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digital.ahrq.gov/sites/default/files/docs/resource/PCC_Schillinger_Q4_ATSM_PCP_GMC.pdf
June 16, 2021 - Our SFHP Nurse Care Managers will follow-up with any patients who provide
out-of-range responses. … During the follow-up phone calls, the nurses will:
• Educate members about diabetes. … Rachel
will work with you to ensure timely follow up of your patient’s needs.
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digital.ahrq.gov/sites/default/files/docs/resource/PCC_Schillinger_Q4_ATSM_PCP_GMC_0.pdf
June 16, 2021 - Our SFHP Nurse Care Managers will follow-up with any patients who provide
out-of-range responses. … During the follow-up phone calls, the nurses will:
• Educate members about diabetes. … Rachel
will work with you to ensure timely follow up of your patient’s needs.
-
digital.ahrq.gov/organization/university-california-davis
January 01, 2023 - Principal Investigator
Armstrong, April
Project Name
Patient-Centered Online Care Model for Follow-Up … Principal Investigator
Armstrong, April
Project Name
Patient-Centered Online Care Model for Follow-Up … Principal Investigator(s)
Marcin, James
Patient-Centered Online Care Model for Follow-Up
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digital.ahrq.gov/ahrq-funded-projects/e-coaching-interactive-voice-response-ivr-enhanced-care-transition-support/annual-summary/2011
January 01, 2011 - Studies examining the care transition intervention (CTI), for which nurses conduct home visits, telephone follow-up … paper-based personal health record (PHR), provides patient medication self-management assistance, timely follow-up … of the year, 182 participants completed the intervention (in-hospital coaching, all IVR surveys, and follow-up … The last participant will end the 90-day follow-up period on February 29, 2012, and appropriate measures
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs023989-shah-final-report-2019.pdf
January 01, 2019 - Follow-up SOC. … Follow up appointment time and date were also
programmed into SMART, and reminders were given to the … Follow up appointment compliance
Patients randomized to the SMART app intervention received appointment … To aid in follow up, SMART also included the ability to have a reminder for an
appointment ‘pop-up’. … Although we found compliance to follow up appointments improved for patients using SMART, we were unable
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs020693-wexler-final-report-2014.pdf
January 01, 2014 - Intervention employed an integrated EMR to
schedule follow-up PCP appointments for Medicaid patients … Results: 28% of intervention patients attended at least one primary care visit at 3-month follow-
up … Intervention group had 2.5 times
the odds of attending a PCP visit at the 3-month follow-up compared … Programs designed to address this issue generally take the
approach of arranging follow-up appointments … A subset of patients from the study sample agreed to be contacted for
follow-up interviews.
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digital.ahrq.gov/medical-condition/endocrine-disease
January 01, 2023 - Endocrine Disease
Electronic detection of delayed test result follow-up … Electronic detection of delayed test result follow-up in patients with hypothyroidism.
-
digital.ahrq.gov/sites/default/files/docs/publication/uc1hs016133-lozzio-final-report-2010.pdf
January 01, 2010 - The data on confirmatory diagnosis, treatment and follow-up for NBS and NHS was entered by
the staff … Tracking of follow-up services by primary diagnosis and history of services received. … Additional data on confirmed diagnosis, treatment, developmental
information and long term follow-up … and development of a
system of reporting of the appropriate treatment and follow-up recommendations … The total
completed follow-up was 68.9% and 98.3% were followed before 3 months.
-
digital.ahrq.gov/ahrq-funded-projects/improving-post-hospital-medication-management-older-adults-health-information
January 01, 2023 - Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization … Population: Patient , Physician
An electronic health record-based intervention to increase follow-up … An electronic health record-based intervention to increase follow-up office visits and decrease rehospitalization … Decision Support System Population: Individuals with Chronic Care Needs , Elderly
Baseline and follow-up … Baseline and follow-up laboratory monitoring of cardiovascular medications.
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digital.ahrq.gov/sites/default/files/docs/workflowtoolkit/CFF_Office_Visit.pdf
March 01, 2009 - informs staff imms,
injections and procedures
needed by
FLAG/VERBAL/WRITTEN
MD informs WHICH staff follow … up appts or outside procedures
needed by
FLAG/VERBAL/WRITTEN
MD completes visit
documentation … chart , gives it back to
NURSING/RECEPTION
Pt checks out at
FRONT
DESK/SCHEDULER,
scheduling follow … up
as necessary
Clinical staff
complete
procedures with
patient
(WHICH) Staff
complete follow … up/outside
procedure
scheduling with
patient
Reception Clinical Physician
Flowchart Example
-
digital.ahrq.gov/sites/default/files/docs/citation/r03hs028033-frey-final-report-2024.pdf
January 01, 2024 - However, even when clinic follow-up does occur,
many children with uncontrolled asthma may not receive … ) the PCP follow-up visit recommended for all hospitalized patients
following discharge.
