article thumbnail

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

Annals of Family Medicine

Setting or Dataset: We used data from Epic on social needs screening and Compass Rose utilization. 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.

Referral 130
article thumbnail

Risks and Needs: Lessons Learned from Assessing Patients Willingness to Receive Help for Social Risks in Primary Care [Social determinants and vulnerable populations]

Annals of Family Medicine

Context: In May 2023, Mayo Clinic implemented a revised screening tool to assess social determinants of health (SDOH) for its patients. Objective: To assess the impact of a question on need for assistance with social risk factors identified through routine screening.

Insiders

Sign Up for our Newsletter

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

article thumbnail

Relationship between Social Risks and Colorectal Cancer Screening/Surveillance in a Large US Health System [Social determinants and vulnerable populations]

Annals of Family Medicine

Context Social determinants of health (SDOH) such as access to care and economic stability negatively impact colorectal cancer (CRC) screening rates. Results Among 159,491 adults age 50-75 eligible for CRC screening/surveillance, younger, male, non-white patients were less likely to be up to date on CRC testing.

Screening 130
article thumbnail

Barriers to and Facilitators of Participant Engagement in a Multi-level Intervention for Type 2 Diabetes and Food Insecurity [Clinical trial]

Annals of Family Medicine

Objective: To explore participants’ barriers to and facilitators of engagement in a multilevel, cross-sector clinical trial designed to address social needs and improve health-related outcomes for individuals with T2D experiencing food insecurity. Setting: Ambulatory clinics (e.g., their 3-month endpoint visit).

Diabetes 130
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

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., Population Studied: Purposive sample of care team members (eg, physicians, social workers, diabetes educators, dietitians, community health workers).

article thumbnail

Social Risk Burden and Its Impact on Healthcare Use in IBD

Physician's Weekly

High social risk burden in adults with IBD drives emergency care use and medication gaps—spotlighting the urgent need for social screening in clinical practice. Social risk burden was categorized as none (0/6 domains), mild (1/6), moderate (2/6), and severe (≥3/6).

article thumbnail

Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

After discussing screening options for substance use disorder, we go on to talk about both the treatments for it and the issues that arise. So, we are not screening for substance use in cancer care, so we don’t get good estimates among people with cancer, which is really how we would prefer to ask the question. Katie: Yeah.

Illness 136