Table 1.

Population-centered digital interventions for primary care.

First author, year	Study design	Description of technology	Sample size	Selected outcomes
Nagykaldi, 2014 [172]	Pre-post	Linking of a regional health system, hospital organization, and preventive services reminder system via HIEa.	346 patients (20% ethnic minorities)	12%-36% increase in preventive service documentation and delivery (P<.001). 9.6% increase in medication reconciliation (P<.001).
Nagykaldi, 2017 [171]	Pre-post	Wellness coordinator connection to HIE organizations, PCPsb, county health departments, and hospitals for preventive care outreach for rural communities.	9138 rural patients	3%-215% increase in delivery of 10 preventive services over 12 months (P=.004). 80% ROIc for selective preventive services (range, 32%-122%). 40% ROI on wellness coordinator employment cost.
Fanizza, 2018 [81]	Open label nonrandomized	Pharmacist connection to the state HIE for comprehensive medication review after discharge and communication with prescribers.	40 patients	25.2% decrease in overall 30-day readmission rates (P=.03). 22.7% decrease in 30-day readmission rates for initial diagnosis (P=.009).
Shade, 2015 [199]	Pre-post	Clinic link to the state surveillance system providing alerts when out-of-care HIV patients present in the EDd or other settings.	6 sites serving underserved communities	ORe 2.61 (95% CI 2.11-3.21) for care retention (P=.001). OR 1.24 (95% CI 1.03-1.49) for being on ARTf (P=.02). OR 4.16 (95% CI 2.54-6.80) for undetectable viral load (P<.001).

^aHIE: health information exchange.

^bPCP: primary care provider.

^cROI: return on investment.

^dED: emergency department.

^eOR: odds ratio.

^fART: antiretroviral therapy.