scholarly journals Improving Hierarchical Condition Category Coding by Family Medicine Residents Using a Web-Based, Interactive Module

2021 ◽  
Vol 53 (3) ◽  
pp. 220-222
Author(s):  
Stuart Zeltzer ◽  
Monique Vanderhoof ◽  
Brian Garvey
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Response Rate ◽  
Positive Impact ◽  
Clinical Communication ◽  
Web Based ◽  
Knowledge Question ◽  
Junior Residents ◽  
Family Medicine Residents ◽  
Hierarchical Condition Category

Background and Objectives: The proper documentation of Hierarchical Condition Category (HCC) codes is essential for risk-adjusted reimbursement, chart accuracy, and clinical communication within primary care, but represents a significant training gap in resident education. Our goal was to improve the understanding and confidence level of family medicine residents with HCC coding during outpatient primary care visits. Methods: We developed and distributed a web-based, interactive module to family medicine residents at our academic institution. We assessed module impact through pre- and postsurveys focusing on knowledge, confidence, and experience with HCC coding. Results: Twenty-eight of 48 preeducation surveys were returned (response rate of 58%), including 16 junior (PGY-1-2) and 12 senior (PGY-3-4) residents. A majority of residents answered each HCC knowledge question correctly. Median baseline confidence with HCC coding for all respondents was 4 (interquartile range [IQR]: 2, 6; scale 0-10; 10=most confident): senior residents 6 (IQR: 5, 7) versus junior residents 2 (IQR: 2, 4). Forty-six percent of respondents noted some previous education on HCC codes, including 75% of senior vs 25% of junior residents. Twenty-six residents completed the educational module. Posttest surveys (n=5, response rate: 19%) demonstrated median confidence of 7 (IQR: 4, 8.5). Conclusions: Family medicine residents displayed a high degree of knowledge but low confidence with HCC coding. Posteducation surveys suggest the possibility of a positive impact of our e-module, though further intervention roll out and data collection are needed to evaluate this effect.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Impact of Interprofessional Care Conferences Across Primary Care and Mental Health Organizations on Family Medicine Resident Learning

2021 ◽  
Vol 53 (4) ◽  
pp. 289-294
Author(s):  
Keri D. Hager ◽  
Jen Nelson Albee ◽  
Carolyn O'Donnell ◽  
Sarah Jackson ◽  
Amelia King ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Family Medicine ◽  
Medication Safety ◽  
Safety Monitoring ◽  
Holistic Care ◽  
Interprofessional Care ◽  
Care Conference ◽  
Family Medicine Residents

Background and Objectives: Patients with severe mental illness often lack care coordination between primary care and mental health providers which can negatively impact patient outcomes. Team-based care is integral in the effective management of patients with multiple comorbidities, with the family physician central in coordinating holistic care. Family medicine residency programs must provide models of effective interprofessional collaboration and mental health treatment to prepare residents to navigate an evolving health care landscape. The objective of this study was to evaluate family medicine residents’ learning about providing holistic care with an interprofessional team and medication safety monitoring from the interprofessional cross-organizational care conference experience. Methods: To bridge care and cultivate the necessary skills, a family medicine clinic and mental health clinic implemented monthly interprofessional care conferences to coordinate care for their shared patients during 2019. Residents who participated in the care conference each (n=11) completed a retrospective pre/postsurvey (11/11=100% response rate) to gather perceptions of what they learned from the interprofessional care conference experience. Results: After participating in the care conference, all residents agreed they understood the elements that must be considered to provide holistic patient care, were confident conducting medication safety monitoring for their patients taking second-generation antipsychotics (eg, lipids, A1C, ECG), and agreed the care conference helped them develop a more comprehensive patient-centered care plan. Additionally, they all intend to work collaboratively across professions in the future. Conclusions: Interprofessional and cross-organizational care conferences create an authentic learning environment that enhances family medicine residents’ understanding and confidence in providing collaborative and holistic care for patients with severe and persistent mental illness.

scholarly journals Effect of Recruitment Methods on Response Rate in a Web-Based Study for Primary Care Physicians: Factorial Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Ryuhei So ◽  
Kiyomi Shinohara ◽  
Takuya Aoki ◽  
Yasushi Tsujimoto ◽  
Aya M Suganuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Controlled Trial ◽  
Response Rates ◽  
Risk Difference ◽  
Web Based ◽  
Subject Line ◽  
Significant Difference ◽  
The Subject

