With an overwhelmed workforce and a surge in mental health service demand, integration is becoming essential to address a consistent issue in behavioral health: access.
Ashley Shattuck, program manager for integrated care and primary care, Hartford (Conn.) HealthCare Medical Group, told Becker’s the system has implemented a collaborative care model that utilizes clinicians who patients already trust — primary care providers.
Hartford HealthCare has integrated 15 licensed clinical social workers who provide behavioral health services into over 40 primary care offices, with 12 offices and three care managers supporting the collaborative care model. A team of three — a psychiatric consultant, a care manager and a primary care provider — works with patients to manage behavioral health conditions in the primary care setting.
The model’s evolving registry of about 150 patients has seen a 78.29% positive change in PHQ-9 scores and an 82% positive change in GAD-7 scores, with average enrollment ranging from three to six months. In the past six months, 45 patients have graduated, Ms. Shattuck said.
Understanding how to achieve and track outcomes has been a focus for the system.
“We have been very intentional about entering those baseline PHQ-9 scores and GAD-7 scores… entering the interval scores when [psychiatrists are] doing systematic case review… and also entering the resolve date and the score, so that way we can track in Epic various outcomes,” Ms. Shattuck said.
These outcomes include graduating from the program, which may occur due to a 50% reduction in scores, scores within a therapeutic range or based on subjective experience. Upon graduation, patients receive certificates and a wellness plan to use if symptoms recur.
All information is available via the online chart, where primary care providers and patients can review the easy-to-access care plan, helping the team stay aligned.
“[The system] focuses on educating not just the primary care providers, but the practice as a whole,” Ms. Shattuck said. “We actually leverage the whole team of the office as just as important in being the eyes and ears and helping the primary care providers identify patients who could benefit from integrated care services.”
Provider surveys, scripting for nurses and medical assistants, and testimonial videos are a few strategies the system uses to educate staff.
Leadership is key to achieving those outcomes, she said.
Primary care providers work to educate and encourage colleagues to utilize the evidence-based model. Education empowers the team to feel more comfortable when explaining collaborative care, especially due to the nuance of the model, Ms. Shattuck said.