1. … Key outcomes of interest:
Final follow-up surveys were completed by 62% of caregivers. … Preliminary outcome data from follow-up caregiver surveys and chart review data
Baseline 2 Month Follow-up … 4 Month Follow-up 6 Month Follow-up 6 Month Chart
Review
Overall
N=26
TEACHH
N=13
SC
N=13
-
digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/tolar-m
January 01, 2023 - PURPOSE: In this paper we follow a community health centre (CHC), and document the changes in work practices … And finally resources in terms of additional personnel or dedicated time are necessary to keep up with … completion of additional tasks by clinical and administrative personnel related to the organization of follow-up … With target areas identified, the work often fell on the office assistants to carry out follow up activities … described this process as a team effort involving the office assistants who were responsible for taking on follow-up
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digital.ahrq.gov/sites/default/files/docs/resource/PCC_Adams_Q2_PHPCounselingActivation.pdf
June 16, 2021 - Counseling Activation
Topic Trigger Group Answer(s)
Counseling
message
Activation
Message
Follow-up … Topic Trigger Group Answer(s)
Counseling
message
Activation
Message
Follow-up Questions
have … Topic Trigger Group Answer(s)
Counseling
message
Activation
Message
Follow-up Questions
Obesity … Topic Trigger Group Answer(s)
Counseling
message
Activation
Message
Follow-up Questions
Med … Topic Trigger Group Answer(s)
Counseling
message
Activation
Message
Follow-up Questions
Med
-
digital.ahrq.gov/sites/default/files/docs/adult-depression-qas-06152022.pdf
June 15, 2022 - QUESTION: During population screening and monitoring, are there any items that might require immediate follow-up … If so, what is the step for managing follow-up? … Plans for
follow-up will be automated messages back to patients if high risk for suicide. … I’m very excited that depression screening and follow-up is becoming one of the primary quality
measures … For all patients struggling with depression, and not
getting adequate care or follow up, that depression
-
digital.ahrq.gov/sites/default/files/docs/publication/r18hs018648-atlas-final-report-2014.pdf
January 01, 2014 - Main outcome measures
included: time from prescription to corresponding follow-‐up laboratory test … ; proportion of follow-
‐up time that patients achieved corresponding risk factor control (A1c, LDL … Among intervention PCPs at follow-‐up, we also
specifically asked about facilitators and barriers … -‐up and when patients and providers should be
alerted when follow-‐up testing did not occur, and … For the 6 patient-‐PCP pairs for whom follow up visits
were not recorded, 3 were lost to follow up
-
digital.ahrq.gov/sites/default/files/docs/survey/interview-guide-to-assess-targeting-medication-nonadherence-using-mobile-phone-messages.pdf
June 16, 2021 - Potential follow-up: Was this
due to the content of the
message?
ii. … Potential follow-up: Was this
because it was received on
your phone?
2. … Potential follow-up: How often and
how many messages would you prefer
to receive?
7. … related activities, such as tracking your
condition, interacting with a healthcare
provider, or looking up
-
digital.ahrq.gov/ahrq-funded-projects/patient-choice-telemedicine-encounters
February 28, 2025 - Primary care telemedicine and care continuity: Implications for timeliness and short-term follow-up healthcare … Technology: Telehealth/Telemedicine
Telemedicine versus in-person primary care: Treatment and follow-up … Telemedicine versus in-person primary care: Treatment and follow-up visits. … Primary care video and telephone telemedicine during the COVID-19 pandemic: Treatment and follow-up health … Treatment and follow-up care associated with patient-scheduled primary care telemedicine and in-person
-
digital.ahrq.gov/sites/default/files/docs/survey/baseline-clinician-interview-script.pdf
June 16, 2021 - Interview Questions
These questions follow up on some of the topics covered in the survey you filled … In your opinion, what are the reasons why clinicians don't follow the guidelines for HTN care? … Do you ever use eCW to pull up summaries for groups ofpatients? … I also have some follow-up questions about information sources and practice guidelines. … How often do you look up information on medications during patient visits?
-
digital.ahrq.gov/sites/default/files/docs/publication/uc1hs015431-brooks-final-report-2007.pdf
January 01, 2007 - 0.552
Follow-up 22 23
Admissions Baseline 15.0 (24.0) 9.0 (13.0)
Follow-up 11.0 (24.0) 9.0 (15.0 … 22 23
0.349
Follow-up 22 23
Admissions Baseline 65.5 (92.0) 48.0 (58.0)
Follow-up 73.0 (94.0) … 23
0.516
Follow-up 21 22
Admissions Baseline 49.0 (75.0) 48.0 (70.0)
Follow-up 49.0 (79.0) 48.5 … (n) Baseline 22 23
0.689
Follow-up 21 22
Admissions Baseline 63.5 (108.0) 55.0 (58.0)
Follow-up … )
Follow-up 86.0 (104.0) 72.5 (107.0)
Compliance (%) Baseline 65.6 71.8
Follow-up 73.8 78.0
*The
-
digital.ahrq.gov/sites/default/files/docs/publication/r18hs017786-ritchie-final-report-2012.pdf
January 01, 2012 - Primary care and specialist follow-up (Pillar 3): The IVR encouraged patients to follow-
up with their … Those
who stated to the IVR they had no follow-up appointment were called by the CTN; the
CTN engaged … in problem-solving dialogue with the patient about making a follow-up
5 … Red flags indicated answers
from the patient that warranted a follow-up all by the care transition coach … Many red flags were identified, suggesting a real need for post-discharge
care and follow-up.