Janice L. Genevro, PhD

 

This is the ninth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

There is growing awareness of the importance of supporting patient self-management as part of a comprehensive approach to caring for people with chronic conditions. This is in part the recognition that 15 minutes with a provider every few months contributes less to patient outcomes than what the patient does every day. This month’s article describes some elements of AHRQ’s Self-Management Support Resource Library, a collection of materials and tools produced by AHRQ and others.

It was developed to help primary care team members learn about self-management support and develop their self-management support skills in working with chronically ill patients. To help practices improve this essential aspect of comprehensive primary care, the resources address what self-management support is, how to implement it, and why it is important. A good place to start is with AHRQ-produced videos that examine the “what, why, and how” of self-management support from the perspectives of experienced primary care teams in sites across the country. These videos also are available on AHRQ Primary Care YouTube channel.

The Library’s resources also include materials from other sources. These include Helping patients help themselves: How to implement self-management support, a paper from the California Health Care Foundation. It defines self-management support (SMS), provides case studies of primary care practices that have implemented SMS, and discusses the business case for SMS. Case studies include settings such as primary care practices, behavioral health programs, and telephone consultations featuring SMS models that rely on the actions of nurses, medical assistants, community health workers (promotoras), and health coach volunteers. “Helping patients take charge of their chronic illnesses” is an article from the American Academy of Family Physicians that introduces SMS concepts, provides a rationale for patient self-management, and gives an example of how to empower patients with information. It makes a case for shifting from an acute-care model to a patient-centered care model that includes SMS.

Enhancing the patient’s ability to manage medication is important. Clearly stating medication instructions improves patient understanding and possibly reduces errors while improving adherence. Explicit and standardized prescription medicine instructions offers tested instructions to simplify complex medicine regimens by using standard time periods for administration. These instructions have also been translated into Chinese, Korean, Russian, Spanish, and Vietnamese.

How to create a pill card helps users create an easy-to-use “pill card” for anyone who has a hard time keeping track of their medicines. Step-by-step instructions, sample clip art, and suggestions for design and use will help to customize a reminder card.

The self-management resources are further supported by AHRQ’s resources to improve health literacy. These were described in more detail in the 5th article in this series (January 2018). In brief, these resources include The Health Literacy Universal Precautions Toolkit–2nd edition and its companion guide, Implementing the Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices. In addition, the Patient Education Materials Assessment Tool features a systematic method to evaluate and compare how understandable and actionable patient education materials are.

 

All of this can come with recertification credit. The Patient Self-Management Support of Chronic Conditions: Framework for Clinicians Seeking Recertification Credit (Maintenance of Certification, Part IV & Performance Improvement–Continuing Medical Education) provides a free, self-contained framework for clinicians to design their own quality improvement project.
 

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is director of the National Center for Excellence in Primary Care Research at AHRQ.

 

This is the ninth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

There is growing awareness of the importance of supporting patient self-management as part of a comprehensive approach to caring for people with chronic conditions. This is in part the recognition that 15 minutes with a provider every few months contributes less to patient outcomes than what the patient does every day. This month’s article describes some elements of AHRQ’s Self-Management Support Resource Library, a collection of materials and tools produced by AHRQ and others.

It was developed to help primary care team members learn about self-management support and develop their self-management support skills in working with chronically ill patients. To help practices improve this essential aspect of comprehensive primary care, the resources address what self-management support is, how to implement it, and why it is important. A good place to start is with AHRQ-produced videos that examine the “what, why, and how” of self-management support from the perspectives of experienced primary care teams in sites across the country. These videos also are available on AHRQ Primary Care YouTube channel.

The Library’s resources also include materials from other sources. These include Helping patients help themselves: How to implement self-management support, a paper from the California Health Care Foundation. It defines self-management support (SMS), provides case studies of primary care practices that have implemented SMS, and discusses the business case for SMS. Case studies include settings such as primary care practices, behavioral health programs, and telephone consultations featuring SMS models that rely on the actions of nurses, medical assistants, community health workers (promotoras), and health coach volunteers. “Helping patients take charge of their chronic illnesses” is an article from the American Academy of Family Physicians that introduces SMS concepts, provides a rationale for patient self-management, and gives an example of how to empower patients with information. It makes a case for shifting from an acute-care model to a patient-centered care model that includes SMS.

