Are Primary Care Providers Offering HIV Testing to Patients in a Predominantly Hispanic Community Health Center? An Exploratory Study

Loss of mobility in older adults (65 and older) is associated with falling, loss of independence, and mortality. This paper, which to the author's knowledge is the first of its kind, summarizes findings of Federally Qualified Health Center (FQHC) case reports and how FQHCs minimize the impacts of mobility loss in older adult patients (who would not receive primary services without these transportation programs) by providing access to primary care services through transportation programs. This paper features the transportation programs of four FQHCs located in both urban and rural United States areas: LifeLong Medical Care (Oakland, CA); Hudson Headwaters Health Network (Queensbury, NY); North End Community Health Center (Boston, MA); Aaron E. Henry Community Health Services Center, Inc. (Clarksdale, MS). This paper is beneficial to primary care providers and public health officials in outlining how transportation may be used to minimize the effects of mobility loss in older adult patients.

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Evaluation of an Interdisciplinary Controlled Substance Review Committee on Opioid Prescribing in a Community Health Center

Pain Medicine ◽

10.1093/pm/pnaa075 ◽

2020 ◽

Vol 21 (9) ◽

pp. 1840-1846 ◽

Cited By ~ 2

Author(s):

Holly C Bourgeois ◽

Rachel C Proteau ◽

Cassandra V Vielma ◽

Daniel M Hartung ◽

Adriane N Irwin

Keyword(s):

Primary Care ◽

Health Center ◽

Community Health Center ◽

Primary Care Providers ◽

Patient Specific ◽

Future Research ◽

Care Providers ◽

Opioid Dose ◽

Opioid Prescribing ◽

Controlled Substance

Abstract Objective To describe recommendations made by an interdisciplinary controlled substance committee and acceptance by primary care providers. Design Retrospective cohort study. Setting Multisite federally qualified health center using an interdisciplinary committee to provide patient-specific recommendations to prescribers with patients using prescription opioids and other controlled substances. Subjects Patients prescribed long-term opioids. Methods We identified and characterized committee recommendations to prescribers between January 1, 2013, and December 31, 2016. We manually reviewed electronic medical records to determine if recommendations were accepted at eight months. The primary outcome was the overall acceptance rate of recommendations. Secondary outcomes were the acceptance of recommendations to reduce opioid doses and change in opioid dose from baseline. Results The committee made 337 recommendations for 94 patients. Of those, 169 recommendations (50.1%) were accepted within eight months. The most common recommendation was to change opioid prescribing (N = 53, 56.4%), but recommendations varied. For patients with a recommendation to change opioid prescribing, this was accepted in 31 of 53 patients (58.5%). Overall, opioid doses decreased from 60 morphine equivalents per day (interquartile range [IQR] = 27.5–135, range = 5–1,260) at baseline to 40 morphine equivalents per day (IQR = 15–105, range = 0–1,260) at eight months (P < 0.001). Conclusions An interdisciplinary committee was well positioned to offer primary care providers with nonopioid options to manage chronic nonmalignant pain and provide support in reducing opioid doses. About half of recommendations were accepted by primary care providers. Future research should focus on strategies to improve the utility of this approach and its impact on clinical outcomes.

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1269. HIV Testing in a Large Community Health Center Serving a Multi-cultural Population: A Qualitative Study of Providers

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1102 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S387-S387

Author(s):

Anthony James ◽

Danelle Marable ◽

Caroline Cubbison ◽

Andrew Tarbox ◽

Sarah Oo ◽

...

Keyword(s):

United States ◽

Primary Care ◽

Hiv Testing ◽

Community Health ◽

Health Center ◽

Ethnic Minorities ◽

Community Health Center ◽

The United States ◽

Urgent Care ◽

Racial Ethnic

Abstract Background In the United States, 15% of people with HIV (PWH) do not know their serostatus, leading to both individual morbidity and HIV transmission to others. While CDC guidelines recommend HIV screening for all individuals aged 13–64 years, racial and ethnic minorities in the United States continue to present to care with advanced HIV infection. Methods Our objective was to assess providers’ perspectives on barriers to and facilitators of HIV testing at an urban community health center serving a predominantly racial/ethnic minority population of low socio-economic status. Study staff conducted five focus groups from January 2017 to November 2017 with 74 health center staff: 20 adult medicine/primary care providers, 28 community health workers (CHWs), six urgent care physicians, six community health administrators, and 14 behavioral health providers. Each focus group ranged from six to 20 participants. In addition to exploring participants’ views on HIV testing in this setting, we also explored potential interventions to improve HIV testing. Interviews were digitally recorded. Data were analyzed using a grounded theory approach. We used open coding to develop themes and compared themes among provider groups. Results The main facilitators of routine HIV testing were clinical training in HIV/hepatitis care and CHWs engaging patients in topics that intersect with HIV risk factors. Providers’ perceptions of key barriers were patients’ cultural perceptions of HIV (e.g. HIV-related stigma), patients’ concerns about test confidentiality, competing medical and social issues, and provider lack of HIV knowledge. All groups agreed that HIV testing should occur through the primary care provider though acknowledged that patients may be seeking healthcare more frequently through mental health, urgent care, or social services than primary care. Primary care physicians wanted easier mechanisms to identify patients in need of HIV testing and assistance with offering the test to non-English language speaking patients. Conclusion Specific, focused efforts can lead to improved HIV testing in racial ethnic minorities in community health centers. Training to improve provider comfort, increasing CHW engagement, and a focus on patients’ cultural beliefs may all have an impact. Disclosures All authors: No reported disclosures.

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Use of seven types of medical jargon by male and female primary care providers at a university health center

Patient Education and Counseling ◽

10.1016/j.pec.2021.08.018 ◽

2021 ◽

Author(s):

Ann Neville Miller ◽

Ajay Bharathan ◽

Venkata Naga Sreelalitapriya Duvuuri ◽

Vanessa Navas ◽

Lisvet Luceno ◽

...

Keyword(s):

Primary Care ◽

Health Center ◽

Primary Care Providers ◽

Care Providers ◽

Male And Female ◽

Medical Jargon

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Perceived efficiency impacts following electronic health record implementation: An exploratory study of an urban community health center network

International Journal of Medical Informatics ◽

10.1016/j.ijmedinf.2010.09.002 ◽

2010 ◽

Vol 79 (12) ◽

pp. 807-816 ◽

Cited By ~ 25

Author(s):

Ann Scheck McAlearney ◽

Julie Robbins ◽

Annemarie Hirsch ◽

Maria Jorina ◽

J. Phil Harrop

Keyword(s):

Electronic Health Record ◽

Community Health ◽

Health Center ◽

Exploratory Study ◽

Urban Community ◽

Community Health Center ◽

Health Record ◽

Electronic Health

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Capturing Relevant Patient Data in Clinical Encounters Through Integration of an Electronic Patient-Reported Outcome System Into Routine Primary Care in a Boston Community Health Center: Development and Implementation Study (Preprint)

10.2196/preprints.16778 ◽

2019 ◽

Author(s):

Stephanie Loo ◽

Chris Grasso ◽

Jessica Glushkina ◽

Justin McReynolds ◽

William Lober ◽

...

Keyword(s):

Primary Care ◽

Community Health ◽

Health Center ◽

Community Health Centers ◽

Community Health Center ◽

Improve Patient Care ◽

Patient Reported Outcome ◽

Patient Reported ◽

Patient Provider Communication ◽

Improve Patient

BACKGROUND Electronic patient-reported outcome (ePRO) systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation. OBJECTIVE This study aimed to implement an ePRO system that administers key health questionnaires in an urban community health center in Boston, Massachusetts. METHODS An ePRO system that administers key health questionnaires was implemented in an urban community health center in Boston, Massachusetts. The system was integrated with the electronic health record so that medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated rollout process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit. RESULTS Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in terms of applying technological innovation to streamline clinical processes and improve patient care. CONCLUSIONS Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model for application of technological innovation to streamline clinical processes and improve patient care.

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