"Team Dynamics, Clinical Work Satisfaction, and Care Coordination Between Primary Care Providers"

84 Background: To improve coordination of cancer care between cancer specialist hospitals and primary care providers (PCPs), the Japanese government accredited cancer specialist hospitals, so called “designated cancer care hospitals (DCCHs)” and introduced “Cancer care coordination instruction fee” which PCPs can receive if they share a cancer critical path (Japanese version of Survivorship Care Plans) of each cancer patient with DCCHs. We sought to assess the current status of coordination of cancer care in Japan and communication between DCCHs and PCPs from PCPs’ point of view. Methods: A cross-sectional mail survey was administered to randomly selected clinic-based PCPs (4,000 clinics) from a nation-wide database of medical institutions authorized by Ministry of Health, Labour and Welfare Japan to treat patients with health insurance (87,869 clinics). The survey evaluated how much PCPs provided cancer follow-up care and how well DCCHs coordinated care and communicated with PCPs in cancer survivorship. Results: 1,873 PCPs returned the questionnaire (response rate: 46.8%). 1,223 (65.3%) answered to provide cancer follow-up care in outpatient setting. Most of the PCPs which provided cancer follow-up care evaluated the care coordination and support by DCCHs were satisfactory (946, 77.4%) but the degree of good evaluation varied by region (highest: 91.3%, lowest: 45.8%). In regression analysis, provision of palliative care by PCPs (OR 1.52 95%CI 1.05-2.17) and use of cancer critical path (OR 2.10 95%CI 1.63-2.71) were significantly correlated with better evaluation of communication and care coordination. Conclusions: DCCHs communicated well with PCPs and PCPs were satisfied with the communication and care coordination by DCCHs. Provision of palliative care by PCPs and use of cancer critical path are likely to lead good care coordination in cancer care.

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Care Seeking Pathway Of Depression In Children And Adolescents: Differences In The Need For Care Coordination Between Patients Managed By Primary Care Providers Or Psychiatrists

Value in Health ◽

10.1016/j.jval.2016.03.1346 ◽

2016 ◽

Vol 19 (3) ◽

pp. A192-A193

Author(s):

A Yucel ◽

H Chen ◽

EJ Essien ◽

R Aparasu ◽

O Mgbere ◽

...

Keyword(s):

Primary Care ◽

Children And Adolescents ◽

Care Coordination ◽

Primary Care Providers ◽

Care Seeking ◽

Care Providers ◽

Need For Care

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Effect of a Digital Precision Public Health Intervention for Care Coordination During Covid-19 Pandemic in Australia: A Real World Study

10.21203/rs.3.rs-882615/v1 ◽

2021 ◽

Author(s):

Andre Q Andrade ◽

Jean-Pierre Calabretto ◽

Nicole L Pratt ◽

Lisa M Kalisch-Ellett ◽

Vanessa T LeBlanc ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Continuity Of Care ◽

Care Coordination ◽

Real World ◽

Primary Care Providers ◽

Patient Specific ◽

Specific Information ◽

Care Providers ◽

Precision Public Health

Abstract Background: Emergencies disproportionally affect vulnerable populations. The COVID-19 pandemic affected older patients with co-morbidities both directly due to more severe infection and indirectly by affecting care provision. To promote continuity of care, public health professionals require tools to quickly and precisely coordinate with primary care providers. This study evaluated whether digital interventions powered by current existing infrastructure are more effective than conventional interventions in promoting primary care appointments during the COVID-19 pandemic. Methods: We developed a digital intervention delivered by secure messaging and compared it to a post delivered intervention to promote continuity of care for vulnerable veterans during COVID-19 in a real world, non-randomised, interventional study. The study was implemented as part of the Veterans’ MATES program, an Australian Government Department of Veterans’ Affairs program to promote improvements in health care for veterans. The intervention provided patient specific information to general practitioners (GPs) to support continuity of care, alongside mailed education to veterans. The intervention key messages were to maintain regular contact with care providers and to continue to adhere to health plans. The intervention took place in April 2020, during the first weeks of COVID-19 social distancing rules in Australia. The main outcome was time to first appointment with the primary general practitioner (GP) measured using a Cox proportional hazards model.Results: GPs received digital messaging for 51,052 veterans and post messaging for 26,859 veterans. The proportion of patients seeing their primary GP during the three months following intervention was higher in the digital group (77.8%) than the post group (61.5%) (p<0.01). Being in the digital group was associated with earlier appointments. Conclusion: Current infrastructure coupled with innovative solutions is effective in promoting care coordination at scale during national emergencies, opening up new perspectives for precision public health initiatives.

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Improving home-based providers’ communication to primary care providers to enhance care coordination

Aging & Mental Health ◽

10.1080/13607863.2014.977772 ◽

2014 ◽

Vol 19 (10) ◽

pp. 921-931 ◽

Cited By ~ 5

Author(s):

Amber M. Gum ◽

Natalie D. Dautovich ◽

Jennifer Greene ◽

Anne Hirsch ◽

Lawrence Schonfeld

Keyword(s):

Primary Care ◽

Care Coordination ◽

Primary Care Providers ◽

Care Providers ◽

Home Based

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Multisystem comorbidities in classic Rett syndrome: a scoping review

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000731 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000731

Author(s):

Cary Fu ◽

Dallas Armstrong ◽

Eric Marsh ◽

David Lieberman ◽

Kathleen Motil ◽

...

