Intervening at Three Levels to Integrate Behavioral Science into the PCMH Jim Hopkins, PhD, LCSW

Introduction What role and level of participation are behavioral scientists playing in the PCMH process of development? Who is doing what? How do we get a handle on the level or degree of incorporation into the PCMH process that the behaviorists have attained? Are we partnering with the Family Physicians to create a whole person care model?

Intro-continued Do we have a unified communications strategy to promote the Behaviorist role in the new PCMH to the other shareholders? Has a mind/body model of healthcare been brought to the attention of the employers, insurers, consumers, and lawmakers?

Need for a Unified Effort Level A – STFM Interest Groups Level B – Practical Aspects of Integration Level C – Reaching Other Systems, Educating and Lobbying the other Stakeholders

STFM Interest Groups Behavioral Science Group on PCMH – set up a communications forum for discussion, problem solving and teaching around the medical home. STFM Education Committee

Practical Steps to Integration “Clearly, before there can be a true collaboration between the medical and mental health domains of medicine, there must be a substantial integration of these dimensions into a common contextual framework.” - Nymburg,J. et al. ‘The art of quietly making noise: orchestrating the integration of behavioral healthcare into a …’ Families, Systems, and Health, Spring,2000, Vol18, p 106.

B. How do we envision our role? Practical steps toward integration, e.g. - One treatment plan containing elements from behavioral scientist and primary care provider, working as teammates, sharing space and files, collaborating in case conceptualization and treatment planning, clarifying roles and goals, (other ideas…)

Other Activities Participate in pilot PCMH projects Incorporate Behavioral Science into insurers’ procurement and performance assessment activity. Build coalitions in support of Behavioral Scientists. Integrate Behavioral Science into other corporate health strategies, e.g. prevention and stress reduction efforts.

C. Reaching other systems Educational and Lobbying Efforts to employers, insurers, consumers, federal and state lawmakers on the essential contributions of Behavioral Scientists to effective and efficient care of the whole patient in the PCMH.

Other Systems Collaborative Family Healthcare Association Kaiser-Permanente, Institute for Health Research Robert Graham Center for Policy Studies in Family Medicine and Primary Care

Educating and Lobbying “Significantly less attention has been paid to the political, relational, and organizational skills that are needed to accomplish the task of actual integration.” – Blount, A. (Ed.) 1998 Integrated Primary Care: The Future of Medical and Mental Health Collaboration. New York: WW Norton.

What do we need to do? Communicate Plan Organize Act Evaluate