How Do We Support Follow-up With the Primary Care Provider After an Emergency Department Visit for Asthma?

PEDIATRICS ◽  
2009 ◽  
Vol 124 (4) ◽  
pp. 1206-1207 ◽  
Author(s):  
M. E. Mansour
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Department Visit ◽  
Care Provider ◽  
Primary Care Provider

scholarly journals Community Primary Care Provider Preferences for Emergency Department Follow-up Recommendations

2017 ◽  
Vol 33 (10) ◽  
pp. 690-693
Author(s):  
Marissa A. Hendrickson ◽  
Eta Obeya ◽  
Andrew R. Wey ◽  
Philippe R. Gaillard
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Provider ◽  
Primary Care Provider

Postconcussion Academic Support in Children Who Attend a Primary Care Provider Follow-up Visit after Presenting to the Emergency Department

2019 ◽  
Vol 209 ◽  
pp. 168-175 ◽  
Author(s):  
Traci R. Snedden ◽  
Lauren A. Pierpoint ◽  
Dustin W. Currie ◽  
R. Dawn Comstock ◽  
Joseph A. Grubenhoff
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Provider ◽  
Primary Care Provider ◽  
Academic Support

scholarly journals Integrating Genomic Screening into Primary Care: Provider Experiences Caring for Latino Patients at a Community-Based Health Center

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Tarika Srinivasan ◽  
Erica J. Sutton ◽  
Annika T. Beck ◽  
Idali Cuellar ◽  
Valentina Hernandez ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Care ◽  
Health Center ◽  
Care Provider ◽  
Primary Care Provider ◽  
Genomic Sequencing ◽  
Community Based ◽  
Genomic Screening

Introduction: Minority communities have had limited access to advances in genomic medicine. Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, partnered to assess the feasibility of offering genomic screening to Latino patients receiving care at a community-based health center. We examined primary care provider (PCP) experiences reporting genomic screening results and integrating those results into patient care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other members of the health care team charged with supporting patients who received positive genomic screening results. Interviews were recorded, transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results indicating a genetic variant that warranted clinical management. PCPs felt genomic screening was valuable to patients and their families, and that genomic research should strive to include underrepresented minorities. Providers identified multiple challenges integrating genomic sequencing into patient care, including difficulties maintaining patient contact over time; arranging follow-up medical care; and managing results in an environment with limited genetics expertise. Providers also reflected on the ethics of offering genomic sequencing to patients who may not be able to pursue diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing advances in precision medicine to community-based health centers serving under-resourced populations. By proactively considering patient support needs, and identifying financial assistance programs and patient-referral mechanisms to support patients who may need specialized medical care, PCPs and other health care providers can help to ensure that precision medicine lives up to its full potential as a tool for improving patient care.

scholarly journals Follow-Up Rates at a Free Ophthalmology Clinic at a Homeless Shelter

2021 ◽  
Vol 13 (01) ◽  
pp. e51-e56
Author(s):  
Lauren Hennein ◽  
Kimberly A. Spaulding ◽  
Veronika Karlegan ◽  
Ogonna N. Nnamani Silva ◽  
Alejandra G. de Alba Campomanes
Keyword(s):  
High School ◽  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider ◽  
Nonprofit Organization ◽  
County Hospital ◽  
Categorical Variables ◽  
Homeless Shelter ◽  
High School Diploma

Abstract Objective Eye health among the homeless community is important, as poor vision makes this population vulnerable and adds significantly to the social and health burden. There is limited knowledge on patient follow-up rates for their eye conditions and barriers to accessing care in this population. The purpose of this retrospective chart review study is to examine follow-up rates and barriers to care for patients referred from a free, medical-student run ophthalmology clinic at a homeless shelter. Methods All patients evaluated at a free ophthalmology clinic from September 2017 to September 2018 were included; no patients were excluded. If indicated, patients were referred for advanced ophthalmologic care at a local county hospital and free eyeglasses at a nonprofit organization. Primary outcomes were follow-up rates at the county hospital and nonprofit organization. Secondary outcomes included prespecified baseline variables hypothesized to be associated with follow-up rates. These categorical variables were compared with Chi-square testing to determine their association with follow-up rates. The hypothesis being tested was formulated before data collection. Results Of the 68 patients, 84% were males with a mean age of 50 years. Overall, 40 patients were referred for free eyeglasses and 17 to the county hospital. Of those referred, 14 patients presented for free eyeglasses and 7 presented to the county hospital. About 79% of patients with a pre-established primary care provider presented to their appointment compared with 20% of those without one (p = 0.03). The 44% of patients with a high school diploma presented while all patients without a high school diploma failed to present (p = 0.04). Vision-threatening conditions identified at the shelter clinic did not affect follow-up rates (p = 0.79). Conclusion Less than half of referred patients in our study presented to their appointments. Barriers to presentation included no primary care provider and lower educational status, with no improvement in follow-up rates among those referred for vision-threatening conditions. Interventions such as health coaching with particular attention to educating patients on the effects of vision-threatening conditions may be warranted, particularly for those not looped into the health care system and those of lower educational attainment.

