US Pediatricians' Attitudes Regarding Public Policies for Low-Income Children and Their Profession's Advocacy Priorities
Conclusions Pediatricians strongly support government policies that impact 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 - April 11, 2018 Category: Pediatrics Source Type: research

The Overall Diagnosis
Publication date: Available online 9 April 2018 Source:Psychiatric Clinics of North America Author(s): Elizabeth Weinberg, David MintzTeaser Optimal patient care in psychiatry necessitates attention to the treatment relationship and to the patient’s experience as an individual. The growth of patient-centered medicine has led to an increased appreciation of the importance of the biopsychosocial formulation, the personhood of both the patient and the physician, the autonomy and authority of the patient, and the therapeutic alliance. Patient-centered medicine, developed by the seminal psychoanalytic theorist Michael Ba...
Source: Psychiatric Clinics of North America - April 10, 2018 Category: Psychiatry Source Type: research

Polycystic ovary syndrome is associated with adverse mental health and neurodevelopmental outcomes.
Abstract Context: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and subfertility but the effects on mental health and child neurodevelopment are unclear. Objectives: To determine if (i) there is an association between PCOS and psychiatric outcomes, and (ii) whether rates of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are higher in children of mothers with PCOS. Design: Data were extracted from the Clinical Practice Research Datalink. Patients with PCOS were matched to two control sets (1:1) by age, BMI and primary care practice. Control set 2...
Source: The Journal of Clinical Endocrinology and Metabolism - April 10, 2018 Category: Endocrinology Authors: Berni TR, Morgan CL, Berni ER, Rees DA Tags: J Clin Endocrinol Metab Source Type: research

The Overall Diagnosis
Optimal patient care in psychiatry necessitates attention to the treatment relationship and to the patient ’s experience as an individual. The growth of patient-centered medicine has led to an increased appreciation of the importance of the biopsychosocial formulation, the personhood of both the patient and the physician, the autonomy and authority of the patient, and the therapeutic alliance. Patient- centered medicine, developed by the seminal psychoanalytic theorist Michael Balint, has its roots in psychodynamic concepts. A psychodynamic approach to psychopharmacology improves psychiatric prescribing, and guides t...
Source: The Psychiatric Clinics of North America - April 9, 2018 Category: Psychiatry Authors: Elizabeth Weinberg, David Mintz Source Type: research

Incorporating PROMIS Symptom Measures into Primary Care Practice —a Randomized Clinical Trial
ConclusionsSimple feedback of symptom scores to primary care clinicians in the absence of additional systems support or incentives is not superior to usual care in improving symptom outcomes.Trial Registrationclinicaltrials.gov identifier: NCT02383862. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 5, 2018 Category: Internal Medicine Source Type: research

Erratum to "Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol".
Erratum to "Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol". Acta Med Port. 2018 Feb 28;31(2):139 Authors: Rosário F, Santos MI, Angus K, Pas L, Ribeiro C, Fitzgerald N PMID: 29600960 [PubMed - in process] (Source: Acta Medica Portuguesa)
Source: Acta Medica Portuguesa - April 1, 2018 Category: General Medicine Tags: Acta Med Port Source Type: research

34.3 improving the detection of individuals at risk of developing psychosis in primary mental health care
DiscussionIncreasing the resources aimed at managing the primary –secondary care interface provides clinical and economic value in this setting. Early detection of CHR-P in primary care is clinically and cost-effectiveThis talk will also introduce the continuation of this work; a 5-year research programme that will focus on the treatment of individuals with psy chotic experiences in primary care settings. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment?
CONCLUSIONS: Recruitment of practices for large-scale practice quality improvement transformation initiatives is difficult and costly. The cost of recruiting practices without existing partnerships is expensive, costing 7 times more than reaching out to familiar practices. Investigators initiating and studying practice quality improvement initiatives should budget adequate funds to support high-touch recruitment strategies, including building trusted relationships over a long time frame, for a year or more. PMID: 29632229 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Fagnan LJ, Walunas TL, Parchman ML, Dickinson CL, Murphy KM, Howell R, Jackson KL, Madden MB, Ciesla JR, Mazurek KD, Kho AN, Solberg LI Tags: Ann Fam Med Source Type: research

