scholarly journals Impact of continued mailed fecal tests in the patient-centered medical home: Year 3 of the Systems of Support to Increase Colon Cancer Screening and Follow-Up randomized trial

Cancer ◽  
2015 ◽  
Vol 122 (2) ◽  
pp. 312-321 ◽  
Author(s):  
Beverly B. Green ◽  
Melissa L. Anderson ◽  
Jessica Chubak ◽  
Sharon Fuller ◽  
Richard T. Meenan ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Randomized Trial ◽  
Medical Home ◽  
Colon Cancer Screening ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Fecal Tests ◽  
Systems Of Support

scholarly journals Increasing uptake of colon cancer screening in a medically underserved population with the addition of blood-based testing

2020 ◽  
Author(s):  
Stephanie Ioannou ◽  
Kyle Sutherland ◽  
Daniel A. Sussman ◽  
Amar R. Deshpande
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Underserved Populations ◽  
Colon Cancer Screening ◽  
Medically Underserved ◽  
Screening Methods ◽  
Medically Underserved Populations ◽  
Medically Underserved Population ◽  
The Impact

Abstract Adherence to colorectal cancer screening is suboptimal, particularly in medically underserved populations. We report here on our assessment of the impact of offering a blood-based screening test on screening rates in a health fair setting. Patients attending student-run health fairs who met colon cancer screening guideline eligibility criteria received a recommendation to attend that screening station. Patients were offered recommended accepted screening methods, and if they declined they were offered blood-based testing. Screening rates, test outcomes, and the rate of follow up completion of colonoscopy were measured and compared with historic screening outcomes. Of 1401 screening eligible patients, 640 (45.7%) attended the colon cancer screening station, of whom 460 were eligible for assessment. Amongst these, none selected colonoscopy, 30 (6.5%) selected FIT, and 430 (93.5%) selected blood-based testing. Only 2 patients returned the FIT. For the blood test, 88 were positive, and 20 of these received a follow up colonoscopy. Based on this assessment, blood-based testing is an effective method to increase screening rates in medically underserved populations, though efforts to further improve access to follow up colonoscopy are necessary.

Retention: Building a Patient-Centered Medical Home in HIV Primary Care through PUFF (Patients Unable to Follow-up Found)

2012 ◽  
Vol 23 (3A) ◽  
pp. 81-95 ◽  
Author(s):  
Amy M. Sitapati ◽  
Jan Limneos ◽  
Militza Bonet-Vázquez ◽  
Moira Mar-Tang ◽  
Huifang Qin ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Hiv Primary Care

scholarly journals A randomized trial of two print interventions to increase colon cancer screening among first-degree relatives

2008 ◽  
Vol 71 (2) ◽  
pp. 215-227 ◽  
Author(s):  
Susan M. Rawl ◽  
Victoria L. Champion ◽  
Linda L. Scott ◽  
Honghong Zhou ◽  
Patrick Monahan ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Randomized Trial ◽  
Colon Cancer Screening ◽  
First Degree Relatives

scholarly journals Evaluation of liver test abnormalities in a patient-centered medical home: do liver test patterns matter?

2018 ◽  
Vol 66 (8) ◽  
pp. 1118-1123 ◽  
Author(s):  
Andrew D Schreiner ◽  
William P Moran ◽  
Jingwen Zhang ◽  
Elizabeth B Kirkland ◽  
Marc E Heincelman ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Repeat Testing ◽  
Liver Test ◽  
Clinical Patterns ◽  
Multiple Abnormalities ◽  
Liver Tests

Abnormal liver tests are extremely common in clinical practice, present with varying patterns and degrees of elevation, and can signal liver injury from a variety of causes. Responding to these abnormalities requires complex medical decision-making and merits investigation in primary care. This retrospective study investigates the association of patterns of liver test abnormality with follow-up in primary care. Using administrative data, this study includes patients with abnormal liver tests seen between 2007 and 2016 in a patient-centered medical home. Liver tests examined include serum bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. Patients entered the cohort on the first liver test elevation. The outcome examined was completion of repeat testing, and the proportions of patients without follow-up were compared by patterns of index abnormality. 9545 patients met the inclusion criteria. Of these, 6155 (64.5%) possessed one liver test abnormality and 3390 (35.5%) possessed multiple abnormalities on index testing. Overall 1119 (11.7%) patients did not have repeat testing performed during the study period. A greater proportion of patients with lone abnormalities lacked repeat testing compared with those patients with multiple abnormalities. Differences in repeat testing appeared when comparing clinical patterns of abnormality, with higher proportions of follow-up in patients with testing suggestive of cholestasis. Over 11% of patients with abnormal liver tests did not undergo repeat testing during the study period. Repeat testing occurred more often in patients with multiple abnormalities and in clinical patterns suggestive of cholestasis. This study highlights a potential opportunity to improve quality of care.

