Annals of Family Medicine

NOVEMBER 20, 2024

Population Studied: Three sites, representing 13 urban and rural primary care practices in Minnesota, Wisconsin, and Florida participated in the Compass Rose pilot. The most common type of support requested related to transportation needs (42%), followed by assistance related to food insecurity (25%), utilities (12%), and housing (9%).

Referral 130

Referral Community Transportation Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: Secondary data on social needs screening and referral generated through Epic. Population Studied: 13 urban and rural primary care practices located across Mayo Clinic sites in Minnesota, Wisconsin, and Florida.

Primary Care 130

Primary Care Referral Routine Screenings Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

A recent review of national diabetes treatment guidelines recommended adjustments to DM to reduce financial strain (eg, selecting lower cost medications), as well as directly intervening in response to an identified social need (eg, referral to a community-based service). Outcome Measure: Themes that emerged from interviews.

Primary Care 130

Primary Care Diabetes Management Provider 130

GeriPal

JUNE 12, 2025

And sort of a few years ago, we would sometimes see referrals a bit later than we would have liked. We are Seeing referrals at an earlier time point, especially at a point that I feel that I can really help a patient. Is it normally the oncologist who’s making the referrals to you or do they come from people outside of oncology?

Patient-Centered 103

Patient-Centered Referral Patients IT 103

GeriPal

FEBRUARY 15, 2024

They weren’t hurt, they didn’t need transport, and we were seeing the same people over and over again. But what was really interesting is the transport to the hospital was actually going down in their system. What do you think of that?” ” And I was fascinated, I’d never really thought about it.

Community 116

Community Transportation IT PCP 116

GeriPal

OCTOBER 17, 2024

Alex 00:12 We have a guest host who has requested this episode, Matt Shuster, who’s a geriatrician and palliative care doc. And also I was in the HVMA primary care program. So kind of from a primary care point of view, the guys are doing okay. He’s in Boston. And Matt brought today’s topic to us.

Primary Care 114

Primary Care Patient-Centered IT Patients 114

GeriPal

JUNE 5, 2025

The obstacles hindering referrals to palliative care services. Practical strategies to overcome these barriers and enhance care. We also take a dive into these 2 articles that Connie first authored: Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78