As health care providers journey deeper in to an era that focuses on improving population health and patient outcomes across delivery settings, one of the integrations that is being sought is an important one between physical health and behavioral health. Physicians and PAs, whether they be in small to large independent practices or in large health systems, are faced on a daily basis with the need to treat patients with both physical and behavioral health issues. Treatment of conditions such as depression in primary care is faced with challenges. The State of Washington will be mandating that physicians be formally trained about suicide prevention. Access to experienced prescribers for drugs to treat behavioral health and timely referrals for ongoing treatment have barriers attached to them. Medical records for patients are incomplete, frequently lacking data about mental health care treatment. Lack of understanding about the reality of privacy laws applicable to access certain information that is perfectly legal to obtain further complicates having relevant patient data. Shortcomings in interoperability of EHRs and the need to often fax patient information are still further difficulties. Getting to full integration of care in this regard isn’t going to be easy or swift. However, it is a laudable goal for patients and all physicians--and one that is being directed from Baltimore, Washington, DC, and Olympia. So, we have to start somewhere when examining further evolutions along the timeline of integration and what can be accomplished in the short term.
With that in mind, the Pierce County Medical Society is going to focus on three immediate goals in the coming weeks and months to assist physicians across all care settings—training, treatment, and referral.
Training—What additional trainings can be accessed by physicians in Pierce County to learn more about screening for behavioral health issues with their patients?
Treatment—What additional resources can be accessed by physicians in Pierce County to improve treatment, especially in the primary care setting, of behavioral health issues such as depression?
Referral—In the instances where the best behavioral health care for the patient must come from another practitioner, what referral method works best for each physician? In-house consults, telemedicine, effective hand-offs to providers in another venue, neighborhood linkages between the physical health care provider and the behavioral health care provider, and in-home follow-up by community health workers or other caregivers are all possibilities, among others.
PCMS is in initial conversations about these matters with potential local collaborators for interested physicians to utilize if they would like assistance in these areas. The Society is keeping in close touch with the large health systems to seek the widest possible reach and the highest levels of success for population health improvement in our community. PCMS also continues to advocate for more behavioral health resources in Pierce County due to a woeful shortage of capability. This includes strong support for the new Tacoma hospital backed by CHI Franciscan and MultiCare. Stay tuned for more developments in these areas. Additionally, future PCMS Practice Success Forum webinars will feature guest speakers about successes in achieving behavioral health and physical health integration.
In the meantime, if there is a behavioral health training or referral resource that has worked for you that you believe your fellow physicians might benefit from, please send your suggestion or experience to PCMS Executive Director Bruce Ehrle at firstname.lastname@example.org
At the link below is a recent piece in HealthLeaders Media about integration being a vital component of efforts to improve population health as well as in the movement toward payment based on quality and value: