Implementation of Patient and Family Advisory Councils in Primary Care Practices in a Large, Integrated Health System
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - September 14, 2018 Category: Internal Medicine Source Type: research

Impact of health care reform on enrolment of immigrants in primary care in Ontario, Canada
ConclusionsImmigrant enrolment rates in new comprehensive primary care models were consistently lower than among long-term residents. This has implication on equitable primary care access for immigrant populations. (Source: Family Practice)
Source: Family Practice - September 14, 2018 Category: Primary Care Source Type: research

Behavioral Health Assessments and Interventions of Psychology Trainees and Residents During Dual Interviewing: Replication and Extension
This study is a replication and extension of a 2013 study describing dual interviewing encounters involving psychology trainees and family medicine residents within an integrated primary care clinic as it relates to behavioral health assessments and interventions. Psychology trainees provided descriptions of 400 collaborative patient encounters involving 337 single and 63 repeat encounters. Psychology trainees coded the frequency of behavioral health assessments and interventions by the psychology trainee, family medicine resident, or both. Seventy-eight percent of encounters contained an assessment, and 20% contained inte...
Source: Journal of Clinical Psychology in Medical Settings - September 12, 2018 Category: Psychiatry & Psychology Source Type: research

Approaches to Behavioral Health Integration at High Performing Primary Care Practices
This article describes the goals for BH integration at 30 high-performing primary care practices and strategies to operationalize these goals. Methods: We conducted a qualitative analysis of BH integration at 30 US primary care practices that had been selected for the Learning from Effective Ambulatory Practices (LEAP) project following an interview-based assessment and rating process. Data collection included formal and informal interviews with practice leaders and staff, as well as observations of clinical encounters. We used a template analysis approach to thematically analyze data. Results: Most LEAP practices looked...
Source: Journal of the American Board of Family Medicine - September 10, 2018 Category: Primary Care Authors: Blasi, P. R., Cromp, D., McDonald, S., Hsu, C., Coleman, K., Flinter, M., Wagner, E. H. Tags: Original Research Source Type: research

Medication Adherence Improvement Similar for Shared Decision-Making Preference or Longer Patient-Provider Relationship
Conclusion: The benefits of SDM over passive decision making on medication adherence were reduced with increasing years of the patient-provider relationship. Having an established relationship with the provider may have a positive impact on medication adherence that is comparable to relationships high in SDM. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - September 10, 2018 Category: Primary Care Authors: Schoenthaler, A., Rosenthal, D. M., Butler, M., Jacobowitz, L. Tags: Original Research Source Type: research

Practice strategies to improve primary care for chronic disease patients under a pay-for-value program
ConclusionsPractices that succeeded in improving care for chronic disease patients pursued a mix of strategies that helped meet immediate care delivery needs while also creating new adaptive structures and processes to better respond to changing pressures and demands. These findings help inform payers and primary care practices seeking evidence-based strategies to foster a stronger delivery system for patients with significant healthcare needs. (Source: Healthcare)
Source: Healthcare - September 7, 2018 Category: Middle East Health Source Type: research

Association of Mindfulness With Residency Preference and Curriculum Selection in Preclinical Osteopathic Medical Students.
Authors: Nayyar N, Saggio G, Plummer M, Jung MK, Kappenberg J Abstract Context: Recent studies suggest the shortage of US primary care physicians will be more than 50,000 by the year 2025. Mindful osteopathic medical students may be more inclined to pursue a career in primary care practice than those demonstrating lower levels of mindfulness. If so, assessing mindfulness before and after admission to medical school may reduce this shortage. Objective: In this cross-sectional survey-based study, the authors assessed whether mindfulness among preclinical osteopathic medical students was associated with (a) their ...
Source: Journal of the American Osteopathic Association - September 6, 2018 Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research

