DO, Referral and Utilities - Primary Care Digest

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

Annals of Family Medicine

NOVEMBER 20, 2024

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.

Referral

Referral Community Transportation Utilities

Optimizing Medical Legal Partnerships for sustainable public funding through the tele-legal model [Mixed methods research]

Annals of Family Medicine

NOVEMBER 20, 2024

Descriptive analysis utilized primary legal record and secondary electronic health record sources. Setting or Dataset: Clinics: AF Williams Family Medicine, Lowry Internal Medicine; EPIC data; legal records. Nine focus groups were conducted and recorded, using semi-structured interviews.

Medical

Medical Referral Screening Internal Medicine

Economic analysis of virtual Medical Legal Partnership model [Economic or policy analysis]

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: Evaluate the economic impact of receiving tele-legal services from Medicaid’s perspective with regard to a) fee- for service (FFS) total cost of care; b) FFS cost of primary care; c) utilization for FFS primary care; d) utilization for FFS and capitated behavioral health (BH) and BH emergency department encounters.

Primary Care

Primary Care Medical Behavioral Health Services Utilities

Adoption, implementation, and impact of a Diabetes Navigator program based in primary care [Diabetes and endocrine disease]

Annals of Family Medicine

NOVEMBER 20, 2024

A retrospective cohort study design was utilized to assess changes in A1c levels over the course of one year pre-enrollment and one year post-enrollment, comparing enrolled and not enrolled patients; a mixed effects interrupted time series model was employed for analysis.

Primary Care

Primary Care Diabetes Referral Integrated Care

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

NOVEMBER 20, 2024

Setting or Dataset: Secondary data on social needs screening and referral generated through Epic. Intervention/Instrument: The intervention includes a short survey to determine patients’ needs with respect to transportation, food insecurity, financial difficulty related to utility payments, and housing.

Primary Care

Primary Care Referral Routine Screenings Patients

Evaluation of Universal Food Insecurity Screening in the Primary Care Setting [Social determinants and vulnerable populations]

Annals of Family Medicine

NOVEMBER 20, 2024

The American Academy of Pediatrics recommends universal screening; however studies have found inconsistencies in screening of FI, documentation of FI, and referral to appropriate resources. Enrollment and referrals in food assistance programs. 73% of FI families had a FI ICD-10 code documented (Table 1).

Primary Care

Primary Care Screening Referral Utilities

Developing actionable strategies to implement evidence-based breast cancer follow-up in primary care using codesign [Dissemination and implementation research]

Annals of Family Medicine

NOVEMBER 20, 2024

Feedback from champions was elicited to improve report accuracy and support tool utility. Champions proposed methods to improve efficiency of documentation using novel techniques and templates, shared resources/referrals, and requested patient-facing materials. prevention metrics and revenue generation).

Primary Care

Primary Care Referral Electronics Utilities

Test-Retest Reliability of Electronic Handgrip Dynamometry and Accelerometry Measured Muscle Function in Older Adults [Musculoskeletal and rheumatology]

Annals of Family Medicine

NOVEMBER 20, 2024

Utilizing new electronic handgrip dynamometer and accelerometer technologies may allow for additional muscle function attributes to be feasibly measured, which in turn, may help elevate prognostic value and specificity for intervention referral. Interclass correlation coefficients were used for the analyses.

Electronics

Electronics Primary Care Utilities Referral

Ambulatory Behavioral Health Referral Patterns in the Setting of Chronic Medical Conditions [Behavioral, psychosocial, and mental illness]

Annals of Family Medicine

NOVEMBER 20, 2024

Early identification and intervention in behavioral aspects of chronic diseases leads to improved function with decreased healthcare utilization, yet we know little about referral patterns for behavioral support of chronic disease. 88% (n= 11,483) of BH referrals were created for the management of a mental health condition.

Referral

Referral Chronic Condition Medical Chronic Disease

The utilization patterns and impact of the Stanford Chronic Pain Self-Management Program in Eastern Ontario, Canada [Pain management]

Annals of Family Medicine

NOVEMBER 20, 2024

Objectives: In this study, we aimed to describe patterns of utilization of a Chronic Pain Self-Management Program (CPSMP) in Eastern Ontario and evaluate the impact of the program on patient activation, a measure of participants’ involvement in their care, their health behaviors, and their knowledge of the condition.

Management

Management Utilities Referral Individual

Addressing diabetes management in the context of social needs: a qualitative study of primary care providers [Diabetes and endocrine disease]

Annals of Family Medicine

NOVEMBER 20, 2024

A recent review of national diabetes treatment guidelines recommended adjustments to DM to reduce financial strain (eg, selecting lower cost medications), as well as directly intervening in response to an identified social need (eg, referral to a community-based service). Setting: Ambulatory clinics (e.g.,

Primary Care

Primary Care Diabetes Management Provider

Provider Attitudes Regarding Osteopathic Manipulative Medicine: A Qualitative Study [Practice management and organization]

Annals of Family Medicine

NOVEMBER 20, 2024

At Mayo Clinic and Mayo Clinic Health Systems (MCHS), merely 28% of DO providers perform OMT, leading to long wait times of over three months for new patients seeking OMT referrals. Objective: This study investigates provider attitudes toward OMT and identifies barriers to referrals to address the unmet patient demand.