Enhancing the patient’s ability to manage medication is important. Clearly stating medication instructions improves patient understanding and possibly reduces errors while improving adherence. Explicit and standardized prescription medicine instructions offers tested instructions to simplify complex medicine regimens by using standard time periods for administration. These instructions have also been translated into Chinese, Korean, Russian, Spanish, and Vietnamese.

How to create a pill card helps users create an easy-to-use “pill card” for anyone who has a hard time keeping track of their medicines. Step-by-step instructions, sample clip art, and suggestions for design and use will help to customize a reminder card.

The self-management resources are further supported by AHRQ’s resources to improve health literacy. These were described in more detail in the 5th article in this series (January 2018). In brief, these resources include The Health Literacy Universal Precautions Toolkit–2nd edition and its companion guide, Implementing the Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices. In addition, the Patient Education Materials Assessment Tool features a systematic method to evaluate and compare how understandable and actionable patient education materials are.

 

All of this can come with recertification credit. The Patient Self-Management Support of Chronic Conditions: Framework for Clinicians Seeking Recertification Credit (Maintenance of Certification, Part IV & Performance Improvement–Continuing Medical Education) provides a free, self-contained framework for clinicians to design their own quality improvement project.
 

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is director of the National Center for Excellence in Primary Care Research at AHRQ.

 

This is the ninth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

There is growing awareness of the importance of supporting patient self-management as part of a comprehensive approach to caring for people with chronic conditions. This is in part the recognition that 15 minutes with a provider every few months contributes less to patient outcomes than what the patient does every day. This month’s article describes some elements of AHRQ’s Self-Management Support Resource Library, a collection of materials and tools produced by AHRQ and others.

It was developed to help primary care team members learn about self-management support and develop their self-management support skills in working with chronically ill patients. To help practices improve this essential aspect of comprehensive primary care, the resources address what self-management support is, how to implement it, and why it is important. A good place to start is with AHRQ-produced videos that examine the “what, why, and how” of self-management support from the perspectives of experienced primary care teams in sites across the country. These videos also are available on AHRQ Primary Care YouTube channel.

The Library’s resources also include materials from other sources. These include Helping patients help themselves: How to implement self-management support, a paper from the California Health Care Foundation. It defines self-management support (SMS), provides case studies of primary care practices that have implemented SMS, and discusses the business case for SMS. Case studies include settings such as primary care practices, behavioral health programs, and telephone consultations featuring SMS models that rely on the actions of nurses, medical assistants, community health workers (promotoras), and health coach volunteers. “Helping patients take charge of their chronic illnesses” is an article from the American Academy of Family Physicians that introduces SMS concepts, provides a rationale for patient self-management, and gives an example of how to empower patients with information. It makes a case for shifting from an acute-care model to a patient-centered care model that includes SMS.

Enhancing the patient’s ability to manage medication is important. Clearly stating medication instructions improves patient understanding and possibly reduces errors while improving adherence. Explicit and standardized prescription medicine instructions offers tested instructions to simplify complex medicine regimens by using standard time periods for administration. These instructions have also been translated into Chinese, Korean, Russian, Spanish, and Vietnamese.

How to create a pill card helps users create an easy-to-use “pill card” for anyone who has a hard time keeping track of their medicines. Step-by-step instructions, sample clip art, and suggestions for design and use will help to customize a reminder card.

The self-management resources are further supported by AHRQ’s resources to improve health literacy. These were described in more detail in the 5th article in this series (January 2018). In brief, these resources include The Health Literacy Universal Precautions Toolkit–2nd edition and its companion guide, Implementing the Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices. In addition, the Patient Education Materials Assessment Tool features a systematic method to evaluate and compare how understandable and actionable patient education materials are.

