scholarly journals Patient, staff, and clinician perspectives on implementing electronic communications in an interdisciplinary rural family health practice

2016 ◽  
Vol 18 (02) ◽  
pp. 149-160 ◽  
Author(s):  
Feng Chang ◽  
Thivaher Paramsothy ◽  
Matthew Roche ◽  
Nishi S. Gupta
Keyword(s):  
Primary Care ◽  
Data Security ◽  
Family Health ◽  
Care Practice ◽  
Care Clinic ◽  
Clinic Staff ◽  
Environmental Scan ◽  
Rural Primary Care ◽  
Clinic Efficiency ◽  
Communications System

Aim To conduct an environmental scan of a rural primary care clinic to assess the feasibility of implementing an e-communications system between patients and clinic staff. Background Increasing demands on healthcare require greater efficiencies in communications and services, particularly in rural areas. E-communications may improve clinic efficiency and delivery of healthcare but raises concerns about patient privacy and data security. Methods We conducted an environmental scan at one family health team clinic, a high-volume interdisciplinary primary care practice in rural southwestern Ontario, Canada, to determine the feasibility of implementing an e-communications system between its patients and staff. A total of 28 qualitative interviews were conducted (with six physicians, four phone nurses, four physicians’ nurses, five receptionists, one business office attendant, five patients, and three pharmacists who provide care to the clinic’s patients) along with quantitative surveys of 131 clinic patients. Findings Patients reported using the internet regularly for multiple purposes. Patients indicated they would use email to communicate with their family doctor for prescription refills (65% of respondents), appointment booking (63%), obtaining lab results (60%), and education (50%). Clinic staff expressed concerns about patient confidentiality and data security, the timeliness, complexity and responsibility of responses, and increased workload. Conclusion Clinic staff members are willing to use an e-communications system but clear guidelines are needed for successful adoption and to maintain privacy of patient health data. E-communications might improve access to and quality of care in rural primary care practices.

Team-based primary care practice and physician's services: Evidence from Family Health Teams in Ontario, Canada

2020 ◽  
Vol 264 ◽  
pp. 113310
Author(s):  
N.H. Somé ◽  
R.A. Devlin ◽  
N. Mehta ◽  
G.S. Zaric ◽  
S. Sarma
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Family Health ◽  
Care Practice

Screening for depression within a rural primary care practice by a self-rating depression scale

2000 ◽  
Vol 6 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Joshua E. Lane ◽  
Sylvia Shellenberger ◽  
Kenneth W . Gresen ◽  
Norman C. Moore
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Depression Scale ◽  
Care Practice ◽  
Rural Primary Care ◽  
Self Rating

Implementing the Chronic Care Model for Improvements in Diabetes Care and Education in a Rural Primary Care Practice

2005 ◽  
Vol 31 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Linda M. Siminerio ◽  
Gretchen Piatt ◽  
Janice C. Zgibor
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Chronic Care ◽  
Primary Care Practice ◽  
Self Management ◽  
Standards Of Care ◽  
Care Practice ◽  
Practice Setting ◽  
Care Model ◽  
Rural Primary Care

Purpose The purpose of this pilot study was to determine the impact of implementing elements of the chronic care model (CCM; decision support, self-management, and delivery system redesign) on providers' diabetes care practices and patient outcomes in a rural practice setting. Methods In this pilot study, 104 patients with type 2 diabetes and 6 providers in a rural primary care practice were involved in an intervention that included a certified diabetes educator (CDE) who educated and supported providers on diabetes management and adherence to the American Diabetes Association (ADA) Standards of Care over the year of the project. The CDE also provided diabetes self-management education (DSME) at the office site for 29 of the 104 patients who received their care in the practice. The following variables were evaluated: provider perceived barriers to care and adherence to ADA standards of care and patient A1C, blood pressure, cholesterol, knowledge, and empowerment levels. Results Provider adherence to ADA Standards of Care increased significantly across all process measures. Patients who received DSME at point of service in the primary care practice setting gained improvements in knowledge, empowerment, A1C, and high-density lipoprotein cholesterol levels. Conclusions Implementing systems to support decision support, selfmanagement education, and delivery system redesign has a positive influence on practices and patient outcomes in outlying rural communities.

scholarly journals Exploring Pharmacy Trainee Experiential Learning in a Full Scope Collaborative Rural Primary Care Practice: A Retrospective Chart Review

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 155
Author(s):  
Sara Robinson ◽  
Feng Chang
Keyword(s):  
Primary Care ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Drug Level ◽  
Care Practice ◽  
Patient Transfers ◽  
Rural Primary Care ◽  
Time Basis ◽  
Acceptance Rates ◽  
The Impact

