Integrating behavioral health care into a primary care setting is a great way to expand the very limited availability of psychiatrists, psychologists, social workers and other professionals with this expertise who are in particularly high demand as patients need support during the COVID-19 pandemic.
It can mean having behavioral health professionals within the same walls of a primary care practice, or practicing primary care as a team with professionals who provide services in or from other locations, or both.
As discussed in a recent AMA Clinical Case Study webinar, when you can make telehealth services part of your integrated behavioral healthcare model, it only enhances the services that can be provided and extends clinicians’ reach to patients who otherwise wouldn’t be that. The ability to easily access mental and behavioral health services.
The interactive webinar provides participants with an overview of opportunities and technologies to deliver integrated mental and behavioral health care through telehealth. A physician and licensed social worker from Oak Street Health, a large network of Medicare value-based primary care centers for adults in Medicare with locations in more than a dozen states, and is based in Chicago, shared their experiences in adding telehealth to integrated behavioral health care. . A North Carolina pediatrician shared her small experience of jumping into telehealth using integrated behavioral health care during COVID-19.
The webinar is part of a telehealth immersion program designed to help clinicians, health practices, and systems implement, improve, sustain, and scale their telehealth efforts. It is also part of the AMA STEPS Forward™ Innovation Academy that allows clinicians to learn from their peers and experts and discover ways to implement time-saving practice innovation strategies.
At Oak Street Health, when shelter requests arrived in place, they had 36 hours to get 40 behavioral health care professionals on an online platform. They have tried to keep the workflow as normal as possible for everyone involved, and move the usual workflows to a default format. As things improved, Oak Street continued a flexible hybrid model of care.
Psychiatrist Justin Hunt, MD, medical director of behavioral health at Oak Street Health, said the model helped them:
- Reduce transportation barriers.
- Have the flexibility to find the right level of care for each person, which can be in-person, video-in-center, video-to-home, phone-to-home, or group.
- Removing access barriers due to poor geographical distribution of nurses and psychiatrists.
- Caring for more patients through psychological counseling compared to 1:1 care.
“It really adds to being a fantastic system for treating patients,” said Dr. Hunt. “If someone has general, direct anxiety, the phone may be fine. But if you need a more robust evaluation of a person with psychosis, getting them into the center is probably the best way to go.”
At a pediatrician’s office in Burlington, North Carolina, which has seen some families for three generations, the epidemic necessitated figuring out how to benefit from their own integrated behavioral health care. It has allowed pediatricians at Burlington Pediatrics to reach their patients in new ways, pediatrician Yoon Boylston, MBA, said during the webinar.
College-aged patients attending school in the state with mental health issues can use telehealth to connect with pediatricians they know well and families feel comfortable connecting during a time when behavioral health needs are increasing for everyone. In one case, a mother was concerned about her daughter’s level of anxiety but could not bring the baby because she was in the intensive care unit with her husband. I used dr. Boylston Telehealth to connect with a mother in one place and a child who was with her grandmother in another.
“I felt like a doctor, this was the time I really met a patient where they needed me and met them wherever they were,” she said. “I’m looking forward to closing this kind of gap even further in the future.”
To help clinicians create practices that are able to help treat the entire patient, the AMA has created
BHI Collaborative with seven other leading medical societies and established the BHI Compendium as a comprehensive collection of online resources.