DEMOCRATIZING DISCOVERY HEALTH WITH N=Me.
Authors: Ofili EO, Pemu PE, Quarshie A, Mensah EA, Rollins L, Ojutalayo F, McCaslin A, Clair BS Abstract Health 360x is a mobile health application and social platform that integrates self-monitoring and decision support for preventive health. We studied 240 diabetic patients in primary care practices and a church community in metropolitan Atlanta. Health coaches were trained on the Health 360x curriculum, which was adapted from the American Association of Diabetes Educators. Participants worked with the health coaches to set goals for diabetes self-management. The intervention included weekly coaching for 12 weeks...
Source: Transactions of the American Clinical and Climatological Association - September 1, 2018 Category: General Medicine Tags: Trans Am Clin Climatol Assoc Source Type: research

Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience
ConclusionsPediatric resident LOE clinics had a greater average number of patient visits and revenue per faculty member but higher costs and lower operating margins than faculty clinics. (Source: Academic Pediatrics)
Source: Academic Pediatrics - September 1, 2018 Category: Pediatrics Source Type: research

United States Pediatricians' Attitudes Regarding Public Policies for Low-Income Children and Their Profession's Advocacy Priorities
ConclusionsPediatricians strongly support government policies that affect child poverty and the provision of basic needs to families. This support should be used to inform professional organizations, advocates, and policy-makers focused on children and families. (Source: Academic Pediatrics)
Source: Academic Pediatrics - September 1, 2018 Category: Pediatrics Source Type: research

Top 20 POEMs of the Past 20 Years: A Survey of Practice-Changing Research for Family Physicians.
This article identifies the POEMs in each of the last 20 years that were highest ranked for having recommended a major and persistent change in practice that year. They include POEMs that recommend a novel, effective intervention, a second group that recommends abandoning an ineffective practice, and a third group that recommends abandoning a potentially harmful practice. The top POEMs of the past 20 years illustrate the breadth of practice change in primary care and the need for family physicians to have a systematic approach to keeping up with the medical literature, such as that in POEMs, especially because many of thes...
Source: Annals of Family Medicine - September 1, 2018 Category: Primary Care Authors: Ebell MH, Barry HC, Shaughnessy AF, Slawson DC, Kulkarni N, Speer L Tags: Ann Fam Med Source Type: research

Social Isolation and Patient Experience in Older Adults.
CONCLUSIONS: Social isolation was associated with negative patient experience in elderly primary care patients. Raising awareness regarding patient social networks among primary care providers and targeted interventions for socially isolated elderly patients aimed at improving the experience of primary care, especially regarding longitudinality, comprehensiveness, and community orientation, may be warranted. PMID: 30201635 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - September 1, 2018 Category: Primary Care Authors: Aoki T, Yamamoto Y, Ikenoue T, Urushibara-Miyachi Y, Kise M, Fujinuma Y, Fukuhara S Tags: Ann Fam Med Source Type: research

Snapshot of the primary care waiting room: Informing practice redesign to align with the Patient's Medical Home model.
CONCLUSION: In this study, the 4 priority pillars for practices to align with the PMH were timely access, team-based care, comprehensive care, and a patient-centred approach. Widespread implementation of advanced access is an urgent priority in light of persisting difficulties in timely access. Team-based and comprehensive care are needed to address the high prevalence of multimorbidity and psychological distress and to support health behaviour change. Finally, the patient-centred approach needs to underpin every care encounter. PMID: 30209115 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - September 1, 2018 Category: Primary Care Authors: Haggerty J, Fortin M, Breton M Tags: Can Fam Physician Source Type: research

Hepatitis C care cascade among persons born 1945-1965: 3 medical centers.
CONCLUSIONS: This analysis showed that although linkage to care was largely successful in the target birth cohort, the largest gap in the HCV care cascade was seen in initiating treatment. Greater emphasis on linking patients to clinical evaluation and treatment is necessary in order to achieve the public health benefits promised by birth-cohort testing. PMID: 30222920 [PubMed - in process] (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - September 1, 2018 Category: Health Management Authors: Brady JE, Vellozzi C, Hariri S, Kruger DL, Nerenz DR, Brown KA, Federman AD, Krauskopf K, Kil N, Massoud OI, Wise JM, Seay TA, Smith BD, Yartel AK, Rein DB Tags: Am J Manag Care Source Type: research