Doctor of Osteopathic Medicine

Doctor of Osteopathic Medicine Provider Management Referral

Using eConsult to access specialist advice for persons living with dementia - A cross-sectional analysis [Geriatrics]

Annals of Family Medicine

NOVEMBER 20, 2024

Intervention/Instrument: We collected basic eConsult service utilization data, including the specialty group consulted and specialist response time, as well as the PCP’s responses to a close-out survey to describe their experience with eConsult. We provide descriptive statistics of the service utilization and taxonomy results.

Primary Care

Primary Care Consulting Community PCP

A feasibility study of the Illuminate 360o approach for monitoring the implementation of a health system innovation [Mixed methods research]

Annals of Family Medicine

NOVEMBER 20, 2024

We utilized theoretical constructs of salutogenesis – manageability, meaningfulness, and coherence; and resilience. Participants provided short reflections about their surgical journey or referral experiences, along with elaborations in quantitative categories.

Referral

Referral Healthcare Provider Utilities

Combating Food Insecurity in Minnesota

Minnesota Academy of Family Physicians

FEBRUARY 20, 2025

Here are some ways family physicians can collaborate with health care systems and community organizations to tackle food insecurity within Minnesota: Expand Food Insecurity Screenings: Train staff to use tools like Hunger Vital Signs and integrate food insecurity screenings into routine care.

Family Physician

Family Physician Community Family Families

Beyond the Diagnosis: A Detailed Characterization of Outpatient Palliative Care Patients [Palliative and end-of-life care]

Annals of Family Medicine

NOVEMBER 20, 2024

Objective Describe the population of patients referred to a palliative care clinic and observe their healthcare utilization patterns. Outcome Measures The primary outcome measures included changes in symptom scores as measured by the Edmonton Symptom Assessment Scale and hospital utilization rates.

Patients

Patients Diagnosis Patient-Centered Utilities

New South Family Medicine and MedSpa Offers Next Level Care

New South Family Medicine and MedSpa

NOVEMBER 24, 2022

Direct primary care offers you and your family top-notch health care, and so much more.like a high patient and provider satisfaction with an improved quality of care. Providers at New South Family Medicine and MedSpa can address the patient's deeper needs, rather than trying to rush through a hectic day full of too-brief appointments.

Family Medicine

Family Medicine DO Families Family

Anatomy of a Healthy Plate- Guest Blogger Rebecca Gray

New South Family Medicine and MedSpa

SEPTEMBER 17, 2019

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Referral

Referral Family Medicine DO Primary Care

RCT of Chaplaincy: Lexy Torke, Karen Steinhauser, LaVera Crawley

GeriPal

APRIL 6, 2023

LaVera: I trained at UCSF in family medicine. Did your intervention Lexy actually have any effect on utilization, which again, somewhat argue is the reason that services palliative care get funded? And so helping physicians have more fluency in general spiritual care and how to make referrals to specialists when needed.

IT

IT Patient-Centered Families Family

Primary Care Digest

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

Optimizing Medical Legal Partnerships for sustainable public funding through the tele-legal model [Mixed methods research]

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Economic analysis of virtual Medical Legal Partnership model [Economic or policy analysis]

Adoption, implementation, and impact of a Diabetes Navigator program based in primary care [Diabetes and endocrine disease]

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

Evaluation of Universal Food Insecurity Screening in the Primary Care Setting [Social determinants and vulnerable populations]

Developing actionable strategies to implement evidence-based breast cancer follow-up in primary care using codesign [Dissemination and implementation research]

Test-Retest Reliability of Electronic Handgrip Dynamometry and Accelerometry Measured Muscle Function in Older Adults [Musculoskeletal and rheumatology]

Ambulatory Behavioral Health Referral Patterns in the Setting of Chronic Medical Conditions [Behavioral, psychosocial, and mental illness]

The utilization patterns and impact of the Stanford Chronic Pain Self-Management Program in Eastern Ontario, Canada [Pain management]

Addressing diabetes management in the context of social needs: a qualitative study of primary care providers [Diabetes and endocrine disease]

Provider Attitudes Regarding Osteopathic Manipulative Medicine: A Qualitative Study [Practice management and organization]

Using eConsult to access specialist advice for persons living with dementia - A cross-sectional analysis [Geriatrics]

A feasibility study of the Illuminate 360o approach for monitoring the implementation of a health system innovation [Mixed methods research]

Combating Food Insecurity in Minnesota

Beyond the Diagnosis: A Detailed Characterization of Outpatient Palliative Care Patients [Palliative and end-of-life care]

New South Family Medicine and MedSpa Offers Next Level Care

Anatomy of a Healthy Plate- Guest Blogger Rebecca Gray

RCT of Chaplaincy: Lexy Torke, Karen Steinhauser, LaVera Crawley

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