Abstract TP356: Post-Acute Stroke Experience Survey- Development and Pilot Testing

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jane A Anderson ◽  
Barbara Kimmel ◽  
Kirt Martin ◽  
Anette Ovalle ◽  
Chizoba Ifeorah ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Care Provider ◽  
Primary Care Provider ◽  
Claims Data ◽  
Stroke Care ◽  
Insurance Status ◽  
Stroke Survivors ◽  
Health Insurance Status

Background: Administrative claims data show variability in post-acute stroke care. Stroke survivors without health insurance are not included in claims data statistics. The PASES survey was developed and tested to describe stroke care experience of underserved survivors participating in V-STOP a telehealth self-management program. Methods: Semi-structured interviews were completed to elicit feedback from survivors on experiences during their stroke event, emergency and hospital care, and after discharge. Items on PASES were established based on participants’ responses and survey was piloted in a sample of underserved survivors (N=95). Descriptive statistics and Chi-square analysis were applied to describe stroke survivors’ experiences and differences based on health insurance status. Results: The sample was 45% female, mean age 57, 18% Black and 60% Hispanic. Most (60%) had an annual income of less than $25,000 and 44% had no insurance. Only 25% reported calling 911. However (60%) report presenting to a hospital within 2 hours of stroke symptoms recognition. Nearly half (42%) reported not knowing whether they received a “clot dissolving” medication. Fifty-four percent did not receive rehabilitation after discharge. Eighty-percent reported seeing a healthcare provider after discharge. Most (61%) saw a primary care provider and 22% saw a neurologist. However, only 24% reported seeing a provider within one month of hospital discharge. No significant differences were identified between insured vs. uninsured with respect to race, ethnicity, income, calling 911, receiving inpatient rehab, seeing a provider after discharge and follow up with primary care provider vs. neurologist. Significant differences were identified between insured vs. uninsured with respect to presenting to a hospital within 2 hours of stroke symptoms (35 vs 18 [p=0.023]) and in receiving no rehab after discharge (27 vs 12 [p=0.02]). Conclusion: Results suggest low utilization of EMS, delayed presentation to hospital, limited access to rehabilitation after discharge and limited access to timely follow-up with stroke specialist among underserved stroke survivors. Health insurance status may influence delayed hospital presentation and access to rehabilitation services.

Post-hospitalization transitions: Examining the effects of timing of primary care provider follow-up

2010 ◽  
Vol 5 (7) ◽  
pp. 392-397 ◽  
Author(s):  
Gregory J. Misky ◽  
Heidi L. Wald ◽  
Eric A. Coleman
Keyword(s):  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider

scholarly journals Early Primary Care Provider Follow-up and Readmission After High-Risk Surgery

JAMA Surgery ◽  
2014 ◽  
Vol 149 (8) ◽  
pp. 821 ◽  
Author(s):  
Benjamin S. Brooke ◽  
David H. Stone ◽  
Jack L. Cronenwett ◽  
Brian Nolan ◽  
Randall R. DeMartino ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Care Provider ◽  
Primary Care Provider ◽  
Early Primary

Reach Out Behavioral Intervention for Hypertension Initiated in the Emergency Department Connecting Multiple Health Systems: Study Protocol for a Randomized Control Trial

2020 ◽  
Author(s):  
William Meurer ◽  
Mackenzie Dinh ◽  
Kelley Kidwell ◽  
Adam Flood ◽  
Emily Champoux ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Emergency Department ◽  
Care Provider ◽  
Primary Care Provider ◽  
Chronic Disease Management ◽  
Emergency Department Patient ◽  
Safety Net ◽  
Health Records ◽  
Electronic Health

Abstract Background: Hypertension is the most important modifiable risk factor for cardiovascular disease, the leading cause of mortality in the United States. The Emergency Department represents an underutilized opportunity to impact difficult-to-reach populations. There are 136 million visits to the Emergency Department each year and nearly all have at least one blood pressure measured and recorded. Additionally, an increasing number of African Americans and socioeconomically disadvantaged patients are overrepresented in the Emergency Department patient population. In the age of electronic health records and mobile health, the Emergency Department has the potential to become an integral partner in chronic disease management. The electronic health records in conjunction with mobile health behavior interventions can be leveraged to identify hypertensive patients to impact otherwise unreached populations. Methods: Reach Out is a factorial trial studying multicomponent, behavioral interventions to reduce blood pressure in the Emergency Department patient population. Potential participants are identified by automated alerts from the electronic health record and, following consent, receive a blood pressure cuff to take home. During the initial screening phase, they are prompted to submit weekly blood pressure readings. Responders with persistent hypertension are then randomized into one of three component arms, consisting of varying intensity levels: (1) healthy behavior text messaging (daily vs. none), (2) blood pressure self-monitoring (daily vs. weekly), and (3) facilitated primary care provider appointment scheduling and transportation (yes vs. no). If participants are randomized to receive facilitated primary care provider appointment scheduling and are not established with a primary care provider, care will be established at a local Federally Qualified Health Center. Participants are followed for twelve-months. Discussion: The Reach Out study is designed to determine which behavioral intervention components or ‘dose’ of components contributes to a reduction in systolic blood pressure after one year (Aim 1). The study will also assess the effect of primary care provider appointment assistance on total primary care follow-up visits of hypertensive patients treated in an urban, safety net Emergency Department (Aim 2). Ideally, the Reach Out system will contribute to hypertension management, serving as a model for safety net hospitals and Federally Qualified Health Centers to improve chronic disease management in underserved communities. Trial Registration: This study was registered at clinicaltrials.gov, identifier NCT03422718. The record was first available to the public on 01/30/2018 prior to the enrollment of patients on 03/25/2019. KEYWORDS Hypertension, Emergency Medicine, Randomized Clinical Trial, Multiphase Optimization Strategy

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