Interprofessional training and team function in patient-centred medical home: Findings from a mixed method study of interdisciplinary provider perspectives.
In conclusion, our findings demonstrate the importance of leadership support and individual job satisfaction in producing highly functioning PCMH teams. Based on qualitative findings, we hypothesize interprofessional training is important, however, inconsistencies in IP training delivery compromise its potential benefit. Future implementation efforts should improve standardization of training process and train team members together. Interprofessional leadership coordination of interprofessional training is warranted. PMID: 30156933 [PubMed - as supplied by publisher] (Source: Journal of Interprofessional Care)
Source: Journal of Interprofessional Care - August 30, 2018 Category: Health Management Tags: J Interprof Care Source Type: research

How Do Innovative Primary Care Practices Achieve the Quadruple Aim?
We report the findings from 38 such practices that fill this gap. We describe how they execute 8 functions that collectively meet patient needs. They include managing populations, providing self-management support coaching, providing integrated behavioral health care, and managing referrals. The functions provide a more actionable perspective on the work of primary care. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Improving Provider Experience and Increasing Patient Access Through Nurse Practitioner–Physician Primary Care Teams
This article describes a model of NP-MD care teams in an urban safety-net primary care practice. Average time to third next available appointment with a team provider (either NP or MD) decreased by nearly 20 days after implementation of the model. In total, 79% of MDs reported that the model was very or extremely helpful in reducing the burden of work between visits and 100% of NPs reported that they were very or extremely satisfied with their current job. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Implementation of a Workflow Initiative for Integrating Transitional Care Management Codes in a Geriatric Primary Care Practice
We implemented a transitional care management service led by a nurse care manager. An interdisciplinary team developed a workflow using a Plan-Do-Study-Act cycle for contacting patients. Of the 146 (97.9%) eligible patients, 143 (97.9%) had a phone call within 48 hours. There were 84 of 120 (70.0%) and 117 of 120 (97.5%) attendance rates of those attending visits within 7 and 14 days. A care manager–led workflow was successfully and easily implemented within a primary care practice. (Source: Journal of Nursing Care Quality)
Source: Journal of Nursing Care Quality - August 24, 2018 Category: Nursing Tags: Articles Source Type: research

Patient Voices Network: Bringing Breast Cancer Awareness and Action into Underserved Communities.
CONCLUSIONS: Community input addressed the need for screening mammography in an underserved community. The partnership approach featured complementary strengths of both patients and University staff, fostered skill building and co-learning, and ultimately strengthened our partnership. A partnered approach may be effective in engaging hard-to-reach populations to address health disparities. PMID: 30129515 [PubMed - as supplied by publisher] (Source: Journal of the National Medical Association)
Source: Journal of the National Medical Association - August 22, 2018 Category: General Medicine Tags: J Natl Med Assoc Source Type: research

Waist Circumference Measurement Diffusion in Primary Care
This sequential explanatory mixed-methods study, informed by the Diffusion of Innovations theory, aimed to gain a deeper understanding of waist circumference measurement rejection in primary care. A convenience sample of primary-care practices generated the quantitative sample. A purposeful selection of providers, sampled from the quantitative sample, comprised the qualitative sample. Waist circumference measurement did not diffuse into practice. Provider characteristics did not correlate with measurement use. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - August 17, 2018 Category: Nursing Authors: Beatrice Gaynor, Barbara Habermann, Regina Wright Tags: Original Research Source Type: research