Keyword(s):

Primary Care ◽

Rett Syndrome ◽

Care Coordination ◽

Clinical Care ◽

Primary Care Providers ◽

Cardiac Conduction ◽

Care Providers ◽

Medical Comorbidities ◽

Medical Needs ◽

Organ Systems

BackgroundRett syndrome (RTT) is a severe, progressive neurodevelopmental disorder with multisystem comorbidities that evolve across a patient’s lifespan requiring attentive coordination of subspecialty care by primary care providers. A comprehensive, up-to-date synthesis of medical comorbidities in RTT would aid care coordination and anticipatory guidance efforts by healthcare providers. Our objective was to review and summarise published evidence regarding prevalence of RTT medical comorbidities across all relevant organ systems.MethodsSearch of PubMed from January 2000 to July 2019 was performed using the search terms (Rett and MECP2 AND patient) OR (Rett and MECP2 AND cohort). Articles reporting the prevalence of clinical findings in RTT were assessed with respect to the size and nature of the cohorts interrogated and their relevance to clinical care.ResultsAfter review of over 800 records, the multisystem comorbidities of RTT were summarised quantitatively from 18 records comprising both retrospective and prospective cohorts (31–983 subjects). Neurological comorbidities had the highest prevalence, occurring in nearly all individuals with gastrointestinal and orthopaedic concerns almost as prevalent as neurological. With the exception of low bone mineral content which was relatively common, endocrine comorbidities were seen in only around one-third of patients. Although more prevalent compared with the general population, cardiac conduction abnormalities were the least common comorbidity in RTT.ConclusionsEffective care coordination for RTT requires knowledge of and attention to multiple comorbidities across multiple unrelated organ systems. Many issues common to RTT can potentially be managed by a primary care provider but the need for sub-specialist referral can be anticipated. Since the median life expectancy extends into the sixth decade with evolving subspecialty requirements throughout this time, paediatric providers may be tasked with continued coordination of these comorbidities or transitioning to adult medicine and specialists with experience managing individuals with complex medical needs.

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Challenges and insights in implementing coordinated care between oncology and primary care providers: a Canadian perspective

Current Oncology ◽

10.3747/co.24.3426 ◽

2017 ◽

Vol 24 (2) ◽

pp. 120 ◽

Cited By ~ 6

Author(s):

J.R. Tomasone ◽

M. Vukmirovic ◽

M.C. Brouwers ◽

E. Grunfeld ◽

R. Urquhart ◽

...

Keyword(s):

Primary Care ◽

Care Coordination ◽

Cancer Care ◽

Program Planning ◽

Primary Care Providers ◽

Models Of Care ◽

Future Research ◽

Care Providers ◽

Coordinated Care ◽

Program Support

We report here on the current state of cancer care coordination in Canada and discuss challenges and insights with respect to the implementation of collaborative models of care. We also make recommendations for future research. This work is based on the findings of the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (canimpact) casebook project. The casebook project identified models of collaborative cancer care by systematically documenting and analyzing Canadian initiatives that aim to improve or enhance care coordination between primary care providers and oncology specialists. The casebook profiles 24 initiatives, most of which focus on breast or colorectal cancer and target survivorship or follow-up care.Current key challenges in cancer care coordination are associated with establishing program support, engaging primary care providers in the provision of care, clearly defining provider roles and responsibilities, and establishing effective project or program planning and evaluation. Researchers studying coordinated models of cancer care should focus on designing knowledge translation strategies with updated and refined governance and on establishing appropriate protocols for both implementation and evaluation.

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Meaningful use care coordination criteria: Perceived barriers and benefits among primary care providers

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocv147 ◽

2015 ◽

Vol 23 (e1) ◽

pp. e146-e151 ◽

Cited By ~ 9

Author(s):

Genna R Cohen ◽

Julia Adler-Milstein

Keyword(s):

Primary Care ◽

Patient Care ◽

Care Coordination ◽

Care Transitions ◽

Meaningful Use ◽

Primary Care Providers ◽

Care Providers ◽

Organizational Strategies ◽

Primary Care Practices ◽

Stage 1

Abstract Background Stage 2 and proposed Stage 3 meaningful use criteria ask providers to support patient care coordination by electronically generating, exchanging, and reconciling key information during patient care transitions. Methods A stratified random sample of primary care practices in Michigan ( n = 328) that had already met Stage 1 meaningful use criteria was surveyed, in order to identify the anticipated barriers to meeting these criteria as well as the expected impact on patient care coordination from doing so. Results The top three barriers, as identified by >65% of the primary care providers surveyed, were difficulty sending and receiving patient information electronically, a lack of provider and practice staff time, and the complex workflow changes required. Despite these barriers, primary care providers expressed strong agreement that meeting the proposed Stage 3 care coordination criteria would improve their patients’ treatment and ensure they know about their patients’ visits to other providers. Conclusion The survey results suggest the need to enhance policy approaches and organizational strategies to address the key barriers identified by providers and practices in order to realize important care coordination benefits.

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