Skip to main content
. Author manuscript; available in PMC: 2020 Feb 12.
Published in final edited form as: J Am Geriatr Soc. 2018 Oct 3;66(10):2009–2016. doi: 10.1111/jgs.15465

Figure 2.

Figure 2.

In the primary care provider (PCP) office, eligible patients are identified, the PCP invites them, and they are given a facilitator appointment. Facilitators guide patients in developing priorities and filling out a priorities template for the electronic health record (EHR). The patient returns to the PCP at a regular or special visit and discusses priorities. PCP and patient work to align care with priorities. Facilitator then follows up with patient to reinforce priorities. The primary care and cardiology offices communicate regarding PPC patients to ensure patients are flagged in cardiology EHR and that the cardiologist has referral, priorities template, and PCP note. Cardiologist discusses priorities and works to align care with patient priorities. Cardiologist and PCP communicate.