Annals of family medicine
-
Annals of family medicine · Sep 2021
Technology-Enabled and Artificial Intelligence Support for Pre-Visit Planning in Ambulatory Care: Findings From an Environmental Scan.
Pre-visit planning (PVP) is believed to improve effectiveness, efficiency, and experience of care, yet numerous implementation barriers exist. There are opportunities for technology-enabled and artificial intelligence (AI) support to augment existing human-driven PVP processes-from appointment reminders and pre-visit questionnaires to pre-visit order sets and care gap closures. This study aimed to explore the current state of PVP, barriers to implementation, evidence of impact, and potential use of non-AI and AI tools to support PVP. ⋯ As health systems transition toward value-based payment models in a world where the coronavirus disease 2019 pandemic has shifted patient care into the virtual space, PVP activities-driven by humans and supported by technology-may become more important and powerful and should be rigorously evaluated.
-
Annals of family medicine · Sep 2021
"I Need to Keep Me and My Mother Safe": The Asylum Crisis at the US-Mexico Border.
In Tijuana, Mexico, 16-year-old Joaquin, a refugee from El Salvador where LGBTQ people are persecuted, was hoping for asylum in the United States based on sexual orientation. But as a volunteer physician in Tijuana, I had learned hard lessons about the asylum process-or lack thereof-at the US-Mexico border. ⋯ The lack of transparency about the realities of this system left thousands of families stranded in Mexico without basic rights such as health care. Health care professionals should be aware of the ongoing asylum crisis and be an active faction in the fight for its reform.
-
The story depicts my close relationship with Mr Schwartz, an elderly Holocaust survivor, spanning over 20 years. During those years, he became a significant patient to me; during my many home visits, we often shared significant conversations about life. When Mr Schwartz was diagnosed at age 90 with advanced cancer, we made an alliance whereby I would represent him in his decision not to receive medical interventions. ⋯ Over the years; I was moved by his honesty, frustrated at my inability to offer him relief or a sense of meaning, and pensive, as I would inevitably reflect on existential issues pertaining to myself and my dear ones. Mourning his loss was complex, for I was very close to him, yet not a part of his family. With whom can we physicians share our sadness at the loss of a person with whom we never actually spent a holiday or family dinner?