Remove Clinic Remove Education Remove Patients Remove Referral
article thumbnail

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. Objective: Our objective was to improve the TCM clinic no-show rate and thereby improve patient outcomes.

article thumbnail

Adoption, implementation, and impact of a Diabetes Navigator program based in primary care [Diabetes and endocrine disease]

Annals of Family Medicine

Context: Patients with diabetes who receive structured and integrated care have better control and outcomes; however, care may shift between multiple settings making coordination challenging. Outcome Measures: Number of patients engaged, resulting referrals, Navigator time per patient, and hemoglobin A1c measures across 2-years.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

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

Annals of Family Medicine

Context: Medical legal partnerships (MLP) are an effective intervention for social determinants of health, like housing, education, and employment status. Participating clinic sites offered convenience sample frame, patients with legal needs were identified through universal and secondary screening approach.

Medical 130
article thumbnail

Artificial Intelligence in Health Care

Integrated Care News by CFHA

That small win reminded me that artificial intelligence is already shaping the way our patients (and our families) search for health advice. I believe that as clinicians, educators and supervisors, we are called to guide this shift. Administrative overload fuels burnout and pushes us away from our patients.

article thumbnail

How to Improve Care for Patients With Multiple Chronic Conditions

Physician's Weekly

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.

article thumbnail

Provider Attitudes Regarding Osteopathic Manipulative Medicine: A Qualitative Study [Practice management and organization]

Annals of Family Medicine

Context: Currently, only 43% of doctors of osteopathic medicine (DOs) nationwide offer osteopathic manipulative treatments (OMT), with half of them providing OMT to ≤5% of their patients. Objective: This study investigates provider attitudes toward OMT and identifies barriers to referrals to address the unmet patient demand.

article thumbnail

Addressing diabetes management in the context of social needs: a qualitative study of primary care providers [Diabetes and endocrine disease]

Annals of Family Medicine

Context: Diabetes management (DM) for patients with Type 2 Diabetes (T2D) can be hindered by non-medical, health-related social needs. Objective: To describe how primary care clinics have considered social needs in DM, and identify opportunities to support primary care clinics. Setting: Ambulatory clinics (e.g.,