A Community Engagement Method to Design Patient Engagement Materials for Cardiovascular Health.
CONCLUSIONS: Cluster-randomized trials with community-based interventions present study design and implementation challenges. The BCTs elicited unique contextual messages and materials, suggesting that interventions designed to help primary care practices decrease CVD risk may not be one size fits all. PMID: 29632227 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: English AF, Dickinson LM, Zittleman L, Nease DE, Herrick A, Westfall JM, Simpson MJ, Fernald DH, Rhyne RL, Dickinson WP Tags: Ann Fam Med Source Type: research

The Alarming Rate of Major Disruptive Events in Primary Care Practices in Oklahoma.
CONCLUSIONS: During a 2-year period, major disruptive events occurred at an alarming rate, adversely affecting quality improvement efforts. Most reported events involved losses of clinicians and staff. More research is needed to identify and address the root causes of these events. PMID: 29632226 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Mold JW, Walsh M, Chou AF, Homco JB Tags: Ann Fam Med Source Type: research

Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices.
CONCLUSION: There is substantial variation in the use of QI strategies among small to medium-size primary care practices across 12 US states. Findings suggest that practices may need external support to strengthen their ability to do QI and to be prepared for new payment and delivery models. PMID: 29632224 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Balasubramanian BA, Marino M, Cohen DJ, Ward RL, Preston A, Springer RJ, Lindner SR, Edwards S, McConnell KJ, Crabtree BF, Miller WL, Stange KC, Solberg LI Tags: Ann Fam Med Source Type: research

Quality of Cardiovascular Disease Care in Small Urban Practices.
CONCLUSION: Achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (ie, 70% or greater). Practices were less likely to meet consistently clinical targets that apply to patients with a history of ASCVD risk factors. Greater emphasis is needed on providing support for small practices to address the complexity of managing patients with multiple risk factors for primary and secondary ASCVD. PMID: 29632222 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Shelley D, Blechter B, Siman N, Jiang N, Cleland C, Ogedegbe G, Williams S, Wu W, Rogers E, Berry C Tags: Ann Fam Med Source Type: research

Finding a Parsimonious Path for Primary Care Practice Transformation.
PMID: 29632221 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Bitton A Tags: Ann Fam Med Source Type: research

Technical Assistance for Primary Care Practice Transformation: Free Help to Perform Unpaid Labor?
PMID: 29632220 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Casalino LP Tags: Ann Fam Med Source Type: research

EvidenceNOW: Balancing Primary Care Implementation and Implementation Research.
Abstract The mission of the Agency for Healthcare Research and Quality (AHRQ) is to generate knowledge about how America's health care delivery system can provide high-quality care, and to ensure that health care professionals and systems understand and use this evidence. In 2015 AHRQ invested in the largest primary care research project in its history. EvidenceNOW is a $112 million effort to disseminate and implement patient-centered outcomes research evidence in more than 1,500 primary care practices and to study how quality-improvement support can build the capacity of primary care practices to understand and a...
Source: Annals of Family Medicine - April 1, 2018 Category: Primary Care Authors: Meyers D, Miller T, Genevro J, Zhan C, De La Mare J, Fournier A, Bennett H, McNellis RJ Tags: Ann Fam Med Source Type: research

HELP for behaviours that challenge in adults with intellectual and developmental disabilities.
CONCLUSION: A structured approach to the assessment and treatment of BTC in adults with IDD helps family physicians provide guideline-directed, individualized care to this population. This includes a systematic evaluation using the HELP framework that takes place over multiple visits. A team of health professionals might be needed for optimal care, but these resources are not routinely available across Canada. PMID: 29650741 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - April 1, 2018 Category: Primary Care Authors: Green L, McNeil K, Korossy M, Boyd K, Grier E, Ketchell M, Loh A, Lunsky Y, McMillan S, Sawyer A, Thakur A, Bradley E Tags: Can Fam Physician Source Type: research

Top studies relevant to primary care practice.
CONCLUSION: Research from 2017 produced several high-quality studies in diabetes management. These have demonstrated benefit for alternative therapies and offered evidence not previously available. This year's selection of studies also provided information on a variety of conditions and therapies that are, or might become, more common in primary care settings. PMID: 29650603 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - April 1, 2018 Category: Primary Care Authors: Perry D, Kolber MR, Korownyk C, Lindblad AJ, Ramji J, Ton J, Allan GM Tags: Can Fam Physician Source Type: research