BACKGROUND Low participation rates are one of the most serious disadvantages of Web-based studies. It is necessary to develop effective strategies to improve participation rates to obtain sufficient data. OBJECTIVE The objective of this trial was to investigate the effect of emphasizing the incentive in the subject line of the invitation email and the day of the week of sending the invitation email on the participation rate in a Web-based trial. METHODS We conducted a 2×2 factorial design randomized controlled trial. We contacted 2000 primary care physicians from members of the Japan Primary Care Association in January 2017 and randomly allocated them to 1 of 4 combinations of 2 subject lines (presence or absence of an emphasis on a lottery for an Amazon gift card worth 3000 yen or approximately US $30) and 2 delivery days (sending the invitation email on Tuesday or Friday). The primary outcome was the response rate defined as the number of participants answering the first page of the questionnaire divided by the number of invitation emails delivered. All outcomes were collected between January 17, 2017, and February 8, 2017. RESULTS We analyzed data from 1943 out of 2000 participants after excluding those whose email addresses were invalid. The overall response rate was 6.3% (123/1943). There was no significant difference in the response rates between the 2 groups regarding incentive in the subject line: the risk ratio was 1.12 (95% CI 0.80 to 1.58) and the risk difference was 0.7% (95% CI –1.5% to 2.9%). Similarly, there was no significant difference in the response rates between the 2 groups regarding sending the email on Tuesday or Friday: the risk ratio was 0.98 (95% CI 0.70 to 1.38) and the risk difference was –0.1% (95% CI –2.3% to 2.1%). CONCLUSIONS Neither emphasizing the incentive in the subject line of the invitation email nor varying the day of the week the invitation email was sent led to a meaningful increase in response rates in a Web-based trial with primary care physicians. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000025317; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029121 (Archived by WebCite at http://www.webcitation. org/6wOo1jl9t)

scholarly journals A Web-Based Survey of Residents’ Views on Advocating with Patients for a Healthy Built Environment in Canada

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Matthew Cruickshank ◽  
Marcus Law
Keyword(s):  
Family Medicine ◽  
Built Environment ◽  
Disease Prevention ◽  
Activity Levels ◽  
Web Based ◽  
Physician’S Role ◽  
University Of Toronto ◽  
The Family ◽  
Physician's Role ◽  
Family Medicine Residents

Purpose. To determine family medicine residents’ perceived knowledge and attitudes towards the built environment and their responsibility for health advocacy and to identify their perceived educational needs and barriers to patient education and advocacy. Methods. A web-based survey was conducted in Canada with University of Toronto family medicine residents. Data were analyzed descriptively. Results. 93% agreed or strongly agreed that built environment significantly impacts health. 64% thought educating patients on built environment is effective disease prevention; 52% considered this a role of family physicians. 78% reported that advocacy for built environment is effective disease prevention; 56% perceived this to be the family physician’s role. 59% reported being knowledgeable to discuss how a patient’s environment may affect his/her health; 35% reported being knowledgeable to participate in community discussions on built environment. 78% thought education would help with integration into practice. Inadequate time (92%), knowledge (73%), and remuneration (54%) were barriers. Conclusions. While residents perceived value in education and advocacy as disease prevention strategies and acknowledged the importance of a healthy built environment, they did not consider advocacy towards this the family physician’s role. Barrier reduction and medical education may contribute to improved advocacy, ultimately improving physical activity levels and patient health outcomes.

scholarly journals Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

2016 ◽  
Vol 2 (2) ◽  
pp. e17 ◽  
Author(s):  
Maxime Dion ◽  
Ndeye Thiab Diouf ◽  
Hubert Robitaille ◽  
Stéphane Turcotte ◽  
Rhéda Adekpedjou ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Descriptive Study ◽  
Shared Decision ◽  
Web Based ◽  
Family Medicine Residents

scholarly journals Improving After-Clinic Work Workflow in a Family Medicine Residency

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Nguyen V ◽  
◽  
Jaqua E ◽  
Oh A ◽  
Altamirano M ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Patient Care ◽  
Primary Care Physicians ◽  
Training Session ◽  
P Value ◽  
Post Intervention ◽  
Family Medicine Residency ◽  
Resident Physicians ◽  
Family Medicine Residents

Introduction: The broad range of patients and diagnoses addressed by primary care physicians lends to a larger after-work clinic load. The resulting after-clinic work, including various in-basket tasks, can be a substantial burden to physicians, and potentially leading to burnout. The goal of this study is to generate a standardized workflow to improve physician after-clinic work efficiency and patient care. Methods: A nine-question pre- and post-intervention survey about afterclinic work management was administered to family medicine residents at a multi-specialty FQHC in California. The intervention was done in June 2020 and included a twenty-minute training session explaining how to implement a standardized in-basket management flowchart in a family medicine residency clinic. Results: Pre- and post-intervention data were analyzed using nonindependent paired sample t-tests. The survey was sent to all 40 family medicine residents. Pre- and post-intervention survey response rate was 77.5% and 97.5% respectively. The result of the nine questions post intervention were statistically significant (p value of <0.001). The standardized flowchart addressed adequate supervision of resident physicians’ patient care. Conclusion: The post-intervention results showed that having a clear and standardized flowchart enhanced the overall knowledge and understanding by the resident physicians in how to management the in-basket workflow. With increased patient access via telehealth and enhanced electronic medical records, it is essential to have effective teaching and supervision of resident physician after-clinic work. Successful teaching of after-clinic work will improve work-life balance and the overall success of the new primary care physician.

