington and Idaho PBRN from 2012-2017.

Screening 130

Screening Insurance Patient-Centered Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

However, poor treatment compliance among thalassemia patients remains a challenge, leading to less successful outcomes and negative perceptions of the disease. The study aimed to explore the lived experiences of thalassemia patients in Eastern India and examined how social relationships impacted treatment adherence.

Individual 130

Individual Relationship Community Family 130

Permanente Medicine

JUNE 10, 2025

June 10, 2025) — Maria Ansari, MD, FACC , co-CEO of The Permanente Federation at Kaiser Permanente, has been named to Modern Healthcare’s list of 50 Most Influential Clinical Executives for 2025. The result is high-quality, high-value care within an integrated system — improving lives and shaping the future of health care.”

Clinic 59

Clinic Patient-Centered Healthcare Medical 59

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: The study encompassed three family medicine residencies in different regions of the US from both University and community-based settings. Results: The curriculum standardized the clinical scholarship process, leading to improved learning outcomes and co-authorship of scholarly works.

Family Medicine 130

Family Medicine DO Family Families 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Researchers and funders are recognizing the urgent need for more inclusive and representative clinical research to advance health equity. Community health centers (CHCs) are recognized as trusted care providers with unique potential to support more effective recruitment and participation approaches.

Patient-Centered 130

Patient-Centered Community Patients Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting & Population: Six practice-based research networks recruited patients aged 18-65 years with upper respiratory symptoms. Patients were recruited from primary care practices, emergency rooms and urgent care centers, and the community (e.g., recruitment flyers).

Telemedicine 130

Telemedicine Primary Care Emergency Room Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

Background Team-based care (TBC) has established benefits for patient outcomes. In both cases, TBC can help by providing a collaborative approach to care that can better manage the complex needs of patients. In both cases, TBC can help by providing a collaborative approach to care that can better manage the complex needs of patients.

Electronics 130

Electronics Provider Family Physician Mental Health 130

Physician's Weekly

JUNE 25, 2025

Caring for patients with multiple chronic conditions requires identifying those at risk, clear communication, and coordinated care to improve outcomes. Many of these patients are clinically complex and receive care from multiple professionals—which creates unique management hurdles.

Chronic Condition 59

Chronic Condition Patients Management Primary Care Physician 59

Annals of Family Medicine

NOVEMBER 20, 2024

Objectives: This presentation looks back on 4 years of working in full partnership with three Atikamekw communities (Manawan, Wemotaci et Opitciwan) in Quebec to better understand, define and co-develop an intervention model to ensure cultural safety in care.

Community 130

Community Patient-Centered Relationship Government 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: After a Samoan patient from New Zealand (NZ) attended a PACE workshop at NAPCRG in 2016 with her general practitioner, she was inspired to set up a Pacific community group to work towards better health outcomes for Pacific people living in South Auckland, NZ.

Community 130

Community General Practitioner Primary Care Consulting 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. Population Studied: 1,792,934 adult patients with at least 1 telehealth (phone, video) or in-person primary care visit. Design and Analysis: Retrospective observational study.

Primary Care 130

Primary Care Screening Telehealth Community 130

Physician's Weekly

JUNE 11, 2025

Patients with hidradenitis suppurative seek advice online, highlighting unmet needs in clinician-patient education regarding daily self-management strategies. For clinicians treating patients with HS, the findings may inform more tailored patient engagement. Patients inquired about general advice for managing HS symptoms.

Education 52

Education Patients Management Patient-Centered 52

Annals of Family Medicine

NOVEMBER 20, 2024

Prior studies focus on the perceived needs of learners rather than needs of the patients or communities in which these residents practice. In accordance with ACGME recommendations, we performed a community needs assessment to inform POCUS curriculum development within a Family Medicine residency.

Community 130

Community Family Medicine DO Education 130

Annals of Family Medicine

NOVEMBER 20, 2024

Successful implementation required the development of a scalable family history collection tool, the Genetic and Wellness Assessment (GWA) and Breast Health Assessment (BHA) tools; integrated pharmacogenomics programming; educational programming; electronic medical record integration; and robust clinical decision support tools.

Community 130

Community Patient-Centered Primary Care Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

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. Population Studied: 119,926 adult patients with one or more primary care visits during the 30-month study period. The difference was the largest for no SDOH risk (61%) vs.

Primary Care 130

Primary Care Referral Electronics Individual 130

Annals of Family Medicine

NOVEMBER 20, 2024

Blood pressure (BP) control (<130/80 systolic/diastolic) is poor nationally, and is inequitable by race/ethnicity, with minimal understanding of the differences within Latino patients by country of origin. Setting: 953 community-based primary care clinics in a national network from 25 states across the United States.

Hypertension 130

Hypertension Community Primary Care Patient-Centered 130

Alabama Academy of Family Physicians

JULY 24, 2024

This year’s event was a testament to the vibrant community of family physicians, medical students, residents, and healthcare professionals dedicated to advancing family medicine in Alabama. in Psychology from Duke University, a Master’s in Rural and Community Health from The University of Alabama, and an M.D.

Medical Student 130

Medical Student Family Medicine DO Family Physician 130

Annals of Family Medicine

NOVEMBER 20, 2024

Population Studied Providers participating in MaPCReN represented 306,394 patients with ≥1 visit between January 1, 2016 and December 31, 2021. A reference set included n=854 randomly selected adults aged ≥60 years, including 148 (17.3%) patients with ≥1 UTI encounter and 703 (82.6%) patients with no UTI encounters.

Primary Care 130

Primary Care Clinical Practice Electronics Diagnosis 130

A Country Doctor Writes

MAY 18, 2025

This was in part because we shared patients and patient experiences between our departments and had a bidirectional way of making warm handoffs. If a primary care patient was going through a difficult time with their social life or mental health, we would walk them down the hall to meet a therapist right then and there.

Primary Care 130

Primary Care Patient-Centered Nurse Practitioner Primary Care Doctor 130

Sound Physicians

JUNE 25, 2025

Who you serve matters Every hospital and facility have a unique patient population and clinical environment. Are you looking for a vibrant city life or a quieter, family-friendly community? Scope of practice: The types of frequent procedures and patient cases vary widely between facilities. All rights reserved.

Clinic 52

Clinic Telemedicine Hospital Families 52

Annals of Family Medicine

NOVEMBER 20, 2024

Existing therapies are suboptimal and many patients resort to opioid therapy. Setting Multi-site study, with participants recruited from outpatient clinical and community settings. Context Chronic low back pain (CLBP) is a serious public health problem impacting function and quality of life (QoL).

Management 130

Management Mental Health Physicals Community 130