Despite reported benefits of pharmacy trainees (e.g., pharmacy students, pharmacy residents) in hospital settings, limited research on the impact of these trainees has been conducted in rural primary care. To explore the potential benefits and impact of pharmacy trainees practicing in a supervised collaborative rural primary care setting, a retrospective chart review was conducted. Drug therapy problems (DTPs) were classified using the Pharmaceutical Care Network Europe (PCNE V9) system. Valuation was measured using a validated tool developed by Overhage and Lukes (1999). Over 16 weeks on a part-time basis, pharmacy trainees (n = 3) identified 366 DTPs during 153 patient encounters. The most common causes for DTPs were related to patient transfers and the need for education. Drug level interventions carried out directly by trainees under supervision accounted for 13.1% of total interventions. Interventions that required prescriber authorization had an acceptance rate of 83.25% higher than previous acceptance rates found in urban primary care settings. About half (51%) of the interventions proposed and made by pharmacy trainees were classified as significant or very significant, suggesting these trainees added significant value to the pharmacy service provided to rural community residents. This study suggests that pharmacy trainees can be effective resources and contribute meaningfully to patient care in a collaborative rural primary care team setting.

scholarly journals The Success Of Behavioral Economics In Improving Patient Retention Within An Intensive Primary Care Practice

2021 ◽  
Author(s):  
Phillip Groden ◽  
Alexandra Capellini ◽  
Erica Levine ◽  
Ania Wajnberg ◽  
Maria Duenas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Economics ◽  
Patient Outcomes ◽  
Care Practice ◽  
Missed Appointments ◽  
Care Clinic ◽  
Visit Adherence ◽  
One Year ◽  
Patient Retention

Abstract BackgroundA minority of the U.S. population comprises a majority of health care expenses. Health system interventions for high-cost populations aim to improve patient outcomes while reducing costly over-utilization. Missed and inconsistent appointments are associated with poor patient outcomes and increased health care utilization. PEAK Health— Mount Sinai’s intensive primary care clinic for high-cost patients— employed a novel behavioral economics-based intervention to reduce the rate of missed appointments at the practice. Behavioral economics has accomplished numerous successes across the health care field; the effect of a clinic-based behavioral economics intervention on reducing missed appointments has yet to be assessed.MethodsThis was a single-arm, pre-post trial conducted over one year involving all active patients (286) at PEAK Health. The intervention consisted of: a) clinic signage, and b) appointment reminder cards containing behavioral economics messaging designed to increase the likelihood patients would complete their subsequent visit; appointment cards (t1) were transitioned to an identical EMR template (t2) at 6 months to boost utilization of this component. The primary objective, the success of scheduled appointments, was assessed with visit adherence: the proportion of successful over all scheduled appointments, excluding those cancelled or rescheduled. The secondary objective, the consistency of appointments, was assessed with a 2-month visit constancy rate: the percentage of patients with at least one successful visit every two months for one year. Both metrics were assessed via a χ² analysis and together define patient retention. ResultsThe visit adherence rate increased from 74.7% at baseline to 76.5% (p= .22) during t1 and 78.0% (p= .03) during t2. The 2-month visit constancy rate increased from 59.5% at baseline to 74.3% (p= .01) post-intervention.ConclusionsA low-resource, clinic-based behavioral economics intervention was capable of improving patient retention within a traditionally high-cost population. A renewed focus on patient retention— employing the metrics described here— could bolster chronic care efforts and significantly improve the outcomes of high-cost programs by reducing the deleterious effects of missed and inconsistent appointments.

scholarly journals Sex/gender bias in the management of chest pain in ambulatory care

2018 ◽  
Vol 14 ◽  
pp. 174550651880564 ◽  
Author(s):  
Christelle Clerc Liaudat ◽  
Paul Vaucher ◽  
Tommaso De Francesco ◽  
Nicole Jaunin-Stalder ◽  
Lilli Herzig ◽  
...  
Keyword(s):  
Primary Care ◽  
Sex Differences ◽  
Cohort Study ◽  
Chest Pain ◽  
Confidence Interval ◽  
Ambulatory Care ◽  
Odds Ratio ◽  
Care Practice ◽  
Care Clinic ◽  
Men And Women

Objective: Cardiovascular diseases (CVD) are the main cause of death worldwide and despite a higher prevalence in men, mortality from CVD is higher among women. Few studies have assessed sex differences in chest pain management in ambulatory care. The objective of this post hoc analysis of data from a prospective cohort study was to assess sex differences in the management of chest pain in ambulatory care. Setting: We used data from the Thoracic Pain in Community cohort study that was realized in 58 primary care practices and one university ambulatory clinic in Switzerland. Participants: In total, 672 consecutive patients aged over 16 years attending a primary care practice or ambulatory care clinic with a complaint of chest pain were included between February and June 2001. Their mean age was 55.2 years and 52.5% were women. Main outcome measures: The main outcome was the proportion of patients referred to a cardiologist at 12 months follow-up. A panel of primary care physicians assessed the final diagnosis retained for chest pain at 12 months. Results: The prevalence of chest pain of cardiovascular origin (n = 108, 16.1%) was similar for men and women (17.5% vs 14.8%, respectively, p = 0.4). Men with chest pain were 2.5 times more likely to be referred to a cardiologist than women (16.6% vs 7.4%, odds ratio: 2.49, 95% confidence interval: 1.52–4.09). After adjustment for the patients’ age and cardiovascular disease risk factors, the estimates did not significantly change (odds ratio: 2.30, 95% confidence interval: 1.30–3.78). Conclusion: Although the same proportion of women and men present with a chest pain of cardiovascular origin in ambulatory care, there is a strong sex bias in their management. These data suggest that effort must be made to assure equity between men and women in medical care.

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