A Country Doctor Writes

MAY 29, 2025

Glenda Cyr has been my patient for many years. Maine has a health information exchange where most hospital systems upload their clinic notes, imaging and laboratory results. In our system, telephone notes, patient letters and office messages are not posted on the information exchange. Lo and behold, it is now normal.

Illness 243

Illness Hospital Appointment Complication 243

A Country Doctor Writes

JUNE 21, 2025

Its basic argument was that it isn’t sustainable to only see patients one by one in traditional doctor visits. I thought of it the other day when I put together a presentation about Galileo’s way of interacting with patients. The physician–patient encounter is health care’s choke point.

Patients 130

Patients Patient-Centered Hypertension Healthcare 130

Annals of Family Medicine

NOVEMBER 20, 2024

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.

Chronic Condition 130

Chronic Condition Medical Patient-Centered Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Prenatal care can be difficult for patients to accomplish, with frequent visits and time-sensitive health screenings. Patient interviews, providing qualitative information to augment study findings. Semi-structured interviews of post-partum patients. Intervention/Instrument: Optional virtual prenatal visits.

Patients 130

Patients Clinic Utilities Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Persistent pain is experienced among nearly half of the patients with long COVID (LC). Objective: To document the lived experience of patients with LC pain, including how they access and receive healthcare, to improve services for LC pain evaluation and treatment.

Patients 130

Patients Insurance IT Mental Health 130

Annals of Family Medicine

NOVEMBER 20, 2024

Community health worker (CHW) interventions show promising outcomes for T2D and HTN control particularly among low income and historically marginalized patients. Objective Evaluate the implementation of a CHW program and its impact on the control of T2D and HTN outcomes among patients with social vulnerabilities.

Hypertension 130

Hypertension Community Diabetes Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

We used the patient portal (Opal) to administer the I-Score, a 7-item electronic patient-reported outcome measure (ePROM) of barriers to ART adherence. Objective: To describe patient and service-related outcomes of the I-Score intervention and outline adherence barrier management by physicians. 10 to T3=2.3/10),

Clinic 130

Clinic Patients Electronics Management 130

Physician's Weekly

JUNE 13, 2025

Based on the findings, of the 56 NCI-CCCs reviewed, 44 (78%) provided sufficient information for readability assessment. gov or required additional inquiries to access information. Specifically, scores across all metrics confirmed that the language used was overly complex and not patient-friendly.

Patients 52

Patients Patient-Centered Clinic Individual 52

Annals of Family Medicine

NOVEMBER 20, 2024

The ability to reach and engage in the care process varies considerably depending on patients’ socio-demographic characteristics which we need to understand to address inequitable access issues. Setting/Dataset: 121,570 registered patients over 18 years of age with an email address available in their electronic medical record.

Healthcare 130

Healthcare Clinic Chronic Condition Finance 130

Annals of Family Medicine

NOVEMBER 20, 2024

Individuals who frequently attend the ED comprise up to 10% of patients, while accounting for a third of ED visits. There is a lack of information on high ED use in other jurisdictions, specifically in Central and Eastern Europe. Objective: To describe frequent ED use among patients in Krakow, Poland. median: 6, IQR: 2.0).

Primary Care 130

Primary Care Patients Consulting Hospital 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective To assess patient perceptions of a primary care-based LM clinic. Population Studied Patients who were referred to or attended the LM clinic between 5/1/22 and 5/31/24 (n=575). There is limited research on implementation of LM in medically underserved communities. Setting: LM Clinic in the SW Virginia safety net.

Clinic 130

Clinic Patients Primary Care Chronic Disease 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: In response to a call initiated by CIHR in 2023, inviting patient, public, and community participation, the Patient Council of the Canadian Primary Care Research Network (CPCRN) responded with a Report on March 25, 2024. Population Studied: CPCRN Patient Council.

Patients 130

Patients Community Primary Care Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Population Primary care providers in 12 Ottawa and Sudbury (Ontario, Canada) practices referred their patients with health or social needs to access needed SP services. Dataset Of the 326 enrolled patients, 150 consented and had their data successfully linked to health administrative data housed at ICES (ARC=83, Ontario-211: 67).

Patient-Centered 130

Patient-Centered Utilities ER Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

Impacts of healthcare sludge on patients have not been well-described. Study Design and Analysis: This sequential/convergent mixed methods study included a patient survey and patient interviews. Study Design and Analysis: This sequential/convergent mixed methods study included a patient survey and patient interviews.

Screening 130

Screening Patients Insurance Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Patient messaging to providers has dramatically increased since the pandemic, leading to informatics efforts to categorize messages to facilitate more efficient review. Conclusion Clinicians generally lack the time to prioritize patient messages. The increased inbox burden has particularly impacted primary care physicians.

Primary Care 130

Primary Care Management Primary Care Physician Patients 130

KevinMD

JUNE 15, 2025

Whether presenting at grand rounds, sharing research at conferences, or explaining treatment plans to patients, your PowerPoint slides can either amplify your message or obscure it in a deluge of information. As health care professionals, we are constantly immersed in data, intricate details, and complex ideas.

Medical 167

Medical Treatment Plan Patients IT 167

Annals of Family Medicine

NOVEMBER 20, 2024

Intervention/Instrument Survey questions focused on socio-demographic information, substance use patterns, health status, use of treatment and harm reduction services, and acceptability of emerging services. Participants received a CA$30 cash honorarium for their time.

Community 130

Community Mental Health Patients Diagnose 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Nearly all patients with type 2 diabetes have comorbid chronic conditions, adding complexity to self-management. A tool to more efficiently relay points of patient-perceived treatment burden during a primary care visit may lead to more patient-centered care plans and improved outcomes.

