Emergency medical services (EMS) in the United States are frequently used for nonurgent medical needs. Use of 911 and the emergency department (ED) for primary care-treatable conditions is expensive, inefficient, and undesirable for patients and providers. The objective is to describe the outcomes from community paramedicine (CP) and mobile integrated health care (MIH) interventions related to the Quadruple Aim. Three electronic databases were searched for peer-review literature on CP-MIH interventions in the United States. Eight articles reporting data from 7 interventions were included. Four studies reported high levels of patient satisfaction, and only 3 measured health outcomes. No study reported provider satisfaction measures. Reducing ED and inpatient utilization were the most common study outcomes, and programs generally were successful at reducing utilization. With reduced utilization, costs should be reduced; however, most studies did not quantify savings. Future studies should conduct economic analyses that not only compare the intervention to traditional EMS services, but also measure potential cost savings to the EMS agencies running the intervention. Most cost savings from reduced utilization will be to insurance companies and patients, but more efficient use of EMS agencies' resources could lead to cost savings that could offset intervention implementation costs. The other 3 aims (health, patient satisfaction, and provider satisfaction) were reported inconsistently in these studies and need to be addressed further. Given the small number of heterogeneous studies reviewed, the potential for CP-MIH interventions to comprehensively address the Quadruple Aim is still unclear, and more research on these programs is needed.

There is no substitute for experience when it comes to designing a PV power system. Almost all system requirements are unique in some way and the ability to anticipate the on-site challenges and design the system accordingly can help ensure an optimum system performance. It's the system performance that is measured and noted by the system user, not the solar panel performance. Although the solar panel usually gets blamed when performance is less than expected, it is usually a system problem such as a poor choice of components, inefficient system architecture, poor installation techniques, or possibly, the wrong PV technology for the application. Especially for the larger PV systems, the key challenge is to design a system that matches the requirements, the environment, location and application, resulting in a high level of performance.

A variety of patient, provider, and county characteristics were associated with CRC screening. Effective strategies to promote CRC screening should address multilevel factors, including: targeting patients with identified individual barriers, modifying physician and clinical practices, and focusing on communities with low socioeconomic status or low levels of medical resources.

No abstract

BACKGROUND The patient‐centered medical home (PCMH) is promoted as a way to improve access to care, health care outcomes, and control costs. The organizational, environmental, and patient characteristics associated with school‐based health centers (SBHCs) obtaining PCMH recognition is currently unknown. A multitheoretical approach was used to explore the correlates of formal PCMH recognition in SBHCs. METHODS The 2013‐2014 National Census of School‐Based Health Centers was used as the primary data source for this analysis. Multivariable logistic regression was used to assess the odds of an SBHC obtaining any type of PCMH recognition, and obtaining national PCMH recognition. RESULTS Only 29% of SBHCs had received any type of recognition as a PCMH and 17% reported receiving national‐level recognition. School‐based health centers that were managed care preferred providers, received Health Resources and Services Administration SBHC Capital Funding, and based in schools without adolescents had greater odds of both types of PCMH recognition outcomes. High levels of revenue from patient billing and more staff were also associated with national PCMH recognition. CONCLUSIONS Financial and personnel resources are needed for national‐level PCMH recognition, and managed care is supportive of PCMH implementation. Efforts should be made to increase medical home activity in SBHCs that serve adolescents.