From the Editor ’s desk....
In order to reach the World Health Organization goal of hepatitis C virus (HCV) elimination, Australia has already expanded the role of primary care with an attempt to prioritise those with advanced HCV-induced liver disease, because they are at the highest risk of liver-related morbidity and mortality. However, as advanced liver disease often remains undetected, and its prevalence in primary care management is unknown, Bloom et al. were interested to evaluate liver stiffness measurement (LSM) as a screening tool to detect individuals with advanced liver disease and predict liver-related events in a prospective cohort of p...
Source: Journal of Hepatology - August 15, 2018 Category: Gastroenterology Authors: Richard Moreau, Ramon Bataller, Thomas Berg, Sophie Lotersztajn, Jessica Zucman-Rossi, Rajiv Jalan Tags: Editorial Desk Source Type: research

Changes in Utilization and Expenditures for Medicare Beneficiaries in Patient-centered Medical Homes: Findings From the Multi-Payer Advanced Primary Care Practice Demonstration
Conclusions: Although the MAPCP Demonstration did not have strong, consistent impacts on utilization and expenditures, this evaluation provides insights that may be useful for the design of future health care transformation models. (Source: Medical Care)
Source: Medical Care - August 14, 2018 Category: Health Management Tags: Patient-centered Care Source Type: research

Health-related quality of life and the physician –patient alliance: a preliminary investigation of ultra-brief, real-time measures for primary care
ConclusionsThe WRS and PAS demonstrate sufficient reliability and validity to move to the next phase of research: a randomized clinical trial comparing the use of real-time feedback from the two measures to treatment as usual targeting outcomes of chronic disease patients. (Source: Quality of Life Research)
Source: Quality of Life Research - August 10, 2018 Category: Health Management Source Type: research

Implementation of the Asthma Control Test in Primary Care to Improve Patient Outcomes
Asthma is one of the major chronic diseases in the pediatric population, affecting 9.5% of children. The National Heart, Lung, and Blood Institute recommends the use of the Asthma Control Test (ACT) for periodic assessment of asthma control. The purpose of this evidence-based project was to implement the Asthma Control Test screening tool into the primary care practice to improve management of patients with asthma by more accurately addressing asthma control. (Source: Journal of Pediatric Health Care)
Source: Journal of Pediatric Health Care - August 10, 2018 Category: Pediatrics Authors: Nancy Cantey Banasiak Tags: Article Source Type: research

Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system
ConclusionUptake of new team-based care delivery models is related to practices ’ ability to respond to change and to adapt team roles in workflow, influenced by both local leadership and stable staffing. Better performance on quality metrics may identify high uptake practices. Our findings can inform expectations for operational and policy leaders seeking to implement change in primary care practices. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - August 6, 2018 Category: Internal Medicine Source Type: research

Teaching Medical Students About Health Systems Science and Osteopathic Principles and Practice Using a Virtual World: The Envision Community Health Center.
This article explains the project, illustrates an alignment with Health Systems Science and osteopathic competencies, and highlights findings from previous research studies. PMID: 30073338 [PubMed - in process] (Source: Journal of the American Osteopathic Association)
Source: Journal of the American Osteopathic Association - August 5, 2018 Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research

Multi-level Influences on Breast Cancer Screening in Primary Care
ConclusionsAfter accounting for woman-level characteristics, the remaining variation in breast cancer screening was largely due to provider and health system variation. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - August 3, 2018 Category: Internal Medicine Source Type: research

Making fall prevention routine in primary care practice: perspectives of allied health professionals
While there is strong evidence that fall prevention interventions can prevent falls in people aged 65 and over, translating evidence into routine practice is challenging. Research regarding how allied health p... (Source: BMC Health Services Research)
Source: BMC Health Services Research - August 3, 2018 Category: General Medicine Authors: Jeannine Liddle, Meryl Lovarini, Lindy Clemson, Lynette Mackenzie, Amy Tan, Sabrina W. Pit, Roslyn Poulos, Anne Tiedemann, Catherine Sherrington, Chris Roberts and Karen Willis Tags: Research article Source Type: research