scholarly journals Practice patterns among early-career primary care (ECPC) physicians and workforce planning implications: protocol for a mixed methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030477
Author(s):  
M Ruth Lavergne ◽  
Laurie J Goldsmith ◽  
Agnes Grudniewicz ◽  
David Rudoler ◽  
Emily Gard Marshall ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Family Medicine ◽  
Practice Patterns ◽  
Early Career ◽  
Mixed Methods Study ◽  
Policy Implications ◽  
Changes Over Time ◽  
Over Time ◽  
Family Medicine Residents

IntroductionCanadians report persistent problems accessing primary care despite an increasing per-capita supply of primary care physicians (PCPs). There is speculation that PCPs, especially those early in their careers, may now be working less and/or choosing to practice in focused clinical areas rather than comprehensive family medicine, but little evidence to support or refute this. The goal of this study is to inform primary care planning by: (1) identifying values and preferences shaping the practice intentions and choices of family medicine residents and early career PCPs, (2) comparing practice patterns of early-career and established PCPs to determine if changes over time reflect cohort effects (attributes unique to the most recent cohort of PCPs) or period effects (changes over time across all PCPs) and (3) integrating findings to understand the dynamics among practice intentions, practice choices and practice patterns and to identify policy implications.Methods and analysisWe plan a mixed-methods study in the Canadian provinces of British Columbia, Ontario and Nova Scotia. We will conduct semi-structured in-depth interviews with family medicine residents and early-career PCPs and analyse survey data collected by the College of Family Physicians of Canada. We will also analyse linked administrative health data within each province. Mixed methods integration both within the study and as an end-of-study step will inform how practice intentions, choices and patterns are interrelated and inform policy recommendations.Ethics and disseminationThis study was approved by the Simon Fraser University Research Ethics Board with harmonised approval from partner institutions. This study will produce a framework to understand practice choices, new measures for comparing practice patterns across jurisdictions and information necessary for planners to ensure adequate provider supply and patient access to primary care.

scholarly journals SUN-LB116 Improved Family Medicine Resident Diabetes Care Through Participation in a Diabetes Clinic

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Key Douthitt ◽  
Wanda Taylor ◽  
Piercy Jonathan ◽  
Crystal Fletcher-Jones ◽  
Juanita Hughes ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Care Provider ◽  
Diabetes Care ◽  
Primary Care Provider ◽  
Primary Care Physicians ◽  
Diabetes Clinic ◽  
Dietary Counseling ◽  
Eye Exams ◽  
Family Medicine Residents

Abstract As the population ages and the prevalence of diabetes increases, the demand for endocrinology services, especially in underserved areas, will continue to exceed availability. Primary care residency training programs must prepare residents to care for high risk patients with diabetes who cannot access specialists. We hypothesized that resident participation in an inter-professional diabetes clinic run by primary care physicians would lead to improved diabetes care in resident patient panels. A diabetes clinic was created in an existing primary care practice at a Federally Qualified Health Center in Eastern Kentucky. All non-pregnant, adult, Type II diabetes patients with a HgbA1C of 8.0% or greater were invited to participate in the clinic. Initial visits included evaluations by a dentist, mental health counselor, social worker, nutritionist, primary care provider, and pharmacist. Four first-year and four second-year family medicine residents rotated through the diabetes clinic and followed the patients as they saw each member of the health care team. On follow-up visits, a resident served as the primary care provider for each patient and participated in post-clinic meetings of the entire healthcare team. Resident patient charts were reviewed 3 months prior to the year-long intervention and data collected was compared to resident patient charts 3 months following the intervention. Ninety patients served as the pre-intervention sample and 108 were in the post-intervention sample. Chi-square analysis showed a statistically significant increase in patients with A1C less than 8.0% pre (57.7%) to post (71.3%) p=0.0468. Overall, there were significant increases in all health-associated behaviors. Patients receiving eye exams increased from pre (29%) to post (66%) intervention significantly; z=-5.2, P&lt;.001. Patients receiving a urine microalbumin test increased from pre (61%) to post (82%) intervention; z=-3.2, P&lt;.001. Patients receiving dietary counseling increased from pre (54%) to post (79%) intervention; z=-3.6, P&lt;.001. Patients receiving foot exams increased from pre (34%) to post (48%) intervention, z=-1.9; p=.03. Resident involvement in a multidisciplinary diabetes clinic led by primary care physicians resulted in a statistically significant increase in HgbA1Cs &lt; 8 among patients in their regular clinic and resulted in a statistically significant increase in their diabetic patients receiving eye exams, dietary counseling, foot exams, and urine microalbumin tests. This study suggests that teaching family medicine residents important diabetes care skills with an inter-professional team approach through the use of a diabetes clinic may be superior to standard educational practices.

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