News
See what’s happening with integration in your neck of the woods:
New Jersey: Making Integration Happen
Integrated behavioral health is receiving quite a bit of attention in New Jersey. A recent opinion piece states the following: “Creating a more efficient and coordinated system that treats the whole person is the right move for New Jersey and especially for patients who will benefit from having their behavioral and physical needs met in the same hospital clinic or community health center.”
Gov. Chris Christie wants to transfer responsibility for New Jersey’s four state psychiatric hospitals, community-based mental health and addiction services, and other behavioral health programs from the Department of Human Services to the Department of Health later this summer. The governor’s plan is designed to improve government efficiency and coordination, and enable patients to receive more complete and effective care by better integrating behavioral and physical health services.
Moreover, the Nicholson Foundation is interested in funding integrated care in New Jersey.
Michigan: Integration Plan Considered Controversial
“What is going on at the Michigan health department about designing four pilot programs to test a controversial plan to combine physical and behavioral Medicaid services among mental health agencies, providers and HMOs?” says Jay Greene of Crain’s Detroit Business newspaper.
Read more using the links above.
California Looks to Support Behavioral Health Data Exchange
“The California Health & Human Services Agency’s Office of Health Information Integrity includes a litany of use cases in the recently published State Health Information Guidance to illustrate numerous instance where sharing protect health information is feasible legally and in the patient’s best interest…
Because patients with behavioral health conditions most likely receive treatment from a multitude of providers across disciplines, their mental health or substance abuse data must be part of an integrated care plan that gives members of the care team access to important information.”
Hawaii: Call for More Integrated Care
Washington State: Integration Saves Lives
Arizona: What is Integrated Care and Why Does it Matter
Research
Here are some of the latest findings on integrated care:
Embrace, integrated primary care for older adults: Embrace slightly improved the perceived quality of care, particularly for elderly people with complex care needs for whom case management was organized. Caregivers judged implementation of integrated care to be greatly improved, though there was still room for further improvement. Further research should be carried out into the effectiveness of integrated primary care for the elderly on health, service-use and healthcare costs.
Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes: The Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
Validating the Rainbow Model of Integrated Care Measurement Tool: This study aimed to validate The Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) which assesses, using a self-administered questionnaire, micro level (clinical), meso level (professional and organisational), macro level (system) and enabling (functional and normative) aspects of integrated care. Preliminary results suggest that the RMIC-MT is both a reliable and valid tool for assessing integrated care in different integrated care settings. The results of the construct and reliability analysis across countries will be presented, interpreted and discussed.
Primary Care Physicians’ Ability to Detect PTSD: This investigation sought to determine whether the complex nature of PTSD, particularly the frequent presence of comorbid physical symptoms that may overshadow PTSD, makes the disorder difficult to detect in primary care settings. These results suggest that primary care physicians are fully capable of accurately identifying PTSD when it presents, regardless of whether the presentation is straightforward or complex. However, limitations must be taken into consideration when interpreting the results, including lack of variance in detection rates.
Ethical and legal issues in integrated care settings: Case examples from pediatric primary care: The purpose of this article is to examine salient ethical and legal dilemmas that may emerge in pediatric IPC practice. These issues are examined through the use of 4 case illustrations that collectively address issues related to consent for services among pediatric populations, confidentiality, scope of practice for the pediatric IPC psychologist, and multiple relationships. We apply an adapted ethical decision-making framework to highlight practice points drawn from each of these cases.
Family therapy as an integrated care model for pediatricians: Family therapy is an important therapeutic modality for children and adolescents with behavioral health problems and disorders. Research studies have consistently demonstrated the efficacy of family therapy for select pediatric patients and their families. Principles of family therapy are presented in this discussion. Examples based on actual cases illustrate what family therapists do and how they might integrate their expertise into cases, while working side-by-side with pediatricians.
