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Implementation of a novel linkage of primary care electronic medical record data with hospital data in South Eastern Ontario [Big data]

Annals of Family Medicine

Context: Currently, primary care data, community data, and hospital data are not linked in Ontario, resulting in a disconnect in continuity of care. We demonstrated the capacity to implement data-drive QI approaches to support patient care across health care sectors using the novel merged datasets.

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

Annals of Family Medicine

Study Design and Analysis: We used information gathered from site visits and team meetings to understand how Compass Rose was being utilized across sites. Setting or Dataset: We used data from Epic on social needs screening and Compass Rose utilization.

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Comparing impact of a holistic patient centered navigation model to an online navigation service on health care utilization [Population health and epidemiology]

Annals of Family Medicine

Context Social prescribing has been linked to better access, improved health and wellbeing, and decreased health care utilization (HCU). Population Primary care providers in 12 Ottawa and Sudbury (Ontario, Canada) practices referred their patients with health or social needs to access needed SP services.

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Primary Care Utilization in Native American Communities: Challenges and Opportunities [Health care disparities]

Annals of Family Medicine

It is paramount to understand the barriers faced by the AI/AN community to better serve their medical needs. The impact of long-standing inadequate access to basic healthcare coupled with generational trauma has contributed to community distrust of western medicine. Population Studied: AI/AN patients residing in the USA.

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Evaluation of Primary Care Provider Utilization by Asthma Patients after the Implementation of Coach McLungsSM [Child and adolescent health]

Annals of Family Medicine

Patients with the worst outcomes often lack continuity of primary care and receive care at emergency departments during exacerbations. Improved asthma outcomes are associated with effective communication between patients and providers, such as using shared decision-making. to 0.08, p=0.44), 5% to 2% ([95%]CI -0.03

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A qualitative evaluation of the implementation of a pre-consultation tool for older adults in primary care [Geriatrics]

Annals of Family Medicine

Context: Pre-consultation telemedicine tools have been proposed as an effective solution to optimize the care of the growing number of older patients with chronic conditions. However, little information exists on how to successfully implement these tools in the primary care setting.

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Measuring Primary Care Access: Aligning Measurement with the Expanding Domains of Access [Systematic review, meta-analysis, or scoping review]

Annals of Family Medicine

Context: Despite the many well-established benefits of primary care (PC), the percentage of Americans with a source of usual care or with an ongoing PC relationship is declining. Objective: To identify existing measures that effectively evaluate access to PC. Measures were further categorized into 13 access domains.