Elevating Oral Health Interprofessional Practice Among Pediatricians Through a Statewide Quality Improvement Learning Collaborative
Conclusion: We demonstrated the effectiveness of a learning collaborative meeting among pediatric primary care providers to adopt OHIPs. This work reveals an actionable pathway to support oral health equity advancement for children through an additional access point of preventive oral care, reinforcement of positive oral health behaviors, and interaction between parent and child for overall health and wellness of the family. (Source: Journal of Public Health Management and Practice)
Source: Journal of Public Health Management and Practice - March 28, 2018 Category: Health Management Tags: Research Reports: Research Full Report Source Type: research

Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol.
CONCLUSION: This review will provide important information for implementing alcohol screening and brief intervention in primary health care.Systematic Review Registration: PROSPERO CRD42016052681. PMID: 29573768 [PubMed - in process] (Source: Acta Medica Portuguesa)
Source: Acta Medica Portuguesa - March 28, 2018 Category: General Medicine Tags: Acta Med Port Source Type: research

Exploring the training and scope of practice of GPs in England, Germany and Spain.
CONCLUSION: Primary health care variations have strong historical roots, derived from the different national experiences and the range of clinical services delivered by GPs. There is a need for an accessible source of information for GPs themselves and those responsible for safety and quality standards of the healthcare workforce. This paper maps out the current situation before Brexit is being implemented in the UK which could see many of the current EU arrangements and legislation to assure professional mobility between the UK and the rest of Europe dismantled. PMID: 29576244 [PubMed - as supplied by publisher] (Sour...
Source: Gaceta Sanitaria - March 27, 2018 Category: International Medicine & Public Health Tags: Gac Sanit Source Type: research

Knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain: the MAMPA study
Conclusion: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines’ recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies. (Source: Journal of Hypertension)
Source: Journal of Hypertension - March 27, 2018 Category: Cardiology Tags: ORIGINAL PAPERS: BP measurement Source Type: research

Confidential Survey Into Southwestern Ontario Suicide: Implication for Primary Care Practice.
Conclusion: The findings from this confidential survey may be important for the formulation of recommendations that could improve suicide prevention in primary care practice. PMID: 29570962 [PubMed - in process] (Source: The Primary Care Companion for CNS Disorders)
Source: The Primary Care Companion for CNS Disorders - March 27, 2018 Category: Primary Care Tags: Prim Care Companion CNS Disord Source Type: research

Landmark Models for Optimizing the Use of Repeated Measurements of Risk Factors in Electronic Health Records to Predict Future Disease Risk.
We present a computationally feasible statistical approach to address the methodological challenges in utilizing historical repeat measures of multiple risk factors recorded in electronic health records to systematically identify patients at high risk of future disease. The approach is principally based on a two-stage dynamic landmark model. The first stage estimates current risk factor values from all available historical repeat risk factor measurements by landmark-age-specific multivariate linear mixed-effects models with correlated random-intercepts, which account for sporadically recorded repeat measures, unobserved da...
Source: Am J Epidemiol - March 23, 2018 Category: Epidemiology Authors: Paige E, Barrett J, Stevens D, Keogh RH, Sweeting MJ, Nazareth I, Petersen I, Wood AM Tags: Am J Epidemiol Source Type: research

Landmark Models for Optimizing the Use of Repeated Measurements of Risk Factors in Electronic Health Records to Predict Future Disease Risk
AbstractThe benefits of using electronic health records (EHRs) for disease risk screening and personalized health-care decisions are being increasingly recognized. Here we present a computationally feasible statistical approach with which to address the methodological challenges involved in utilizing historical repeat measures of multiple risk factors recorded in EHRs to systematically identify patients at high risk of future disease. The approach is principally based on a 2-stage dynamic landmark model. The first stage estimates current risk factor values from all available historical repeat risk factor measurements via l...
Source: American Journal of Epidemiology - March 23, 2018 Category: Epidemiology Source Type: research

[The Jena Anxiety Monitoring List (JAMoL) - a tool for the evidence-based treatment of panic disorder with or without agoraphobia in primary care].
CONCLUSIONS: The JAMoL enables primary care practice teams to continuously monitor anxiety symptoms and treatment adherence in patients with panic disorder with or without agoraphobia. Within the behavior therapy-oriented treatment program 'Jena-PARADISE', the JAMoL constitutes an important case management tool. PMID: 29544715 [PubMed - as supplied by publisher] (Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen)
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - March 21, 2018 Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research

