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Article History

Received: 30 March 2026

Accepted: 6 July 2026

First Online: 4 August 2026

Declarations

Conflict of interest: This study was funded by the U.S. Department of Health and Human Services, Office of the National Coordinator for Health IT (Cooperative Agreement #90AX0043). Federal authors contributed to this work as part of their official duties. Accordingly, the funding organization had a role in the design and conduct of the study; collection, management, analysis, and interpretation of deidentified data; preparation and review of the manuscript; and the decision to submit the manuscript. M.H.G. and C.R. are employees of the U.S. Department of Health and Human Services and report no conflicts of interest. J.E. is an employee of Georgetown University and reports no conflicts of interest. R.P. and A.B. are employees of the American Board of Family Medicine and contributed to this research through Cooperative Agreement #90AX0043. In the past 36 months, R.P. has received grant support from the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention; served as a subcontractor for the American Family Cohort Research Study; lectured at George Washington University; consulted with the Health Minister of Alberta, Canada; and served as an advisor to the National Academies’ Consensus Study on Family Caregivers and the Health Care Cost Institute. In the past 36 months, A.B. has served as President-Elect of the North American Primary Care Research Group (NAPCRG) and as a member of the Board of Directors for the Rural Medical Training Consortium. Robert Phillips currently serves as the Home Secretary of the National Academy of Medicine.