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Transitional Care Management care team impact on no-show rates to hospital discharge appointments [Patient education/adherence]

Annals of Family Medicine

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. Objective: Our objective was to improve the TCM clinic no-show rate and thereby improve patient outcomes.

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An Open Letter to Robert F. Kennedy, Jr. On Why Integrated Care Should Be a Cornerstone of the HHS Agenda

Integrated Care News by CFHA

It moves away from fragmented systems, provides alternatives to medication-only treatment paths, and leads patients to practical pathways for healing—whether for anxiety, diabetes management, depression, or addiction. It provides immediate, non-stigmatized behavioral health support at the point of medical care, often in the same visit.

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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. 1072 patients with COPD were identified within the merged dataset, 50% of whom visited the ED within two years. Following patient review by clinician, 77 patients were deemed eligible.

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Maryland's Primary Care Program: incremental progress or breakthrough?

The Health Policy Exchange

Our residency, formerly a collaboration with Providence Hospital, is now known as the Medstar Health/Georgetown-Washington Hospital Center Family Medicine Residency Program. What hasn't changed is that our family medicine residents remain excited about health policy and advocacy. Phillips, Jr.

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Developing an intervention to assist older patients communication with their GP practice after discharge from hospital [Community based participatory research]

Annals of Family Medicine

Context In the post-discharge period from hospital acute inpatient care, the older patient is at risk from a lack of joined-up care. Hospitals write discharge summaries to family medicine providers. Though patients/carers are often copied in, they seldom get a plain English version or space to discuss its contents.

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Electronic Health Record Use and Patient-Centredness [Education and training]

Annals of Family Medicine

Context: Large-scale electronic health record (EHR) programs have reported a number of issues to their implementation in primary care including physician patient-centredness and clinical performance. Setting: An academic primary care clinic based in a hospital. Population: Ten resident physicians and six staff physicians.

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San Luis Obispo Physician Launches New Medical Practice with Exclusive Service Program from Concierge Choice Physicians

Concierge Choice Physicians

Margaret Greenough, a family medicine specialist in San Luis Obispo, CA, has opened a new medical practice offering patients the Concierge Choice FullFlex™ program. Dr. Greenough is part of a growing movement of physicians offering CCP’s FullFlex model of concierge medicine.