The Impact of a Health Information Technology–Focused Patient-centered Medical Neighborhood Program Among Medicare Beneficiaries in Primary Care Practices: The Effect on Patient Outcomes and Spending
Conclusions: These results indicate that TransforMED’s program reduced service use for Medicare FFS beneficiaries, but also show that the program did not have statistically significant favorable impacts in the quality-of-care processes or spending domains. These results suggest that providing practices with population health management and cost-reporting software—along with technical assistance for how to use them—can complement practices’ own patient-centered medical home transformation efforts and add meaningfully to their impacts on service use. (Source: Medical Care)
Source: Medical Care - March 16, 2018 Category: Health Management Tags: Original Articles Source Type: research

Incorrect Age Range
This article was corrected online. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - March 14, 2018 Category: General Medicine Source Type: research

Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)
Conclusions: Practice leaders need to be conscious of obstacles when they increase expectations of MAs, and they must be willing to invest time and resources into developing their MA workforce. An environment that allows open dialog with MAs and rewards and compensation that recognizes their increased efforts will help make expansion of MA roles occur more smoothly and efficiently. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 13, 2018 Category: Primary Care Authors: Ferrante, J. M., Shaw, E. K., Bayly, J. E., Howard, J., Quest, M. N., Clark, E. C., Pascal, C. Tags: Original Research Source Type: research

Moving Away from the Tip of the Pyramid: Screening and Brief Intervention for Risky Alcohol and Opioid Use in Underserved Patients
Conclusions: Providers mainly focus efforts on the relatively few patients at the tip of the pyramid (substance use dependence) rather than on the majority of patients who comprise the middle of the pyramid (risky substance use). Practice change strategies are needed to increase universal screening with a focus on risky substance use, particularly in practices serving racial/ethnic communities. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 13, 2018 Category: Primary Care Authors: Venner, K. L., Sanchez, V., Garcia, J., Williams, R. L., Sussman, A. L. Tags: Original Research Source Type: research

Effect of a Digital Health Intervention on Receipt of Colorectal Cancer Screening in Vulnerable Patients: A Randomized Controlled Trial.
Conclusion: A digital health intervention that allows patients to self-order tests can increase CRC screening. Future research should identify methods for implementing similar interventions in clinical care. Primary Funding Source: National Cancer Institute. PMID: 29532054 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - March 13, 2018 Category: Internal Medicine Authors: Miller DP, Denizard-Thompson N, Weaver KE, Case LD, Troyer JL, Spangler JG, Lawler D, Pignone MP Tags: Ann Intern Med Source Type: research

Theory-based development of an implementation intervention to increase HPV vaccination in pediatric primary care practices
The national guideline for use of the vaccine targeting oncogenic strains of the human papillomavirus (HPV) is an evidence-based practice that is poorly implemented in primary care. Recommendations include com... (Source: Implementation Science)
Source: Implementation Science - March 13, 2018 Category: Health Management Authors: Jane M. Garbutt, Sherry Dodd, Emily Walling, Amanda A. Lee, Katharine Kulka and Rebecca Lobb Tags: Research Source Type: research

Physical activity levels in adults and older adults 3 –4 years after pedometer-based walking interventions: Long-term follow-up of participants from two randomised controlled trials in UK primary care
ConclusionsIntervention participants followed up from both trials demonstrated higher levels of objectively measured PA at 3 –4 years than controls, similar to previously reported 12-month trial effects. Pedometer interventions, delivered by post or with nurse support, can help address the public health physical inactivity challenge. Trial registrationsPACE-UP isrctn.com ISRCTN98538934; PACE-Lift isrctn.com ISRCTN42122561. (Source: PLoS Medicine)
Source: PLoS Medicine - March 9, 2018 Category: Internal Medicine Authors: Tess Harris Source Type: research

Frequency of blood pressure and estimated glomerular filtration rate monitoring in patients affected by hypertension: a retrospective study with 176 565 patients in Germany
Conclusion The frequency of BP and eGFR monitoring was low in Germany in 2016. Several demographic and clinical variables had a significant impact on this frequency. (Source: Blood Pressure Monitoring)
Source: Blood Pressure Monitoring - March 6, 2018 Category: Cardiology Tags: Clinical Methods and Pathophysiology Source Type: research

