Family Medicine

Protected EHR-only slots increased productivity without reducing patient communication

Reserving one appointment slot per half-day for asynchronous EHR work was associated with higher physician productivity per session. Protected time modestly reduced overall EHR work without shifting tasks to nights or weekends. Patient communication volume, including messaging, did not decline after implementing the protected EHR slot. This scheduling change appears to improve efficiency while preserving access and timely responses. 1

Remote GP consultations surged during COVID-19 with persistent sociodemographic disparities

Among 19 million English adults, remote consultations rose from 10.1 million to 32.7 million annually during the pandemic. Before COVID-19, adults aged 85 years and older most often used remote visits; during the pandemic, ages 18–49 became predominant users. Men were consistently less likely than women to have remote consultations across all years. The most affluent patients had the lowest probability of remote consultations before and during the pandemic. White patients had the highest probability of remote use, underscoring equity concerns as digital access expands. 2

Later primary care visits were linked to poorer antihypertensive filling and adherence

In 936,502 U.S. adults with hypertension, later appointment times were associated with lower odds of prescription filling and 90-day adherence. Compared with 7 AM visits, 5 PM visits had 8.8% lower odds of filling and 10.6% lower odds of adherence. Each later hour corresponded to shorter visits, fewer days’ supply, and less fixed-dose combination prescribing. These time-of-day patterns appeared only for filled prescriptions, implicating prescribing and dispensing processes rather than patient characteristics. 3

Immigrant children had worse access, partly offset by inclusive state insurance policies

Analysis of 277,386 children showed immigrant children had lower odds of uninterrupted insurance than U.S.-born peers. They also had reduced odds of a usual place for primary and sick care and higher odds of foregone medical care. Immigrant children experienced more difficulty obtaining subspecialty referrals, even after multivariable adjustment. In states with the most inclusive insurance policies, immigrant children had substantially higher odds of uninterrupted coverage than in restrictive states. 4