scholarly journals Motivating residents to change communication: the role of a brief motivational interviewing didactic

2019 ◽  
Vol 20 ◽  
Author(s):  
Lisa Renee Miller-Matero ◽  
Erin T. Tobin ◽  
Elizabeth Fleagle ◽  
Joseph P. Coleman ◽  
Anupama Nair
Keyword(s):  
Motivational Interviewing ◽  
Medical Home ◽  
Training Programs ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Residency Programs ◽  
Change Communication ◽  
Post Test

Abstract Introduction: Motivational interviewing (MI) is a patient-centered approach that encourages patients to change behaviors. MI training programs have increased residents’ knowledge and use of MI skills; however, many residency programs may not have the time to dedicate to lengthy MI programs. The purpose of this study was to evaluate the benefits of a brief MI didactic for residents in an academic internal medicine patient-centered medical home. Methods: Thirty-two residents completed a 1-h MI training between October 2016 and June 2017 and completed measures on their knowledge of, confidence using, and utilization of MI skills prior to the training, immediately after the training, and at a 1-month follow-up. Results: The residents’ knowledge of and confidence using MI skills increased from pre-test to post-test and also increased from pre-test to the 1-month follow-up. Conclusion: The utilization of MI skills increased from pre-test to the 1-month follow-up. A 1-h didactic offers benefits to residents.

scholarly journals Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Olga Moshkovich ◽  
Lydie Lebrun-Harris ◽  
Laura Makaroff ◽  
Preeta Chidambaran ◽  
Michelle Chung ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Medical Home ◽  
Health Care Services ◽  
Health Belief ◽  
Health Centers ◽  
System Level ◽  
Patient Centered Medical Home ◽  
Patient Centered

Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS) persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs) have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH) transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs) and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

Accountable Care in Transitions (ACTion): A Team-Based Approach to Reducing Hospital Utilization in a Patient-Centered Medical Home

2017 ◽  
Vol 31 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Emily M. Hawes ◽  
Jennifer N. Smith ◽  
Nicole R. Pinelli ◽  
Rayhaan Adams ◽  
Gretchen Tong ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Medical Provider ◽  
Care Needs ◽  
Patient Centered ◽  
Access To Primary Care ◽  
Transition Points ◽  
The Impact

Background: There is limited data describing the role of the patient-centered medical home (PCMH) in successful transitions programs and more information is needed to determine the transition points where pharmacist involvement is most impactful. Methods: A family medicine center developed a multidisciplinary outpatient-based transitions program focused on reducing emergency department (ED) and hospital use in medically complex patients. Key team members were a medical provider, clinical pharmacist practitioner (CPP), and care manager. The objective was to evaluate the impact of the program by comparing utilization before and after the intervention and to identify patient and process characteristic predictors of 30-day rehospitalizations. Results: Of the 268 patients included, the mean time to follow-up appointment attended was 11.6 (11.8) days after discharge. The majority of patients (72%) saw their primary care provider at follow-up. Patients experiencing the multidisciplinary intervention had lower 30-day rehospitalizations at 7, 14, and 30 days postdischarge with significance achieved at 14 and 30 days. Compared to before the intervention, reductions in both ED visits and hospitalizations as well as increases in clinic visits were seen at 1, 3, and 6 months. CPP involvement was associated with lower rehospitalizations (7.7% vs 18.8%; P = .04). Conclusion: A multidisciplinary outpatient-based transitions program embedded in the PCMH increased access to primary care and reduced hospital and ED utilization. Face-to-face CPP involvement significantly lowered rehospitalizations. This program describes a standardized approach to complex care needs with defined roles, a model that may be generalizable and reproduced in other medical homes.

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