 

All of this can come with recertification credit. The Patient Self-Management Support of Chronic Conditions: Framework for Clinicians Seeking Recertification Credit (Maintenance of Certification, Part IV & Performance Improvement–Continuing Medical Education) provides a free, self-contained framework for clinicians to design their own quality improvement project.
 

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is director of the National Center for Excellence in Primary Care Research at AHRQ.

 

This is the seventh in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Thus far, this series has discussed topics such as shared decision making, team-based care, and integrating behavioral health and primary care. All of these are important topics, but this raises the question, “How do I make the changes to my practice?” This month’s article discusses AHRQ’s resources for transforming your practice to be able to better introduce these advances.

A good place to start is AHRQ’s Improving Primary Care Practice page, which offers a wide range of resources designed to help practices improve their care. Here are some of the improvement topics for which resources are available:

Building capacity for quality improvement in primary care. Primary care practices often benefit from external support and assistance while they develop the capacity to carry out quality improvement activities as an integral part of their work. These resources describe approaches and supports that are needed to build QI capacity in primary care.

 

Care coordination. The main goal of care coordination is to meet patients’ needs and preferences in the delivery of high-quality, high-value health care. This means that the patient’s needs and preferences are known and communicated at the right time to the right people, which results in safe, appropriate, and effective care. AHRQ’s resources in this area offer examples of care coordination approaches and activities, as well as guidance and models for understanding and measuring patients’ perceptions of care coordination.

Improvement approaches related to patient engagement and support. Several different types of resources related to patient engagement are available. These include the what, why, and how of self-management support, implementing health literacy universal precautions, and engaging patients and families in patient safety efforts.

AHRQ’s Primary Care YouTube channel offers videos from clinical staff, researchers, and others describing their work in many of these areas.

Other resources also are available. One of the most popular approaches to transformation involves taking steps to make your practice a patient-centered medical home (PCMH). AHRQ’s Patient-Centered Medical Home Resource Center website features evidence, examples, and lessons learned from primary care practices that have transformed their approach to the organization and delivery of care. Policymakers, researchers, practices, and practice facilitators can access evidence-based resources about the medical home and its potential to transform primary care and improve the quality, safety, efficiency, and effectiveness of U.S. health care.

 

While the goal of practice transformation is the improvement of patient care and patient outcomes, patient and staff satisfaction (including issues regarding provider burnout) must not be lost in the process. The Clinician & Group Survey of the Consumer Assessment of Healthcare Providers and Systems assesses patient experiences with health care providers and staff in doctors’ offices. Survey results can be used to improve care provided by individual providers, sites of care, medical groups, or provider networks, as well as equip consumers with information they can use to choose physicians and other health care providers, physician practices, or medical groups. The survey includes standardized questionnaires for adults and children. The adult questionnaire can be used in both primary care and specialty care settings; the child questionnaire is designed for primary care settings but could be adapted for specialty care. Users can also add supplemental items to customize their questionnaires.

For many practices, working with a practice facilitator will be a big part of the transformation. Practice facilitation is an evidence-based approach to quality improvement in primary care practices. It will be discussed at length next month. In addition, in July and August, we will discuss optimizing health information technology and workflow in your practice.

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is the director of the National Center for Excellence in Primary Care Research at AHRQ.

 

This is the seventh in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Thus far, this series has discussed topics such as shared decision making, team-based care, and integrating behavioral health and primary care. All of these are important topics, but this raises the question, “How do I make the changes to my practice?” This month’s article discusses AHRQ’s resources for transforming your practice to be able to better introduce these advances.

A good place to start is AHRQ’s Improving Primary Care Practice page, which offers a wide range of resources designed to help practices improve their care. Here are some of the improvement topics for which resources are available:

Building capacity for quality improvement in primary care. Primary care practices often benefit from external support and assistance while they develop the capacity to carry out quality improvement activities as an integral part of their work. These resources describe approaches and supports that are needed to build QI capacity in primary care.

