1. Health Related Lifestyle Interventions in Primary Care Samantha Monson, PsyD, Clinical Psychologist Robert Keeley, MD MSPH, Physician Matthew Engel, MPH, Researcher Collaborative Family Healthcare Association 15 th Annual Conference October 10-12, 2013 Broomfield, Colorado U.S.A. Session #E1c Friday, October 11, 2013

2. Faculty Disclosure We have not had any relevant financial relationships during the past 12 months.

3. Objectives Describe a unique model for handing patients back a portion of their care. Identify potential pitfalls in having patients drive their own care. Discuss the challenges of reframing an established integrated care model.

4. Lowry Family Health Center 8,000 unique patients per year Children & adults FM residency 7 medical providers – 5 MDs, 2 NPs 1 FTE psychologist/ psychology fellow 0.6 FTE LCSW

5. Current State Global Scope of Care: – Mental & Physical Care Environment – Integrated care – Patient centered care – Medical homes Primary preventative care Lowry Integrated with on site psychologist/fellow Patient Navigators for outreach NCQA PCMH Largely uninsured/publicly insured panel Onsite ancillary services

6. Integrated care Aims Center

7. Process Develop Instrument – Focus Groups – Interviews Engage Clinical Staff Implement Evaluate

8. Instrument Elicit Patient Goal Establish Readiness to change Engage with resources

9. Instrument

13. What went right Over 500 patients have filled in our form

15. What went right Over 500 patients have filled in our form Over 100 “warm hand-offs” to BHC 80% delivered some form of aid High satisfaction

16. What went right Patient resistance Staff resistance – Lack of consistency – Roll confusion Resources were misunderstood Challenge engaging telephonically not so v

17. Lessons Learned Behavior change takes everyone Question first Engage practice staff – Grassroots Read into resistance Prepare to enact cultural change

18. Culture Shift Patients are not always willing or ready to take control of their health Providers are not always willing or ready to give up that control New treatment options require extensive communication/coordination amongst teams

19. Learning Assessment Audience Question & Answer

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