Screening for Prostate Cancer
In this issue ofJAMA, Martin and colleagues report the results of the third, and with more than 400  000 participants by far the largest, randomized trial of prostate-specific antigen (PSA) screening for prostate cancer. The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) joins the US Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) trial (about 77 000 particip ants) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial (about 162 000 participants) in attempting to settle the question of the balance of benefits and harms from PSA screening. In this cluster r...
Source: JAMA - March 6, 2018 Category: General Medicine Source Type: research

Effect of 1-Time PSA Screening on Prostate Cancer Mortality
This cluster randomized trial evaluates the effect of a single prostate-specific antigen (PSA) screening test on 10-year prostate cancer –specific mortality among men aged 50 to 69 years treated at UK primary care practices. (Source: JAMA)
Source: JAMA - March 6, 2018 Category: General Medicine Source Type: research

Somatoform disorder in primary care: The influence of co ‐morbidity with anxiety and depression on health care utilization
ConclusionNot a single but only the presence of multiple co‐morbidities predicts primary and mental HCU in patients with somatoform disorder. Health care utilization might be essentially influenced by the associated psychological distress, which should be considered in treatment. (Source: Journal of Evaluation in Clinical Practice)
Source: Journal of Evaluation in Clinical Practice - March 2, 2018 Category: General Medicine Authors: Paul H üsing, Bernd Löwe, Katharina Piontek, Meike Shedden‐Mora Tags: ORIGINAL ARTICLE Source Type: research

Patients' perceptions of access to primary care: Analysis of the QUALICOPC Patient Experiences Survey.
CONCLUSION: Despite criticisms of access to primary care, this study found that Ontario patients belonging to primary care practices have favourable impressions of their access. There were few statistically significant relationships between patient characteristics and access, and these relationships appeared to be weak. PMID: 29540392 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - March 1, 2018 Category: Primary Care Authors: Premji K, Ryan BL, Hogg WE, Wodchis WP Tags: Can Fam Physician Source Type: research

Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs).
CONCLUSIONS: Practice leaders need to be conscious of obstacles when they increase expectations of MAs, and they must be willing to invest time and resources into developing their MA workforce. An environment that allows open dialog with MAs and rewards and compensation that recognizes their increased efforts will help make expansion of MA roles occur more smoothly and efficiently. PMID: 29535239 [PubMed - in process] (Source: American Family Physician)
Source: American Family Physician - March 1, 2018 Category: Primary Care Authors: Ferrante JM, Shaw EK, Bayly JE, Howard J, Quest MN, Clark EC, Pascal C Tags: J Am Board Fam Med Source Type: research

Use of Asthma APGAR Tools in Primary Care Practices: A Cluster-Randomized Controlled Trial.
CONCLUSIONS: Introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines. PMID: 29531100 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 1, 2018 Category: Primary Care Authors: Yawn BP, Wollan PC, Rank MA, Bertram SL, Juhn Y, Pace W Tags: Ann Fam Med Source Type: research

Team-based primary care: The medical assistant perspective
Conclusion: Team-based care can provide low-status health care workers with more fulfilling work and strengthen relationships across status lines. The extent of this positive impact may depend on supporting factors at the organization, team, and individual worker levels. Practice Implications: To maximize the benefits of team-based care, primary care leaders should recognize the larger role that MAs play under this model and support them as increasingly valuable team members. Contingent on organizational conditions, practices may find MAs who are willing to manage the increased workload that often accompanies team-bas...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research

Offsetting Patient-Centered Medical Homes Investment Costs Through Per-Member-Per-Month or Medicare Merit-based Incentive Payment System Incentive Payments
We examined potential offsets through commercial payer per-member-per-month (PMPM) payments and the Medicare Merit-based Incentive Payment System (MIPS) for a network that spent $4 818 260 over 4 years obtaining and renewing PCMH recognition for 57 practices. With PMPM payments of $3.37 to $8.98, “breakeven” requires that 2.4% to 6.4% of the network's 1645 commercially insured patients per physician be covered, while applying MIPS incentive payments of half the maximum available each year to the network's average 2016 Medicare reimbursement of $196 812 per physician showed they would exceed PCMH costs by 2022. ...
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Establishing Teams: How Does It Change Practice Configuration, Size, and Composition?
Little is known about how practices reorganize when transitioning from traditional practice organization to team-based care. We compared practice-level (1) configuration as well as practice- and team-level (2) size and (3) composition, before and after establishing teams. We employed a pre-/poststudy using personnel lists of 1571 to 1711 staff (eg, job licenses, titles, and team assignment) and practice manager surveys. All personnel (physician and nonphysician) worked within 18 Massachusetts academic primary care practices participating in a 2-year learning collaborative aimed at establishing team-based care. We found tha...
Source: The Journal of Ambulatory Care Management - February 24, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Health Outcomes from Assisted Living Facilities: a Cohort Study of a Primary Care Practice
The population of older US adults residing in assisted living facilities (ALFs) is growing, yet health data on this population is relatively sparse. We aimed to describe health outcomes of ALF residents in the greater Rochester, Minnesota area compared to age and sex matched community dwelling elders. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Mairead Bartley, M. Bartley, S. Quigg, A. Chandra, P.Y. Takahashi Tags: Research Source Type: research

