Integrated Care News by CFHA

MAY 1, 2025

That small win reminded me that artificial intelligence is already shaping the way our patients (and our families) search for health advice. Our Patients Are Already Using AI Many people now ask their first health question to a chatbot rather than to a clinician. Evidence‑informed care was literally at his fingertips.

Patient-Centered 130

Patient-Centered Integrated Care Primary Care Healthcare Professional 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Patients with chronic medical conditions (CCs) and behavioral comorbidities have lower quality of life and increased healthcare expenses. Our work builds a foundation for cost-effective workflows to support patients with multimorbidity. Among the completed encounters, the average days from referral to encounter was 27.2.

Referral 130

Referral Chronic Condition Medical Chronic Disease 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

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 130

Primary Care Referral Screening Patient-Centered 130

Physician's Weekly

JUNE 13, 2025

There is robust data regarding the importance of patient connection and engagement in the hospital and clinic setting. Many of us are taught in medical school and residency the importance of patient communication on improving patient satisfaction scores, quality metrics, and professional fulfillment.

Chronic Disease Management 52

Chronic Disease Management Community Education Chronic Disease 52

Annals of Family Medicine

NOVEMBER 20, 2024

Objectives: We explored how to design a system to provide near real-time feedback on context and impacts to inform health system innovations; and how to operationalize data collection across diverse patient populations and providers. Study Design and Analysis: We used a mixed-method complexity-informed methodology.

Healthcare 130

Healthcare Referral Provider Utilities 130

Minnesota Academy of Family Physicians

FEBRUARY 20, 2025

Through food pharmacies, food insecurity screenings and innovative community partnerships, health care providers are ensuring patients get the nourishment they need to thrive. Family physicians play a pivotal role in combating food insecurity, serving as trusted advocates for their patients and connecting them to essential food resources.

Family Physician 52

Family Physician Community Family Families 52

Medical Xpress

MAY 3, 2023

Genetic testing for hereditary cancers, such as breast, colon, pancreatic, and ovarian cancer, helps at-risk individuals understand their familial risk for these diseases and make informed decisions about next steps in care.

Referral 97

Referral Utilities Individual Family 97

Hitchcock Family Medicine

AUGUST 26, 2024

Tip 1: Do Research and Obtain Referrals Start your search by asking friends, family, and colleagues for recommendations. Word-of-mouth referrals can provide valuable insights into a doctor's practice, professionalism, and bedside manner. Choose a clinic close to your home or workplace to make visits more convenient.

Family Doctor 52

Family Doctor Family Families Board-Certified 52

The Physicians Foundation

AUGUST 15, 2024

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., Jubril Oyeyemi, M.D., The award is named in honor of Richard (Buz) Cooper, M.D., president of The Physicians Foundation.

Primary Care 40

Primary Care Community Chronic Disease Management Education 40

Louisville Lectures

MAY 5, 2023

Boot Camp: PHASE TWO Or, Emergencies and Assessing Them This week, we will look at two highly anticipated videos, Electrolyte Emergencies by Dr. Eleanor Lederer and Assessing the Seriously Ill Patient by Dr. David Nunley. Are you a resident or medical student looking to learn practical, evidence based approaches to your patients?

Internal Medicine 52

Internal Medicine Patient-Centered Education Hospital 52

Physicians Alliance of Connecticut

MARCH 28, 2025

Even if they don’t have the same condition as you, they can provide information about things like the doctor’s reputation or bedside manner. Research shows that board-certified doctors make fewer errors and provide better care to their patients. Others choose to focus their practice on specific conditions or types of patients.

Board-Certified 52

Board-Certified Appointment Insurance Consulting 52

Plum Health

MAY 22, 2023

Employers are increasingly finding that DPC offers a personalized doctor-patient relationship, comprehensive preventive care, and overall cost savings. Thus, DPC forms a better long-term investment focused on preventive care, as opposed to only treating patients post-diagnosis. If you have a great relationship with your PCP, keep it!

Primary Care 52

Primary Care PCP PCP Insurance 52

Physicians Alliance of Connecticut

MARCH 5, 2025

At PACT Endocrinology, a referral isn’t required. Fortunately, there are still endocrinologists accepting new patients (including at PACT). Search online: An online search for the best endocrinology near me could help you find local doctors who treat your condition and are accepting new patients.

Board-Certified 52

Board-Certified Primary Care Insurance Diabetes 52

Tiny Physician

JULY 12, 2021

The working hours will be over 12 hours per day in any clinical post-graduate course at any college, but it won’t affect your state of mind if the faculties and other staffs are cooperative. The more you see patients at the OP department/ ER, the easier it will be for you to identify sick children who needs immediate care.

Internal Medicine 52

Internal Medicine Management ER Referral 52

The Clinical Problem Solvers

MARCH 14, 2025

Dr. Benton mentors clinical and research physicians, fellows, and postdoctoral trainees. Clinically, he cares for youth and families through the Department of Psychiatry & Behavioral Sciences and the new Division of Addiction Medicine at Boston Children’s Hospital. Child and Adolescent Psychiatric Clinics of North America.

Mental Health 52

Mental Health Community Patient-Centered Hospital 52

PEMBlog

MAY 20, 2025

Learning Objectives Demonstrate the ability to use shared decision-making strategies when discussing imaging options with families of pediatric patients presenting to the Emergency Department. Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Policy Statement. Pediatrics. 2024;154(1):e2024066854.

