1. Agency for Healthcare Research and Quality (AHRQ) Web-based Tools that Assess and Promote the Integration of Behavioral Health into Primary Care Practices Neil Korsen, MD, MsC, Medical Director, Behavioral Health Integration, MaineHealth Garrett Moran, PhD, Vice President, Westat Vasudha Narayanan, MA, MBA, MS, Associate Director, Westat Joshua Noda, MPP, Senior Study Director, Westat Collaborative Family Healthcare Association 17 th Annual Conference October 15-17, 2015 Portland, Oregon U.S.A. Session # D4a October 17, 2015

2. Faculty Disclosure The presenters of this session have NOT had any relevant financial relationships during the past 12 months.

3. Learning Objectives At the conclusion of this session, the participant will be able to: Better understand the products available on the AHRQ Academy web-based portal that support and promote integration of behavioral health into primary care. Conduct a self-assessment and determine aspects on integration they need help with and understand how to use the Integration Playbook for their respective setting/practice Utilize the tools and resources available on the AHRQ Academy web-based portal to gain additional knowledge about, and develop an action plan of next steps for integrating behavioral health into primary care.

4. Bibliography / Reference 1. Kathol, Roger G., and Bruce L. Rollman. "Value-based financially sustainable behavioral health components in patient-centered medical homes." The Annals of Family Medicine 12.2 (2014): 172-175. 2. Massachusetts Patient Centered Medical Home Initiative (2012). Behavioral Health Integration Tool Box: http://pcmhlearning.ehs.state.ma.us/atutor/login.php 3. Melek, S. P., D. T. Norris, and J. Paulus. "Economic impact of integrated medical- behavioral healthcare: Implications for psychiatry." Arlington VA: American Psychiatric Association (2014). 4. Patient-Centered Primary Care Institute (2013). Primary Care Behavioral Health Toolkit: http://www.pcpci.org/sites/default/files/resources/PCBH%20Implementation%2 0Kit _ FINAL.pdf 5. Safety Net Medical Home Initiative. Ratzliff A. Organized, Evidence-Based Care Supplement: Behavioral Health Integration. Phillips KE, Holt BS, eds. Seattle, WA: Qualis Health, MacColl Center for Health Care Innovation at the Group Health Research Institute, and the University of Washington ’ s AIMS Center; 2014

5. Funded under contract #HHSA290-2010-00002i by the Agency for Healthcare Research and Quality AHRQ Web-based Tools that Assess and Promote the Integration of Behavioral Health into Primary Care October 17, 2015

6. Purpose of Academy Project To build a centralized and respected resource hub to provide the tools and materials to advance integration, and to promote a collaborative environment for dialogue and discussion among leaders throughout behavioral health and primary health care arenas.

7. Academy Portal Literature Collection Clinical Outcome Measures HIT Case Studies Lexicon Workforce competencies IBHC Measures Atlas Implementation Playbook Tools Overview

8. Academy Portal http://integrationacademy.ahrq.gov/

9. New & Notable Section Integrated Care Map Portal Features

10. New & Notable

11. Integrated Care Map

12. Literature Collection http://integrationacademy.ahrq.gov/literaturecollection http://integrationacademy.ahrq.gov/literaturecollection

13. Literature Collection Includes literature published since 2000 Academy Literature Collection comprises approximately 3,200 journal article references. Over 500 Grey literature references are included in the Literature Collection to further the Academy’s mission to gather all sources of information on integration.