Reflections of the quality of primary care in Canada and Israel
AbstractRachel Podell and her colleagues at the National Program for Quality Indicators in Community Healthcare in Israel have provided a clear and engaging description of thequality of primary care provided to the elderly in Israel. They examine changes overtime, variation across sub-groups, and comparisons with other countries. Over a 13year timeframe, most of the included process measures improved substantially, withfairly minor differences between demographic groups and largely favourablecomparisons with other countries.In the Podell et al article, there are few direct comparisons of primary care available between Cana...
Source: Israel Journal of Health Policy Research - August 3, 2018 Category: International Medicine & Public Health Source Type: research

Educational Text Messages Decreased Emergency Department Utilization Among Infant Caregivers: A Randomized Trial
Publication date: August 2018Source: Academic Pediatrics, Volume 18, Issue 6Author(s): Amy Ladley, Amanda Waltos Hieger, Joshua Arthur, Matthew BroomAbstractObjectiveTo determine the feasibility and effectiveness of text messages as an educational tool to reduce the prevalence of nonurgent emergency department (ED) visits among a population with high levels of low health literacy.MethodsThis prospective, randomized experiment conducted in a large, urban, academic pediatric primary care practice enrolled 231 caregivers of infants into 2 groups: enhanced standard of care materials at well-child visits through 6 months (n&thi...
Source: Academic Pediatrics - August 2, 2018 Category: Pediatrics Source Type: research

Primary care integration in rural areas: A community-focused approach.
Current and developing models of integrated behavioral health service delivery have proven successful for the general population; however, these approaches may not sufficiently address the unique needs of individuals living in rural and remote areas. For all communities to benefit from the opportunities that the current trend toward integration has provided, it is imperative that cultural and contextual factors be considered determining features in care delivery. Rural integrated primary care practice requires specific training, expertise, and adjustments to service delivery and intervention to best meet the needs of rural...
Source: Families, Systems, and Health - August 2, 2018 Category: International Medicine & Public Health Source Type: research

Breastfeeding to 12 mo and beyond: nutrition outcomes at 3 to 5 y of age.
Conclusions: Breastfeeding for ≤12 mo was associated with decreased nutrition risk and healthier eating behaviors and dietary intake at 3-5 y of age. We found insufficient evidence of additional benefit for breastfeeding beyond 12 mo of age. The TARGet Kids! practice-based research network is registered at www.clinicaltrials.gov as NCT01869530. PMID: 30101330 [PubMed - in process] (Source: Am J Clin Nutr)
Source: Am J Clin Nutr - August 1, 2018 Category: Nutrition Authors: Borkhoff CM, Dai DWH, Jairam JA, Wong PD, Cox KA, Maguire JL, Birken CS, Macarthur C, Parkin PC, TARGet Kids! Collaboration Tags: Am J Clin Nutr Source Type: research

Starting Early: Promoting Emotional and Behavioral Well-Being in Infant and Toddler Well-Child Care.
This article presents a developmentally focused approach to integrating the growing science of early childhood social-emotional development into primary care practice, providing both empiric and practical rationales. [Pediatr Ann. 2018;47(8):e317-e322.]. PMID: 30102755 [PubMed - in process] (Source: Pediatric Annals)
Source: Pediatric Annals - August 1, 2018 Category: Pediatrics Authors: Russell D, Gleason MM Tags: Pediatr Ann Source Type: research

Defining the Place of Direct Primary Care in a Value-Based Care System.
CONCLUSIONS: Physicians seeking strategies to reduce administrative burden, spend more time with patients, or simply streamline their practice may experience benefits in transitioning to a retainer practice such as direct primary care. There are foundational concepts about direct primary care, including advantages, drawbacks, and ethical considerations, to heed when transitioning to this model. There is a need for further research to quantify key data about direct primary care and its effects on patient outcomes and physician burnout and satisfaction. PMID: 30193018 [PubMed - in process] (Source: WMJ)
Source: WMJ - August 1, 2018 Category: General Medicine Authors: Carlasare LE Tags: WMJ Source Type: research

Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a “chart closure” hard stop
AbstractObjectiveTo evaluate provider responses to a narrowly targeted “Best Practice Advisory” (BPA) alert for the intensification of blood pressure medications for persons with diabetes before and after implementation of a “chart closure” hard stop, which is non-interruptive but demands an action or dismissal before the chart can be closed.Materials and MethodsWe designed a BPA that fired alerts within an electronic health record (EHR) system during outpatient encounters for patients with diabetes when they had elevated blood pressures and were not on angiotensin receptor blocking medications. The...
Source: Journal of the American Medical Informatics Association - July 27, 2018 Category: Information Technology Source Type: research

A protocol for a cluster randomized trial comparing strategies for translating self-management support into primary care practices
Advanced primary care models emphasize patient-centered care, including self-management support (SMS), but the effective use of SMS for patients with type 2 diabetes (T2DM) remains a challenge. Interactive beh... (Source: BMC Family Practice)
Source: BMC Family Practice - July 24, 2018 Category: Primary Care Authors: W. Perry Dickinson, L. Miriam Dickinson, Bonnie T. Jortberg, Danielle M. Hessler, Douglas H. Fernald and Lawrence Fisher Tags: Study protocol Source Type: research

Perceptions, Attitudes, and Behaviors of Primary Care Providers Toward Obesity Management: A Qualitative Study.
CONCLUSION: Obesity is not being effectively managed in these primary care practices and three common themes/obstacles must be addressed. PMID: 30024289 [PubMed - in process] (Source: Journal of Community Health Nursing)
Source: Journal of Community Health Nursing - July 21, 2018 Category: Nursing Tags: J Community Health Nurs Source Type: research

Reforming Payment for Primary Care —It’s Not Just the Money, It’s the Payment System
Poor Medicaid reimbursement stands as a frequently cited cause of reluctance by many primary care practices to serve Medicaid ’s expanding population. With payment rates a fraction of those for Medicare and commercial insurance, most primary care practices find Medicaid reimbursement insufficient. The expansion of Medicaid eligibility by the Patient Protection and Affordable Care Act (ACA) creates an urgent need to engag e more primary care practices and, if already participating, to expand their Medicaid roles. To encourage this expansion, the ACA legislated a normalizing of Medicaid reimbursement so that the reimbu...
Source: JAMA Internal Medicine - July 16, 2018 Category: Internal Medicine Source Type: research

Differences between GP perception of delivered empathy and patient-perceived empathy: a cross-sectional study in primary care.
Abstract BACKGROUND: Empathy has positive effects on a range of healthcare outcomes. It is therefore an important skill for a GP. However, the correlation between GP perception of delivered empathy and patient perception of GP empathic communication during consultations is still unclear. AIM: To investigate the correlation between GP perception of delivered empathy and patient-perceived empathy. DESIGN AND SETTING: Cross-sectional study in primary care in the Netherlands, between December 2016 and February 2017. METHOD: GPs and their patients were asked to fill in an empathy questionnaire directly a...
Source: The British Journal of General Practice - July 16, 2018 Category: Primary Care Authors: Hermans L, Hartman TO, Dielissen PW Tags: Br J Gen Pract Source Type: research

Blood pressure control rates measured in specialty vs primary care practices within a large integrated health system
The Journal of Clinical Hypertension, EarlyView. (Source: The Journal of Clinical Hypertension)
Source: The Journal of Clinical Hypertension - July 16, 2018 Category: Cardiology Authors: Sarah J. Billups PharmD , Joseph J. Saseen PharmD , Joseph P. Vande Griend PharmD , Lisa M. Schilling MD, MSPH Source Type: research

Co-located specialty care within primary care practice settings: A systematic review and meta-analysis
ConclusionsCo-located specialty care in primary care settings may support the aims of high value care delivery. However, additional studies are needed to further evaluate the value of co-location of specific specialties and stronger data on impact to health outcomes and cost. (Source: Healthcare)
Source: Healthcare - July 11, 2018 Category: Middle East Health Source Type: research

