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Community Integration: Pushing the Boundaries for a Better World

Integrated Care News by CFHA

On October 6, 2017, a van loaded with medical supplies departed from the Health Center, bound for the local airport. The Holyoke Health Center, in collaboration with the Family Resource Center at Enlace de Familias , played a pivotal role in this local relief effort. Where can we start?

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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

Background: Multiple chronic conditions (MCC) the most common condition seen in practice are present in 33% of adults and 80% of individuals age > 65. The apps also collect patient reported data on goals, social needs, and functional status. The mixed methods evaluation includes focus groups, user testing, and surveys.

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Addressing Medication Safety in Patients with Multiple Chronic Conditions during Transitions of Care: A Caregiver Perspective [Geriatrics]

Annals of Family Medicine

Context: Transitions of care (TOC) between healthcare settings carry numerous safety hazards and high risk for medication harm, particularly for patients with multiple chronic conditions (MCCs). Results: Study participants shared both their experiences related to medication safety, as well as barries to patient-centeredness.

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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

Intervention: COACH — a patient-facing decision support tool integrated into the electronic record. Outcome Measures: Interview questions and analysis were guided by five CFIR domains (innovation source, inner and outer setting, individuals, and implementation process). Consideration of the care team workflows (i.e.,

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Patient experience with Social Prescribing Program in Ontario, Canada [Social determinants and vulnerable populations]

Annals of Family Medicine

Context Social Prescribing (SP) is an approach to help individuals address their health and social needs wherein a healthcare practitioner refers patients to non-clinal services in the community. Models of SP vary, and the experience of patients across these models is less known. ARC: All (N=17) participants used navigation.

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A Call to Improve Readability of Patient Facing Trial Information

Physician's Weekly

Their recent study, which was presented online in Gynecological Cancer, assessed the readability of gynecologic cancer clinical trial descriptions on National Cancer Institute Designated Comprehensive Cancer Center (NCI-CCC) websites. gov or required additional inquiries to access information.

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Validation of the "Proactive" self-assessment tool for older people to identify their own risk of functional decline [Screening, prevention, and health promotion]

Annals of Family Medicine

Population studied: Individuals aged 65 years and older recruited in primary care clinics or senior residences. A single participant with severe loss of autonomy found Proactive less useful as it did not provide him with any new information. Setting: Community-based. Some comprehensibility issues were addressed in a modified version.

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