This year is almost over, a signal it is time to highlight all the great blog posts published in 2018. We have terrific writers in the CFHA community who collectively represent unequaled experience and thinking in the field right now. Catherine Van Fossen et al wrote about a new tool that measures family functioning. They wrote “family functioning is not consistently measured in clinical health care settings or large-scale studies investigating child wellness. … we sought to identify a measure that enabled individuals to report their own functioning.” Barry Jacobs, a national expert on family caregiving, asks “So can families reduce healthcare costs? Probably, though we need many more robust studies with different populations to settle the question.”
One area we emphasize on the CFHA blog is research in integration. A constant challenge in disseminating integrated care is controlling the variability that naturally comes with the different clinic contexts and patient demographics across the country. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) is a tool for measuring fidelity to the Primary Care Behavioral Health (PCBH) model. Greg Beehler reported that “the PPAQ-2 will [soon] be made available. … [it] has been expanded and re-validated to include new subscales to address essential components of collaborative care management. The PPAQ-2 will now be useful for both PCBH providers and care managers.”
We had a short series on quality improvement in health care by Alex Young and Kevin Raddean. Alex gave a brief description of QI while Kevin introduce readers to the fishbone diagram, (aka Ishakawa diagram). Finally, we published two reports on current finding in research: one in September and then one in November. Check out these reports for a quick guide to latest findings in integration.
Many CFHA members are heavily involved in training the next generation of workers in collaborative care, giving us a good reason to cover this subject on a regular basis. Each year we promote the STFM behavioral science fellowship, this year written by Max Zubatsky. Writing about supervision in integrated care, Kyler Shumway argues that “On the playing field of integrated care, supervisors have the opportunity to equally inspire and lead others.” Lastly, Katie Snow gives advice for new workers in the field of integration. She writes “For those who, like me, enter the integrated care world as a mental health provider not formally trained or experienced in PCBH or another model, working in a medical clinic feels like visiting a distant land with unfamiliar customs and language.” Her five tips will certainly help any new professional.
A regular topic on the blog is the PCBH model, a popular approach that is gaining in momentum but outpacing empirical research. Dennis Freeman answered questions about strategies for financing a PCBH-based service. He argues that “BHCs working in the PCBH model need to prove–with data–the presence of the behavioral health provider on the primary care team improves clinical outcomes, enhances practice efficiency and reduces total healthcare costs for the panel of patients cared for by the practice.” Ryan Landoll reports results of a quality improvement project undertaken by the USAF using PCBH within a stepped care framework. In one year, these sites doubled the number of behavioral health encounters, reached 150% more of the beneficiary population, and saved community mental health costs by over $100,000. These results far outpaced their peer institutions while maintaining high levels of patient satisfaction. We published other PCBH posts on patient outcomes and emergency room visits.
Next year the blog format will change significantly. We are moving to a columnist-model and are combining the CFHA and Families & Health blogs into one single blog featuring posts on innovations in team-based and family-centered collaborative care. Have a wonderful start to the New Year and stay tuned for more great writing in 2019.