 

Care coordination. The main goal of care coordination is to meet patients’ needs and preferences in the delivery of high-quality, high-value health care. This means that the patient’s needs and preferences are known and communicated at the right time to the right people, which results in safe, appropriate, and effective care. AHRQ’s resources in this area offer examples of care coordination approaches and activities, as well as guidance and models for understanding and measuring patients’ perceptions of care coordination.

Improvement approaches related to patient engagement and support. Several different types of resources related to patient engagement are available. These include the what, why, and how of self-management support, implementing health literacy universal precautions, and engaging patients and families in patient safety efforts.

AHRQ’s Primary Care YouTube channel offers videos from clinical staff, researchers, and others describing their work in many of these areas.

Other resources also are available. One of the most popular approaches to transformation involves taking steps to make your practice a patient-centered medical home (PCMH). AHRQ’s Patient-Centered Medical Home Resource Center website features evidence, examples, and lessons learned from primary care practices that have transformed their approach to the organization and delivery of care. Policymakers, researchers, practices, and practice facilitators can access evidence-based resources about the medical home and its potential to transform primary care and improve the quality, safety, efficiency, and effectiveness of U.S. health care.

 

While the goal of practice transformation is the improvement of patient care and patient outcomes, patient and staff satisfaction (including issues regarding provider burnout) must not be lost in the process. The Clinician & Group Survey of the Consumer Assessment of Healthcare Providers and Systems assesses patient experiences with health care providers and staff in doctors’ offices. Survey results can be used to improve care provided by individual providers, sites of care, medical groups, or provider networks, as well as equip consumers with information they can use to choose physicians and other health care providers, physician practices, or medical groups. The survey includes standardized questionnaires for adults and children. The adult questionnaire can be used in both primary care and specialty care settings; the child questionnaire is designed for primary care settings but could be adapted for specialty care. Users can also add supplemental items to customize their questionnaires.

For many practices, working with a practice facilitator will be a big part of the transformation. Practice facilitation is an evidence-based approach to quality improvement in primary care practices. It will be discussed at length next month. In addition, in July and August, we will discuss optimizing health information technology and workflow in your practice.

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is the director of the National Center for Excellence in Primary Care Research at AHRQ.

 

This is the seventh in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Thus far, this series has discussed topics such as shared decision making, team-based care, and integrating behavioral health and primary care. All of these are important topics, but this raises the question, “How do I make the changes to my practice?” This month’s article discusses AHRQ’s resources for transforming your practice to be able to better introduce these advances.

A good place to start is AHRQ’s Improving Primary Care Practice page, which offers a wide range of resources designed to help practices improve their care. Here are some of the improvement topics for which resources are available:

Building capacity for quality improvement in primary care. Primary care practices often benefit from external support and assistance while they develop the capacity to carry out quality improvement activities as an integral part of their work. These resources describe approaches and supports that are needed to build QI capacity in primary care.

 

Care coordination. The main goal of care coordination is to meet patients’ needs and preferences in the delivery of high-quality, high-value health care. This means that the patient’s needs and preferences are known and communicated at the right time to the right people, which results in safe, appropriate, and effective care. AHRQ’s resources in this area offer examples of care coordination approaches and activities, as well as guidance and models for understanding and measuring patients’ perceptions of care coordination.

Improvement approaches related to patient engagement and support. Several different types of resources related to patient engagement are available. These include the what, why, and how of self-management support, implementing health literacy universal precautions, and engaging patients and families in patient safety efforts.

AHRQ’s Primary Care YouTube channel offers videos from clinical staff, researchers, and others describing their work in many of these areas.

Other resources also are available. One of the most popular approaches to transformation involves taking steps to make your practice a patient-centered medical home (PCMH). AHRQ’s Patient-Centered Medical Home Resource Center website features evidence, examples, and lessons learned from primary care practices that have transformed their approach to the organization and delivery of care. Policymakers, researchers, practices, and practice facilitators can access evidence-based resources about the medical home and its potential to transform primary care and improve the quality, safety, efficiency, and effectiveness of U.S. health care.

 

While the goal of practice transformation is the improvement of patient care and patient outcomes, patient and staff satisfaction (including issues regarding provider burnout) must not be lost in the process. The Clinician & Group Survey of the Consumer Assessment of Healthcare Providers and Systems assesses patient experiences with health care providers and staff in doctors’ offices. Survey results can be used to improve care provided by individual providers, sites of care, medical groups, or provider networks, as well as equip consumers with information they can use to choose physicians and other health care providers, physician practices, or medical groups. The survey includes standardized questionnaires for adults and children. The adult questionnaire can be used in both primary care and specialty care settings; the child questionnaire is designed for primary care settings but could be adapted for specialty care. Users can also add supplemental items to customize their questionnaires.

For many practices, working with a practice facilitator will be a big part of the transformation. Practice facilitation is an evidence-based approach to quality improvement in primary care practices. It will be discussed at length next month. In addition, in July and August, we will discuss optimizing health information technology and workflow in your practice.

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is the director of the National Center for Excellence in Primary Care Research at AHRQ.

This is the fourth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Many patients with anxiety, depression, behavioral problems, substance abuse, and other mental and behavioral health conditions turn to their primary care providers as their first, and often only, source of mental health care. Unfortunately, this care may not be as effective as patients and primary care personnel would hope or expect it to be. Problems exist with missed or inaccurate diagnoses, referrals and coordination of care, and other failures in detection and treatment (NIMH Integrated Care Web site, accessed Oct. 1, 2017).

There are evidence-based ways to improve this care, however. Behavioral health integration is care that results from a practice team of primary care and behavioral health clinicians, working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population. This care may address common primary care issues such as mental health and substance abuse conditions, health behaviors (including their contribution to chronic medical illness), life stressors and crises, stress-related physical symptoms, and ineffective patterns of health care utilization. The Agency for Healthcare Research and Quality created the Academy for Integrating Behavioral Health and Primary Care to serve as a national resource and a coordinating center for people committed to delivering comprehensive, whole-person health care.

Through the Academy’s web portal interested clinicians, health care administrators, quality improvement specialists, and others can access a wide range of resources related to behavioral health integration. A hallmark of the site is the Integration Playbook, developed as a guide to integrating behavioral health in primary care and other ambulatory care settings. The Playbook assists the growing number of primary care practices and health systems that are beginning to design and implement integrated behavioral health services. The Playbook’s implementation framework is designed to be meaningful at any level of integration development.

The Playbook is backed by years of AHRQ work that produced the Academy’s Lexicon for Behavioral Health and Primary Care Integration. The Academy’s Lexicon was created in recognition of the importance of developing shared language that enables communication and collaboration across sites, disciplines, and time. It is a set of concepts and definitions developed by expert consensus to provide a functional definition of behavioral health integration as implemented in actual practice settings. The consensus Lexicon enables effective communication and concerted action among clinicians, care systems, health plans, payers, researchers, policymakers, and patients working for effective, widespread implementation on a meaningful scale.

One challenge in implementing primary care and behavioral health integration is connecting the community engaged in integrated health care. Often behavioral health and primary care providers operate within the same building or organization but are not be aware of each other’s presence. One goal of the Academy is to unite these disparate efforts and direct providers towards one another in an attempt to facilitate collaboration. In the same vein, the Academy aims to offer resources to patients and the community on integration, including the identification of integrated practices they can access.

In addition, in order to measure quality of care in this new approach to health care delivery, the Academy created the Atlas of Integrated Behavioral Health Care Quality Measures. Intended for practices and teams that wish to understand whether they are providing high-quality integrated behavioral health care or are preparing to implement integrated care, the Atlas aims to support the field of integrated behavioral health care measurement by 1) presenting a framework for understanding measurement of integrated care; 2) providing a list of existing measures relevant to integrated behavioral health care; and 3) organizing the measures by the framework and by user goals to facilitate selection of measures.
 

