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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

Population Studied: Three sites, representing 13 urban and rural primary care practices in Minnesota, Wisconsin, and Florida participated in the Compass Rose pilot. We had lower referral completions than expected because of the difficulty connecting with patients asynchronously.

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Association of Tobacco Assessment and Cessation Assistance with Social Determinants of Health Risk in Primary Care [Smoking cessation]

Annals of Family Medicine

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%

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Effect of brief dermoscopy training on primary care providers' diagnostic accuracy on a test and in practice [Education and training]

Annals of Family Medicine

Objective: To evaluate the effect of brief dermoscopy training on primary care providers' diagnostic accuracy on a test and in clinical practice. Setting: Divisions of Family Medicine and Community Internal Medicine at a large academic medical center in Southeast Minnesota.

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Implementation of Combined PCBH and CCBHC Models: Key Considerations

Integrated Care News by CFHA

On January 7, 2025, SAMHSA announced the award of one-year Certified Community Behavioral Health Clinics (CCBHCs) Demonstration planning grants to 14 states and Washington, D.C., CCBHCs focus on comprehensive behavioral health services, ensuring 24/7 crisis care, care coordination, and a broader continuum of behavioral health treatment.

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Primary Care Perspectives on Access to Specialty Care in Rural Communities: A Mixed-Method Study [Health care disparities]

Annals of Family Medicine

Rural facilities report challenges and solutions to meet community needs for specialty care. American Medical Association Physician Masterfile Population Studied: Cardiologists, neurologists, oncologists, or pulmonologists; rural health systems leaders. Objective: This study sought to analyze changes in the U.S.

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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.,

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Combating Food Insecurity in Minnesota

Minnesota Academy of Family Physicians

A Collaborative Approach Between Health Care Providers and Community Partners Food insecurity affects thousands of Minnesotans, often contributing to chronic health conditions and overall poor health outcomes. M Health Fairview’s Fair Table program ensures convenient access to food during medical appointments.