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Describing Differences Across Place and Provider in Canadian Team-Based Care Settings Using Electronic Health Records [Health care informatics]

Annals of Family Medicine

In both cases, TBC can help by providing a collaborative approach to care that can better manage the complex needs of patients. The system is used by different provider types to document needs and care in both urban and rural settings. Analysis We apply topic modeling to the codes recorded for clients.

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Advancing Primary Care through a Model Unit for Innovative Practice Enhancement [Practice management and organization]

Annals of Family Medicine

Setting or Dataset: Data includes secondary data gathered through Epic electronic medical records system as well as primary data collected from physicians, APPs, and staff working in the MU. measures of provider and staff satisfaction). measures of provider and staff satisfaction).

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Pain-Related Medication in Adults with Intellectual Disability: a systematic review [Pain management]

Annals of Family Medicine

Objective: To synthesize literature on pain-related medication in adults with ID and examine how it relates to MLTCs and polypharmacy and explore the views of adults with ID, caregivers and healthcare providers on pain medication use. Measures: Varied by study design; self/carer-report or electronic health records (EHR).

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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. Referrals were not placed for patients being discharged to another facility or who already had an outside primary care provider.

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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. Population Studied: Primary care team members involved in high blood pressure management. Intervention: COACH — a patient-facing decision support tool integrated into the electronic record. Study design: Deductive qualitative analysis.

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Electronic consultation questions asked to addiction medicine specialists by primary care providers: Retrospective content analysis

Canadian Family Physician

Objective To determine the major themes among clinical questions asked to addiction medicine specialists sent by primary care providers (PCPs) via the Champlain Building Access to Specialists through the eConsultation (BASE™) electronic consultation (eConsult) service and the PCP-perceived benefits of this service.

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Development and Testing of an Interoperable e-care Plan for Person-Centered Care Planning for Multiple Chronic Conditions [Multimorbidity]

Annals of Family Medicine

Because people with MCC typically see multiple providers in multiple care settings often using different EHRs, critical information is difficult to obtain, leading to fragmented care, clinician and patient burden, and suboptimal outcomes. Results of testing and evaluation will be presented.