The impact of tailored intervention services on charges and mortality for adult super-utilizers
Publication date: Available online 25 August 2017Source: HealthcareAuthor(s): Josh Durfee, Tracy Johnson, Holly Batal, Jeremy Long, Deborah Rinehart, Rachel Everhart, Carlos Irwin Oronce, Ivor Douglas, Kimberly Moore, Adam AtherlyAbstractBackgroundInterventions designed to improve care and reduce costs for patients with the highest rates of hospital utilization (super-utilizers) continue to proliferate, despite conflicting evidence of cost savings.MethodsWe evaluated a practice transformation intervention that implemented team-based care and risk-stratification to match specific primary care resources based on need. This i...
Source: Healthcare - July 11, 2018 Category: Middle East Health Source Type: research

Leveraging technology to promote smoking cessation in urban and rural primary care medical offices
We examined the use of automated voice recognition (AVR) messages targeting smokers from primary care practices located in underserved urban and rural communities to promote smoking cessation. We partnered with urban and rural primary care medical offices (n = 7) interested in offering this service to patients. Current smokers, 18 years and older, who had completed an office visit within the previous 12 months, from these sites were used to create a smoker's registry. Smokers were recruited within an eight county region of western New York State between June 2012 and August 2013. Participants were contacted over si...
Source: Preventive Medicine - July 11, 2018 Category: International Medicine & Public Health Source Type: research

Mean HbA1c, HbA1c variability, and mortality in people with diabetes aged 70 years and older: a retrospective cohort study
Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Angus Forbes, Trevor Murrells, Henrietta Mulnier, Alan J SinclairSummaryBackgroundGlycaemic targets for older people have been revised in recent years because of concern that more stringent targets are associated with increased mortality. We aimed to investigate the association between glycaemic control (mean HbA1c) and variability (variability of HbA1c over time) and mortality in older people with diabetes.MethodsWe did a 5-year retrospective cohort study using The Health Improvement Network database, which includes dat...
Source: The Lancet Diabetes and Endocrinology - July 10, 2018 Category: Endocrinology Source Type: research

Correlates of Burnout in Small Independent Primary Care Practices in an Urban Setting
Background: Little is known about the prevalence and correlates of burnout among providers who work in small independent primary care practices (
Source: Journal of the American Board of Family Medicine - July 9, 2018 Category: Primary Care Authors: Blechter, B., Jiang, N., Cleland, C., Berry, C., Ogedegbe, O., Shelley, D. Tags: Original Research Source Type: research

Co-located specialty care within primary care practice settings: A systematic review and meta-analysis
ConclusionsCo-located specialty care in primary care settings may support the aims of high value care delivery. However, additional studies are needed to further evaluate the value of co-location of specific specialties and stronger data on impact to health outcomes and cost. (Source: Healthcare)
Source: Healthcare - July 6, 2018 Category: Middle East Health Source Type: research

The impact of tailored intervention services on charges and mortality for adult super-utilizers
Publication date: Available online 25 August 2017Source: HealthcareAuthor(s): Josh Durfee, Tracy Johnson, Holly Batal, Jeremy Long, Deborah Rinehart, Rachel Everhart, Carlos Irwin Oronce, Ivor Douglas, Kimberly Moore, Adam AtherlyAbstractBackgroundInterventions designed to improve care and reduce costs for patients with the highest rates of hospital utilization (super-utilizers) continue to proliferate, despite conflicting evidence of cost savings.MethodsWe evaluated a practice transformation intervention that implemented team-based care and risk-stratification to match specific primary care resources based on need. This i...
Source: Healthcare - July 6, 2018 Category: Middle East Health Source Type: research

Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners
Data from 2008-2016 show that both rural and non-rural primary care practices increasingly involve nurse practitioners (NPs) to deliver care. (Source: RAND Research Health and Health Care)
Source: RAND Research Health and Health Care - July 6, 2018 Category: Health Management Authors: Hilary Barnes; Michael R. Richards; Matthew D. McHugh; Grant Martsolf Source Type: research