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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

Combining these datasets in a consolidated data repository could result in an improved understanding of the care journey, support the healthcare needs of Ontario Health Team priority populations, promote continuity of care improvements across sectors, and decrease burden on emergency departments (EDs) and primary care providers.

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Resident Voices: Key Findings from Journal Club Surveys [Education and training]

Annals of Family Medicine

Context Journal Club serves as an essential platform in medical education for enhancing critical thinking skills, promoting evidence-based practice, and fostering scholarly discussions among residents. Additionally, residents were provided with a detailed rubric outlining specific metrics on which their presentations would be evaluated.

Education 130
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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

Referrals were not placed for patients being discharged to another facility or who already had an outside primary care provider. A referral order was created in the hospital system’s electronic health record to the "Hospital Discharge Clinic," and referrals were placed for urgent (7-day) or routine (14-day) TCM appointments.

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A Multisite CFIR Study of Readiness to Implement Collaboration Oriented Approach to Controlling High Blood Pressure (COACH) [Dissemination and implementation research]

Annals of Family Medicine

Setting: Three academic health systems with EPIC and Oracle electronic health records. Intervention: COACH — a patient-facing decision support tool integrated into the electronic record. COACH was embraced for its relative advantage over traditional workflows and its potential to empower and educate patients.

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

Annals of Family Medicine

Context: Medical legal partnerships (MLP) are an effective intervention for social determinants of health, like housing, education, and employment status. Study Design and Analysis: Tele-legal services were provided by one full time poverty lawyer and paralegal January 2021-June 2023.

Medical 130
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Prioritizing Actionable Implementation Strategies to Support Breast Cancer Follow-up in Primary Care [Cancer research (not screening)]

Annals of Family Medicine

Cross panel strategies where consensus was reached included: (1) educating PC providers on survivorship guidelines, (2) enabling screening reminders, templates, and monitoring alerts in the electronic medical record, (3) educating patients on survivorship and communicating needs with PC, and (4) increasing oncology-PC communications.

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Contraceptive counseling for gender-diverse patients: A community needs assessment [Health care disparities]

Annals of Family Medicine

These barriers combined with inadequate medical education on care for SGM patients contribute to poor reproductive outcomes, including high rates of teen and unplanned pregnancy. Most respondents preferred to receive the resource in discussion with their healthcare provider and for distribution through a QR code.

Community 130