Annals of Family Medicine

NOVEMBER 20, 2024

Context: Medical legal partnerships (MLP) are an effective intervention for social determinants of health, like housing, education, and employment status. Descriptive analysis utilized primary legal record and secondary electronic health record sources. Nine focus groups were conducted and recorded, using semi-structured interviews.

Medical 130

Medical Referral Screening Internal Medicine 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The Transitional Care Management (TCM) clinic visit is a uniquely billed visit type to review a recently discharged patient’s hospital course, reconcile medications, and continue ongoing workup. Population Studied: Inpatients were referred if they were being discharged from the Family Medicine service to home.

Appointment 130

Appointment Hospital Management Family Medicine 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Despite copious evidence of the positive health impact of Medical legal partnerships (MLP), public funding remains subject to economic arguments seeking return on investment (ROI) from the perspective of public payers. Setting or Dataset: Medicaid Claims, Epic electronic health record.

Primary Care 130

Primary Care Medical Behavioral Health Services Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Population Studied: Patients with recent hemoglobin A1c levels of ≥8% were invited to join the Diabetes Navigator program, identified through the electronic health record at two academic primary care clinics. Results: We identified 176 patients with recent hemoglobin A1c ≥8%.

Primary Care 130

Primary Care Diabetes Referral Integrated Care 130

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. Referral to counseling (7.5% overall) and provision of tobacco cessation medications (3.5% Design and Analysis: Observational study.

Primary Care 130

Primary Care Referral Electronics Individual 130

Integrated Care News by CFHA

MAY 1, 2025

Traylor and colleagues (2025) show that generative‑AI tools can boost health literacy by translating medical jargon into plain language. Reclaiming Time and Attention Primary care professionals may log more than eleven hours a day, over half of it in the electronic health record (Menchaca, 2025). Annals of Family Medicine , 23(1), 5–6.

Patient-Centered 130

Patient-Centered Integrated Care Primary Care Healthcare Professional 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Primary care providers in Canada face significant workload challenges, including managing prescriptions, referrals, and laboratory tests alongside patient visits. This study aims to analyze electronic medical record (EMR) data to understand these workload dynamics. referrals, and 6.6 (2.8) prescriptions, 1.1 (0.5)

Primary Care 130

Primary Care Referral Provider Electronics 130