Family 101

Family Families Hospital Patient-Centered 101

FDA Law Blog

OCTOBER 28, 2024

To this end, FDA recently announced the publication of a guidance titled “Considerations for Long-Term Clinical Neurodevelopmental Safety Studies in Neonatal Product Development,” (the “Guidance”). Beyond that, the Guidance again describes general considerations, patient/population-specific considerations, and product-specific considerations.

Clinic 64

Clinic Physicals IT Referral 64

GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. And I think that we’re at this kind of crossroads right now in dysphagia, and dysphagia management where our patients are suffering. We revisit it, and make things better for our patients.

IT 124

IT Patient-Centered Hospital Individual 124

FDA Law Blog

JANUARY 6, 2022

Wasserstein — “EKRA” refers to the Eliminating Kickbacks in Recovery Act, which was part of the Substance Use – Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018. EKRA is codified at 18 U.S.C. § 220 and was described on HP&M’s blog here. 18 U.S.C. § 18 U.S.C. § 18 U.S.C. §

Lab Testing 52

Lab Testing Referral Individual Patient-Centered 52

FDA Law Blog

JANUARY 6, 2022

Wasserstein — “EKRA” refers to the Eliminating Kickbacks in Recovery Act, which was part of the Substance Use – Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018. EKRA is codified at 18 U.S.C. § 220 and was described on HP&M’s blog here. 18 U.S.C. § 18 U.S.C. § 18 U.S.C. §

Lab Testing 40

Lab Testing Individual Referral Patient-Centered 40

FDA Law Blog

SEPTEMBER 29, 2021

The 340B program, authorized under Section 340B of the Public Health Services Act and administered by HRSA, imposes a ceiling price on pharmaceutical manufacturer sales to “covered entities,” which are certain health clinics that receive federal funding and certain types of safety net hospitals to provide them drugs at lower prices.

Manufacturing 52

Manufacturing Government Referral Provider 52

GeriPal

JUNE 12, 2025

Summary Transcript CME Summary If you’re anything like me, you might find the process of what happens to patients when they visit a radiation oncologist somewhat mysterious. Anish 01:02 Well, I speak, you know, from a physician lens of some of the patients that I get referred, and by the time there’s. This is not a good option.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. But watch out! Travel time can leave this champ vulnerable to fatigue and no-shows.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

SEPTEMBER 7, 2023

Does it improve outcomes that patients, caregivers, and clinicians care about? hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? Welcome back, William. William: Thanks so much.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. ABIM MOC credit will be offered to subscribers in November, 2024.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

JULY 11, 2024

It’s a jampacked 50 minutes, filled with pearls on taking care of patients with liver disease. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Can you come and be in our clinic once a week? What’s the connection and why?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

ABIM

JUNE 24, 2025

Expanding ABIM’s engagement with stakeholder communities such as early career physicians, specialty societies and patient-focused organizations. Upgrades to the ABIM website and Physician Portal for 2025, designed to make it easier for both physicians and the public to find information.

Board-Certified 40

Board-Certified Board-Certified Physicians Government Community 40

GeriPal

JUNE 9, 2022

Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . In contrast to geriatrics, the evidence base for palliative care lagged clinical growth, in part because palliative care has no centralized “home” at the National Institutes of Health. Patients have all sorts of problems.

Consulting 99

Consulting Patient-Centered Diagnosis IT 99

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Then, “Keep your hand up if you frequently refer patients with cancer pain to a psychologist?” That rings true to me. All hands go up. All hands go down.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. Going into patient’s homes was eye opening. They were stunned by the number of calls for lift assistance for older adults who had fallen.

Community 114

Community Transportation IT PCP 114

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. When I see a patient? He’s in Boston.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JUNE 5, 2025

The obstacles hindering referrals to palliative care services. We also take a dive into these 2 articles that Connie first authored: Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice. Practical strategies to overcome these barriers and enhance care. Thank you so much.

Referral 78

Referral Nurse Practitioner Consulting Board-Certified 78

GeriPal

JULY 21, 2022

I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. Initially, it was just because there weren’t really answers for my patients. We’re going to go into how to talk to patients about this, because Emmy, you’ve done some research on it.

IT 102

IT Family Families Diagnosis 102

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. And yet, the only thing that may be worse than a prognostic calculator is a clinician relying solely on their clinical intuition.

IT 95

IT Clinic Screening Patients 95

PEMBlog

JANUARY 16, 2025

Well dive into the clinical presentations, including acute and chronic symptoms, the dangers of sudden sniffing death, and the specific risks associated with nitrites, hydrocarbons, and nitrous oxide. Formulate effective strategies for identifying, managing, and preventing inhalant misuse in pediatric patients. Ganetsky M (ed).

Complication 52

Complication Patient-Centered Management Patients 52

GeriPal

APRIL 6, 2023

Today we have a star-studded lineup, including Lexy Torke of Indiana University, who discusses her RCT of a chaplaincy intervention for surrogates of patients in the ICU , published in JPSM and plenary presentation at AAHPM/HPNA. These studies are important. So, learn as many as you can and what they’re all about.

IT 99

IT Patient-Centered Families Family 99