14. Clinical Outcome Measures http://integrationacademy.ahrq.gov/evaluationtools http://integrationacademy.ahrq.gov/evaluationtools

15. A literature search was conducted to find peer reviewed articles and reports that focus on the quality of integration between behavioral and physical health care settings. The literature search was limited to prevalent physical and mental health conditions that are commonly comorbid such as diabetes, cardiovascular disease, depression, and anxiety. Clinical health outcomes were used as the primary markers of quality. Clinical Outcome Measures

16. HIT Case Studies http://integrationacademy.ahrq.gov/content/Case%20Studies%20of%20HIT%20for%20Behavioral%20Health%20Integration http://integrationacademy.ahrq.gov/content/Case%20Studies%20of%20HIT%20for%20Behavioral%20Health%20Integration

17. Real-world examples of health systems and group practices that have adopted HIT tools for integrative purposes. – Cherokee Health Systems – Community Health Plan of Washington – Intermountain Healthcare – MaineHealth Case Studies highlight challenges and successes of the HIT implementations that may serve as a guide to practices in their efforts to integrate behavioral health in primary care. HIT Case Studies

18. The Lexicon http://integrationacademy.ahrq.gov/lexicon http://integrationacademy.ahrq.gov/lexicon

19. The Lexicon Set of concepts and definitions developed by expert consensus for what we mean by behavioral health and primary care integration—a functional definition —what things look like in practice. This consensus Lexicon enables effective communication and concerted action among clinicians, care systems, health plans, payers, researchers, policymakers, business modelers, and patients working for effective, widespread implementation on a meaningful scale.

20. A Guidebook of Professional Practices http://integrationacademy.ahrq.gov/sites/default/files/AHRQ_AcademyGuidebook.pdf http://integrationacademy.ahrq.gov/sites/default/files/AHRQ_AcademyGuidebook.pdf

21. Identifies the key professional practices that are prominent among exemplary integrated primary care organizations. Aim is to help other sites achieve the goal of integrating care more effectively. Findings are organized into two categories: Organization-Level Professional Practices and Interpersonal and Individual Professional Practices. A Guidebook of Professional Practices

22. Atlas of Integrated Behavioral Health Care Quality Measures http://integrationacademy.ahrq.gov/atlas http://integrationacademy.ahrq.gov/atlas

23. Aims to support the field of integrated behavioral health care measurement by: – Presenting a framework for understanding measurement of integrated care; – Providing a list of existing measures relevant to integrated behavioral health care; and – Organizing the measures by the framework and by user goals to facilitate selection of measures. Newly created User’s Guide IBHC Measures Atlas

24. Implementation Playbook

25. For practices working to integrate behavioral health in ambulatory care settings. Customized approach based on clinician’s setting’s Self-Assessment Checklist for Integrating Behavioral Health and Ambulatory Care results. Most tips and examples are offered with primary care in mind, but can translate to medical specialties such as neurology, oncology, or occupational medicine. At each step of implementation, the Playbook provides tips, resources, and examples for integrating behavioral health in your setting. The Playbook will help you find your own path for accomplishing integration by applying knowledge about using successful approaches and avoiding possible barriers. Implementation Playbook

26. Self-Assessment Checklist for Integrating Behavioral Health and Ambulatory Care

27. Developed based on the AHRQ Lexicon for Behavioral Health and Primary Care Integration. Maps to AHRQ’s Integration Playbook so that practices can use the assessment to customize their implementation approach for their setting. Used to assess where an organization stands with respect to all aspects of integration. Useful exercise as one navigates integrating behavioral health into a primary or ambulatory care setting. Can be used multiple times before, during, or after implementation of the integrated program Self-Assessment Checklist for Integrating Behavioral Health and Ambulatory Care

28. Academy Community Coming Soon!

29. Contact information: Neil Korsen, MD, MaineHealth - KORSEN@mmc.orgKORSEN@mmc.org Garrett Moran, PhD, Westat – GarrettMoran@westat.com GarrettMoran@westat.com Vasudha Narayanan, Westat – VasudhaNarayanan@westat.com VasudhaNarayanan@westat.com Joshua Noda, Westat - JoshuaNoda@westat.comJoshuaNoda@westat.com Integration Academy General Mailbox - integrationacademy@westat.com integrationacademy@westat.com Questions

30. Session Evaluation Please complete and return the evaluation form to the classroom monitor before leaving this session. Thank you!