Integrated care, the process of coordinating physical and mental health care, can often seem unattainable due to limited provider resources or the lack of behavioral health expertise in primary care. While very real, these barriers can also be viewed as opportunities for thoughtful applications of integrated care technology that can solve many of the fundamental challenges providers face in an overwhelmed healthcare system.
In a recent webinar, “Overcoming the Top Five Barriers to Integrated Care,” Dr. Tom Zaubler, Chief Medical Officer at NeuroFlow, and Matt Miclette, VP of Clinical Operations at NeuroFlow, explored common challenges to implementing integrated care and strategies to overcome them. In this blog we’ll share some of the key takeaways from that session. Register to watch the full webinar here.
No Resources to Integrate Care
One of the most common objections we hear from the providers we work with is that they don’t have the resources, particularly the staff, to manage and execute care integration. Many care teams are overwhelmed supporting high need populations and only have the bandwidth to refer individuals with behavioral health needs to behavioral health specialists. But, because the traditional healthcare system is so siloed, and there is a shortage of behavioral health specialists to meet the current need, many of these referrals are never completed. Referred individuals often return to providers because their physical and mental health continues to deteriorate.
Integrating care actually frees up care team resources because many patients, particularly those with chronic conditions, return to providers less frequently when a model like collaborative care or behavioral health integration is in place. “That revolving door starts to revolve a lot more slowly,” said Tom in the webinar. “Patients are not as likely to need readmission medically because you are addressing the underlying psychiatric issues, and the patients are getting better.”
Technology also plays an important role by providing greater efficiency. Technology solutions support remote delivery of assessments, making population-wide screening possible. Moreover, technology can easily collect and analyze behavioral health data and transfer that information to the provider’s EHR. These workflows eliminate the manual data entry and additional workload many providers expect when considering integrated care.
Lack of Behavioral Health Care Expertise
Another common concern providers often cite is a lack of training and expertise in behavioral health care. Some providers fear prescribing to individuals with behavioral health conditions due to liability concerns. Counterintuitively, primary care providers are actually the leading prescribers of psychotropics like antidepressants. This concern also overlooks the fact that most integrated care models embrace a team-based approach where behavioral health care managers and psychiatric consultants are involved in treatment plans.
In the collaborative care model, for example, a psychiatric consultant will review a provider’s caseload and recommend treatment plans. Behavioral health care managers, usually social workers, often provide brief interventions and counseling to further support individuals in the provider’s case load.
Technology also facilitates care team collaboration and streamlines integrated care delivery. “Technology has allowed us to do this remotely,” said Matt. “We can request remote psychiatric consultations during case reviews where we discuss each patient. It’s a very efficient way to deliver psychiatric care to a population.”
Watch the Webinar
The above points are just some of the objections to integrated care that Tom and Matt analyzed and challenged during the webinar. They provided practical advice on leveraging technology to scale integrated care, strategies to improve cost effectiveness, and tips for gradually integrating care within a health system. Watch the complete webinar discussion here.