Links from the NCEPCR site:

Tools and Resources for Research, Quality Improvement, and Practice

https://www.ahrq.gov/ncepcr/research-qi-practice/practice-transformation-qi.html

Academy Web Portal: https://www.integrationacademy.ahrq.gov

The Integration Playbook: https://integrationacademy.ahrq.gov/playbook/about-playbook

Lexicon: https://integrationacademy.ahrq.gov/lexicon

Atlas of Integrated Behavioral Health Care Quality Measures: https://integrationacademy.ahrq.gov/resources/ibhc-measures-atlas

These and other tools can be found at the NCEPCR Web site: https://www.ahrq.gov/ncepcr.

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is director, National Center for Excellence in Primary Care Research, AHRQ.

This is the fourth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Many patients with anxiety, depression, behavioral problems, substance abuse, and other mental and behavioral health conditions turn to their primary care providers as their first, and often only, source of mental health care. Unfortunately, this care may not be as effective as patients and primary care personnel would hope or expect it to be. Problems exist with missed or inaccurate diagnoses, referrals and coordination of care, and other failures in detection and treatment (NIMH Integrated Care Web site, accessed Oct. 1, 2017).

There are evidence-based ways to improve this care, however. Behavioral health integration is care that results from a practice team of primary care and behavioral health clinicians, working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population. This care may address common primary care issues such as mental health and substance abuse conditions, health behaviors (including their contribution to chronic medical illness), life stressors and crises, stress-related physical symptoms, and ineffective patterns of health care utilization. The Agency for Healthcare Research and Quality created the Academy for Integrating Behavioral Health and Primary Care to serve as a national resource and a coordinating center for people committed to delivering comprehensive, whole-person health care.

Through the Academy’s web portal interested clinicians, health care administrators, quality improvement specialists, and others can access a wide range of resources related to behavioral health integration. A hallmark of the site is the Integration Playbook, developed as a guide to integrating behavioral health in primary care and other ambulatory care settings. The Playbook assists the growing number of primary care practices and health systems that are beginning to design and implement integrated behavioral health services. The Playbook’s implementation framework is designed to be meaningful at any level of integration development.

The Playbook is backed by years of AHRQ work that produced the Academy’s Lexicon for Behavioral Health and Primary Care Integration. The Academy’s Lexicon was created in recognition of the importance of developing shared language that enables communication and collaboration across sites, disciplines, and time. It is a set of concepts and definitions developed by expert consensus to provide a functional definition of behavioral health integration as implemented in actual practice settings. The consensus Lexicon enables effective communication and concerted action among clinicians, care systems, health plans, payers, researchers, policymakers, and patients working for effective, widespread implementation on a meaningful scale.

One challenge in implementing primary care and behavioral health integration is connecting the community engaged in integrated health care. Often behavioral health and primary care providers operate within the same building or organization but are not be aware of each other’s presence. One goal of the Academy is to unite these disparate efforts and direct providers towards one another in an attempt to facilitate collaboration. In the same vein, the Academy aims to offer resources to patients and the community on integration, including the identification of integrated practices they can access.

In addition, in order to measure quality of care in this new approach to health care delivery, the Academy created the Atlas of Integrated Behavioral Health Care Quality Measures. Intended for practices and teams that wish to understand whether they are providing high-quality integrated behavioral health care or are preparing to implement integrated care, the Atlas aims to support the field of integrated behavioral health care measurement by 1) presenting a framework for understanding measurement of integrated care; 2) providing a list of existing measures relevant to integrated behavioral health care; and 3) organizing the measures by the framework and by user goals to facilitate selection of measures.
 

Links from the NCEPCR site:

Tools and Resources for Research, Quality Improvement, and Practice

https://www.ahrq.gov/ncepcr/research-qi-practice/practice-transformation-qi.html

Academy Web Portal: https://www.integrationacademy.ahrq.gov

The Integration Playbook: https://integrationacademy.ahrq.gov/playbook/about-playbook

Lexicon: https://integrationacademy.ahrq.gov/lexicon

Atlas of Integrated Behavioral Health Care Quality Measures: https://integrationacademy.ahrq.gov/resources/ibhc-measures-atlas

These and other tools can be found at the NCEPCR Web site: https://www.ahrq.gov/ncepcr.