Primary Care 130

Primary Care Diabetes Screening Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

While the clinical performance of NIPS is well-documented, to our knowledge, no research has documented its impact on pregnant women’s health-related quality of life (HRQoL), thus hampering informed decision-making about prenatal options. This evidence will inform future decision aids about prenatal screening.

Screening 130

Screening Physicals Patients Clinic 130

Annals of Family Medicine

NOVEMBER 20, 2024

Understanding health information seeking behavior is critical in providing effective interventions and improving quality of life for patients, especially for those facing complex health needs. The data was obtained from the 2022 Health Information National Trends Survey® (HINTS). Objectives. Conclusions.

Patients 130

Patients Families Family Government 130

Annals of Family Medicine

NOVEMBER 20, 2024

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. Setting: Three academic health systems with EPIC and Oracle electronic health records.

Electronics 130

Electronics Patient-Centered Hypertension Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Data visualization is useful to contemporary methods designed for clarity and communication of information. Although data visualization is gaining traction in the hypertension, its use in health education and information dissemination is still underutilized. Setting or Dataset two primary health centers.

Hypertension 130

Hypertension Primary Care General Practitioner Management 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: 1) Test the virtual model of MLP to achieve more favorable economies of scale 2) Develop a policy-informed lexicon for MLP to inform model development, D&I research, and improve data sharing across models to ultimately advance sustainable state-based funding for MLP. Intervention/Instrument: Legal-needs screening tool.

Medical 130

Medical Referral Screening Internal Medicine 130

Annals of Family Medicine

NOVEMBER 20, 2024

Electronic risk assessment and communication may enhance screening and prevention, but patient perspectives are understudied. Study design and analysis Our approach was informed by the Theoretical Framework of Acceptability. Patient coinvestigators and clinicians were involved in all research steps.

Screening 130

Screening Patients Referral Family 130

Integrated Care News by CFHA

JUNE 12, 2025

We offered trauma-informed support and helped newly displaced individuals connect with health and community resources. We must understand how the current policies impact access to care and identify policy-related barriers faced by our patients and families. Key Principles for Success Center patient voice in every phase.

Community 130

Community Integrated Care Patient-Centered Families 130

Integrated Care News by CFHA

MARCH 12, 2025

Given the complex interplay among these functions, gathering patient perspectives on those core functions seems key to effectively operationalizing and measuring them. Patients experience primary care firsthand, offering valuable insights into the accessibility, scope, coordination, and continuity of services. ” 4.

Integrated Care 130

Integrated Care Families Family Mental Health 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objectives: To link primary care electronic medical record (EMR) data with community and hospital data and to test the utility of the merged dataset through a targeted quality improvement (QI) intervention among high-risk patients with chronic obstructive pulmonary disease (COPD). Risk factors (i.e.,

Primary Care 130

Primary Care Electronics Hospital Medical 130

Physician's Weekly

JUNE 25, 2025

Caring for patients with multiple chronic conditions requires identifying those at risk, clear communication, and coordinated care to improve outcomes. Many of these patients are clinically complex and receive care from multiple professionals—which creates unique management hurdles.

Chronic Condition 52

Chronic Condition Patients Management Primary Care Physician 52

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Patients with diabetes who receive structured and integrated care have better control and outcomes; however, care may shift between multiple settings making coordination challenging. Outcome Measures: Number of patients engaged, resulting referrals, Navigator time per patient, and hemoglobin A1c measures across 2-years.

Primary Care 130

Primary Care Diabetes Referral Integrated Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context The introduction of the Human Papillomavirus (HPV) test and the 2012 Cervical Cancer Screening (CCS) guidelines expanded the way providers offer and interpret screening for their patients. Also, more Black women reported being informed about the type of CCS they received. population.

Screening 130

Screening Utilities Patient-Centered Insurance 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. We also assessed patterns of social risks and need for assistance among our patient populations. Of those patients with an episode (i.e.,

Referral 130

Referral Community Transportation Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Dataset: We conducted a qualitative study utilizing the Database of Individual Patient Experiences (DIPEx) methodology - a time-tested, research-based approach for conducting and disseminating health and healthcare experiences. For challenges, Latina women reported the need to experience more trauma informed care by providers.

Healthcare 130

Healthcare Provider Healthcare Experience Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

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. The apps also collect patient reported data on goals, social needs, and functional status.

Chronic Condition 130

Chronic Condition Patient-Centered Primary Care Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Continuous quality improvement (CQI) is a promising method for improving the healthcare system and responding effectively to changing patient needs. Each case has been informed champion, change agent, peers and managers. The champion and peers targeted by the change were recruited to inform each case.

Healthcare 130

Healthcare Clinic Individual Management 130

Annals of Family Medicine

NOVEMBER 20, 2024

However, mental health conditions and health-related social needs (HRSNs) can complicate patients’ success. Addressing mental health and HRSNs can improve diabetes outcomes, but stigma surrounding these issues can make both patients and providers uncomfortable during clinical discussions.

Mental Health 130

Mental Health Diabetes Relationship Primary Care 130

Alabama Academy of Family Physicians

AUGUST 28, 2024

In Alabama, the call to reform the prior authorization system is reaching a crescendo, with numerous physicians and patient advocates pushing for substantial changes. ” This not only exacerbates health issues but often contributes to heightened stress and deterioration in patient health.

Insurance 130

Insurance Diagnose Provider Patients 130

Integrated Care News by CFHA

MAY 1, 2025

That small win reminded me that artificial intelligence is already shaping the way our patients (and our families) search for health advice. Our Patients Are Already Using AI Many people now ask their first health question to a chatbot rather than to a clinician. Evidence‑informed care was literally at his fingertips.

Patient-Centered 130

Patient-Centered Integrated Care Primary Care Healthcare Professional 130