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Spreading the gospel of care integration is not for sprinters. To be sure, this game is for long distance runners. One of the beauties of integration is that individual clinics and care systems can use whatever model meets the needs of their patients and matches their available resources. This variability, though, also makes it challenging for systematically disseminating integrated care and measuring effectiveness outcomes.
But this is old news, right? Many industries, including healthcare, have shared quality metrics that can measure value and performance at any site across the landscape. These metrics offer a shared language and measuring stick for researchers, payors, and process engineers to use. They reduce variability and allow organizations to connect, share, and learn from one another (e.g., benchmarking).
In the field of behavioral health integration, the National Committee for Quality Assurance (NCQA) and the Agency for Healthcare Research and Quality (AHRQ) have made past efforts to develop certifications and lexicons, respectively, to reduce variability in our field.
One natural outcome of these past efforts has been the development and distribution of validated measures of integration. These measurement tools allow an organization to quickly benchmark their performance against external criteria.
The Practice Integration Profile is an example of a validated measure of behavioral health integration that practices can use to determine their current level of integration. To date, the PIP has been used by thousands of practices across the United States.
A recent publication by Juvena Hitt et al., (2021) from the Journal of Clinical Psychology in Medical Settings reports new findings on the PIP’s internal consistency, intra-rater consistency, and inter-rater consistency with a large new sample of practices. The findings demonstrate the PIP is a reliable measure of integration. Practices may consider using the PIP as both a quality improvement and health services research tool.
Hitt et al. recommend future research should examine the use of the PIP in improvement and research projects and develop a shorter version of the measure. As integration becomes more the norm than the exception, managers, payors, and researchers should adopt reliable and validated measures that make their jobs easier.
More information about the Practice Integration Profile Version 2.0 is available here: https://www.umassmed.edu/cipc/scholarship-research/practice-integration-profile-pip/
Link to the PIP 2.0 is here: https://umassmed.co1.qualtrics.com/jfe/form/SV_2t5gZOBTkUlr5bL
Hitt, J.R., Brennhofer, S.A., Martin, M.P. et al. (2021). Further Experience with the Practice Integration Profile: A Measure of Behavioral Health and Primary Care Integration. J Clin Psychol Med Settings. https://doi.org/10.1007/s10880-021-09806-z
Macchi, C. R., Kessler, R., Auxier, A., Hitt, J. R., Mullin, D., van Eeghen, C., & Littenberg, B. (2016). The practice integration profile: rationale, development, method, and research. Families, Systems, & Health, 34(4), 334. https://doi.org/10.1037/fsh0000235
Mullin, D. J., Hargreaves, L., Auxier, A., Brennhofer, S. A., Hitt, J. R., Kessler, R. S., … & van Eeghen, C. (2019). Measuring the integration of primary care and behavioral health services. Health services research, 54(2), 379-389. https://doi.org/10.1111/1475-6773.13117
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