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is director, National Center for Excellence in Primary Care Research, AHRQ.

This is the fourth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Many patients with anxiety, depression, behavioral problems, substance abuse, and other mental and behavioral health conditions turn to their primary care providers as their first, and often only, source of mental health care. Unfortunately, this care may not be as effective as patients and primary care personnel would hope or expect it to be. Problems exist with missed or inaccurate diagnoses, referrals and coordination of care, and other failures in detection and treatment (NIMH Integrated Care Web site, accessed Oct. 1, 2017).

There are evidence-based ways to improve this care, however. Behavioral health integration is care that results from a practice team of primary care and behavioral health clinicians, working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population. This care may address common primary care issues such as mental health and substance abuse conditions, health behaviors (including their contribution to chronic medical illness), life stressors and crises, stress-related physical symptoms, and ineffective patterns of health care utilization. The Agency for Healthcare Research and Quality created the Academy for Integrating Behavioral Health and Primary Care to serve as a national resource and a coordinating center for people committed to delivering comprehensive, whole-person health care.

Through the Academy’s web portal interested clinicians, health care administrators, quality improvement specialists, and others can access a wide range of resources related to behavioral health integration. A hallmark of the site is the Integration Playbook, developed as a guide to integrating behavioral health in primary care and other ambulatory care settings. The Playbook assists the growing number of primary care practices and health systems that are beginning to design and implement integrated behavioral health services. The Playbook’s implementation framework is designed to be meaningful at any level of integration development.

The Playbook is backed by years of AHRQ work that produced the Academy’s Lexicon for Behavioral Health and Primary Care Integration. The Academy’s Lexicon was created in recognition of the importance of developing shared language that enables communication and collaboration across sites, disciplines, and time. It is a set of concepts and definitions developed by expert consensus to provide a functional definition of behavioral health integration as implemented in actual practice settings. The consensus Lexicon enables effective communication and concerted action among clinicians, care systems, health plans, payers, researchers, policymakers, and patients working for effective, widespread implementation on a meaningful scale.

One challenge in implementing primary care and behavioral health integration is connecting the community engaged in integrated health care. Often behavioral health and primary care providers operate within the same building or organization but are not be aware of each other’s presence. One goal of the Academy is to unite these disparate efforts and direct providers towards one another in an attempt to facilitate collaboration. In the same vein, the Academy aims to offer resources to patients and the community on integration, including the identification of integrated practices they can access.

In addition, in order to measure quality of care in this new approach to health care delivery, the Academy created the Atlas of Integrated Behavioral Health Care Quality Measures. Intended for practices and teams that wish to understand whether they are providing high-quality integrated behavioral health care or are preparing to implement integrated care, the Atlas aims to support the field of integrated behavioral health care measurement by 1) presenting a framework for understanding measurement of integrated care; 2) providing a list of existing measures relevant to integrated behavioral health care; and 3) organizing the measures by the framework and by user goals to facilitate selection of measures.
 

Links from the NCEPCR site:

Tools and Resources for Research, Quality Improvement, and Practice

https://www.ahrq.gov/ncepcr/research-qi-practice/practice-transformation-qi.html

Academy Web Portal: https://www.integrationacademy.ahrq.gov

The Integration Playbook: https://integrationacademy.ahrq.gov/playbook/about-playbook

Lexicon: https://integrationacademy.ahrq.gov/lexicon

Atlas of Integrated Behavioral Health Care Quality Measures: https://integrationacademy.ahrq.gov/resources/ibhc-measures-atlas

These and other tools can be found at the NCEPCR Web site: https://www.ahrq.gov/ncepcr.

Dr. Genevro is a health scientist at AHRQ. Dr. Ganiats is director, National Center for Excellence in Primary Care Research, AHRQ.