Annals of Family Medicine

NOVEMBER 20, 2024

Population Studied: 13 urban and rural primary care practices located across Mayo Clinic sites in Minnesota, Wisconsin, and Florida. The final question asked patients, who have at least one risk factor, if they would like assistance with their need(s).

Primary Care 130

Primary Care Referral Routine Screenings Patients 130

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. Of those patients with an episode (i.e.,

Referral 130

Referral Community Transportation Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: To describe how primary care clinics have considered social needs in DM, and identify opportunities to support primary care clinics. family medicine, general internal medicine, endocrinology) affiliated with an academic medical center serving a diverse population in a mid-western metropolitan area.

Primary Care 130

Primary Care Diabetes Management Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Health-related social needs (HRSN), such as housing, food, and transportation, play a major role in overall patient health and well-being. The Coronavirus-19 (COVID-19) pandemic amplified HRSN disparities, adding stress to social support systems.

Transportation 130

Transportation Screening Individual Primary Care 130