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. Referral to counseling (7.5%

Primary Care 130

Primary Care Referral Electronics Individual 130

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. Below, I share three reasons why. References Menchaca, J.

Patient-Centered 130

Patient-Centered Integrated Care Primary Care Healthcare Professional 130

Annals of Family Medicine

NOVEMBER 20, 2024

SUD screening is not universally done in primary care (PC). In our institution, screenings are completed for patients ≥15 years during well visits; those not presenting for well visits and under 15 may represent missed opportunities. Population: All patients aged 12-17 seen in the 3 practices during a 3-month study period.

Primary Care 130

Primary Care Screening Referral Wellness Visit 130

Common Sense Family Doctor

MARCH 15, 2025

In a traditional health care setting, many administrative burdens and barriers stand in the way of patients receiving evidence-based care. Although not originally applied to health care processes, sludge audits can improve the efficiency of health systems and patients’ experiences. Travel to the doctor’s office. Wait times.

Screening 52

Screening Insurance Primary Care Referral 52

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The rise in social needs screening in primary care settings has led to questions about program design and implementation strategies. Multisector coordination is critical for effective screening and referral initiatives. Contact hours included a mix of in-person visits and phone calls.

Primary Care 130

Primary Care Referral Screening Patient-Centered 130

Annals of Family Medicine

MAY 27, 2025

PURPOSE This study aimed to assess how agile implementation–driven iterative processes and tailored workflows can facilitate the implementation of a digital cognitive assessment (DCA) tool for patients aged 65 years or older into primary care practices. RESULTS The intervention engaged 69 (63.8%) of 108 clinicians across the 7 clinics.

Primary Care 130

Primary Care Screening Referral Clinic 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. Encourage Healthy Eating Through Vouchers: Many clinics and systems have voucher programs in place to help supplement food for patients.

Family Physician 52

Family Physician Community Families Family 52

Annals of Family Medicine

NOVEMBER 20, 2024

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.,

Primary Care 130

Primary Care Diabetes Management Provider 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 Chronic Disease Education 52

Annals of Family Medicine

NOVEMBER 20, 2024

Davos Alzheimer’s Collaborative Healthcare System Preparedness (DAC-SP) aims to catalyze global healthcare system transformation, providing Alzheimer’s patients and their families quicker access to life-changing innovations and therapies. clinical consensus, financing mechanisms) and the organization (e.g.,

Primary Care 130

Primary Care Screening Healthcare Finance 130

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

Blood, Sweat, and Tears

MAY 24, 2022

I was so burnt out, dragging my feet, lugging my head from patient to patient. She was always the first one to notice and address patient difficulties. She would peer out at the gate of the clinic and start predicting what cases we would see. We didn’t have to wait long before the first patient came in.

Referral 52

Referral Community Patients Specialization 52

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. Who do we have with us today? Katie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening Clinic 136

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

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. Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life (related study here ). That rings true to me.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

FEBRUARY 6, 2025

How should we screen for cognitive impairment? So let’s just say you have a healthy 55 year old or 65 year old in your clinic. Who do you think we should be screening and how should we be screening them for these symptoms? Well, so I guess it depends on what you say screening. Nate 05:29 Ooh.

Primary Care 96

Primary Care Diagnosis Screening IT 96

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.

Nurse Practitioner 78

Nurse Practitioner Referral 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.

Families 102

Families IT Family Diagnosis 102

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. It was eyeopening to see patients in their own home. And so that really triggered my interest.

Community 115

Community Transportation IT PCP 115

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. James: Yeah.

IT 95

IT Clinic Screening Patients 95

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. It is a screening? These studies are important. I guess FICA is not as cool as SKY. Is it an assessment?

IT 99

IT Patient-Centered Families Family 99

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. Scientific American Letter to the Editor: Response to Downar et al.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

MARCH 10, 2022

Now when I say variation, I’m not talking about small little clinically questionable variations. Ruth: I do have to also say that it’s important to remember that feeding tube use and hospital transfers for people with advanced dementia has no demonstrated clinical benefit. Joan: A lot of my work comes out of my clinical practice.

Nurse Practitioner 60

Nurse Practitioner Hospital Families Family 60

GeriPal

FEBRUARY 24, 2022

Should we focus on something else, both from a clinical and a research perspective? We see our patients and our families throughout the illness trajectory into the hospital. And maybe we should have more patient-centered conversations. Like, should we be doing advance care planning? What’s the evidence behind it?

Illness 98

Illness Patient-Centered IT Families 98

GeriPal

JULY 20, 2023

Clinicians could care for patients across state lines, could prescribe opioids without in person visits, could bill at higher rates for telemedicine than previous to the pandemic. Many patients benefited, not only those isolating due to covid, but also patients in rural areas, patients who are homebound, and many others.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73