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries
There is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. Th... (Source: BMC Health Services Research)
Source: BMC Health Services Research - February 21, 2018 Category: General Medicine Authors: M. Bonciani, W. Sch äfer, S. Barsanti, S. Heinemann and P. P. Groenewegen Tags: Research article Source Type: research

Adolescents With Depression Found to Benefit From Collaborative Care Program
Depression is common among adolescents, yet an estimated 40% never receive treatment. Astudy inPsychiatric Services in Advance suggests that embedding psychiatric services within a primary care setting can reduce depressive symptoms in this group.For the study, Nathan Shippee, Ph.D., of the University of Minnesota, Minneapolis, and colleagues from the Mayo Clinic assessed the effectiveness of EMERALD (Early Management and Evidence-based Recognition of Adolescents Living with Depression), a collaborative care program in a busy primary care practice in the Midwest.Patients aged 12 to 18 with a depression diagnosis score of &...
Source: Psychiatr News - February 20, 2018 Category: Psychiatry Tags: adolescent collaborative care depression Nathan Shippee Patient Health Questionnaire for Adolescents Robert J. Hilt Source Type: research

Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: lessons learned from a multi-practice evaluation portfolio.
Conclusions and implications: SBIRT is an effective tool that can empower primary care providers to identify and treat patients with substance use and mental health problems before costly symptoms emerge. Using the pragmatic best practices we describe, primary care providers may improve their ability to successfully create, implement, and sustain SBIRT in their practices. PMID: 29450101 [PubMed - in process] (Source: Public Health Reviews)
Source: Public Health Reviews - February 17, 2018 Category: International Medicine & Public Health Tags: Public Health Rev Source Type: research

Effectiveness in Regular Practice of Collaborative Care for Depression Among Adolescents: A Retrospective Cohort Study.
Authors: Shippee ND, Mattson A, Brennan R, Huxsahl J, Billings ML, Williams MD Abstract OBJECTIVE: Depression is common among adolescents, but many lack ready access to mental health services. Integrated models of care for depression are needed, along with evidence to support their use in regular practice. The authors examined the effectiveness of an ongoing collaborative care program for depressed adolescents embedded in a busy primary care practice. METHODS: This retrospective cohort study assessed EMERALD (Early Management and Evidence-based Recognition of Adolescents Living with Depression), a collaborative...
Source: Psychiatric Services - February 17, 2018 Category: Psychiatry Tags: Psychiatr Serv Source Type: research

Closing the loop with an enhanced referral management system
AbstractObjectiveTo evaluate the impact of a referral manager tool on primary care practices.Materials and MethodsWe evaluated a referral manager module in a locally developed electronic health record (EHR) that was enhanced to improve the referral management process in primary care practices. Baseline (n = 61) and follow-up (n = 35) provider and staff surveys focused on the ease of performing various steps in the referral process, confidence in completing those steps, and user satisfaction. Additional metrics were calculated that focused on completed specialist visits, acknowledged notes, and p...
Source: Journal of the American Medical Informatics Association - February 17, 2018 Category: Information Technology Source Type: research

A risk prediction model to allow personalized screening for cervical cancer
Conclusions and relevanceA multivariable model using data from the electronic health record was able to stratify women across a 50-fold gradient of risk for CIN2+. After further validation, use of a similar model could enable more targeted cervical cancer screening. (Source: Cancer Causes and Control)
Source: Cancer Causes and Control - February 15, 2018 Category: Cancer & Oncology Source Type: research