Formalizing the curbside: digitally enhancing access to specialty care.

Asynchronous medical care has increased in utilization, patient interest, and industry demand. While E-consults have been discussed extensively in the literature, there are rare examples of a multispecialty implementation within a large health system. Here, we describe our experience in implementing an internal E-consult program for asynchronous, nonurgent communication between ambulatory specialists and primary care providers in our large multispecialty regional health system.

Ad hoc teams and telemedicine during COVID-19.

The pandemic has required creative and agile teamwork and leadership. Creativity was especially necessary when employing the social distancing requirements for this disease. To ensure compliance while also meeting the needs of our system and community, a huge telemedicine initiative was deployed.

Quality improvement initiative for pain management practices in primary care.

In the context of both chronic pain and opioid crises, this large-system quality improvement project sought to increase use of evidence-based multimodal pain management strategies. Primary care providers (PCPs) in internal medicine and family medicine identified as above-median prescribers of 30-day opioid supplies were selected for intervention. PCPs received individualized email letters showing their opioid prescribing patterns relative to peers and urging them to view an internal pain/opioid educational video and related system guidelines.

Diagnostic Accuracy in Primary Care E-Visits: Evaluation of a Large Integrated Health Care Delivery System's Experience.

Objective: To compare diagnostic accuracy between primary care E-Visit and face-to-face (F2F) encounters for low-acuity illnesses.

Patients And Methods: This cross-sectional retrospective analysis of electronic health records in a large not-for-profit integrated delivery system included patients covered by the health care system's employee health plan with an established affiliated physician-patient relationship and an F2F encounter in the past 12 months who had an E-Visit (n=490) or an F2F (n=2201) primary care encounter for a low-acuity illness from July 1, 2015, through December 22, 2016. Patients with a related follow-up visit within 10 days resulting in a revised diagnosis, as determined by 2 physician reviewers, were compared (1) including only the first encounter for each patient and (2) including all encounters more than 10 days apart for included patients.

A new kind of normal: qualitative accounts of Multifamily Group Therapy for acquired brain injury.

Acquired brain injuries (ABI) can have a major impact on social participation, causing increased social isolation and emotional distress for people with the injury and their family members. Multifamily Group Therapy (MFGT) provides information, resources, problem-solving strategies and opportunities for social networking for families where one member has an illness. By qualitatively examining the experience of group participation from the perspectives of both individuals with ABI and their family members, the present study aimed to elucidate the processes underlying and factors influencing success of facilitated MFG programmes with families impacted by ABI.