Integrated healthcare is a system of care delivery that incorporates the physical, mental, social and, at times, financial perspectives into the deployment of patient care. The integrated healthcare model is one that responds to the complexity of the US healthcare system with a simplified and holistic approach that depends on multidisciplinary teams of providers working cohesively to execute.
The inefficiencies, fragmentation and misaligned incentives that hurt the modern healthcare system are being met with an innovative, integrative model. It addresses healthcare challenges by consolidating care while offering a wider range of medical and even non-medical services in a single setting.
Primary care is in an optimal position to integrate care to provide a higher standard of health services with efficiency, treating patients in a way that reflects the impact high-quality care can have on their lives. Integration at the primary care level can benefit patients by fostering productive relationships with more frequent and higher-quality engagement. Additional avenues for community and public health initiatives are primed to take advantage of the deeper trust the integrative care model can foster between practitioners and patients.
What makes healthcare integrative?
Integrated care is a collaboration between different healthcare touchpoints working in concert to deliver coordinated care. Integrated care enables a higher degree of personalization, cost-effectiveness and improved outcomes.
While much of the conversation justifiably revolves around how mental health care can be better incorporated into the integrated primary care model, it isn’t the only type of care that can be included.
An integrated care service array can include:
- Mental health care
- Preventative care
- Community-based care
- Family medicine care
- Elder care
- Chronic disease management
- Health monitoring
- Testing and diagnostics
These types of care, along with mental health care and behavioral health services, represent a future primary care model that addresses a range of health needs and focuses on the whole patent. Rather than addressing patients’ acute complaints within a vacuum, only for frustrations and visits to mount, diverse services can anticipate and address a wider range of needs.
These services can offer:
- Medication management
- Nutritional services
- Counseling services
- Family therapy
- Case management
- Social services
- Digital health services
Integrating Your Practice
To work properly, integrative care must address the front and back ends of the point of care. An integrated primary care model will require modifications at the clinical, operational, cultural and even financial levels of your organization. While in some cases this will involve a substantive modification of your current processes, there are intermediate steps you can take while developing your long-term integrative plan.
Hire Flexible Practitioners
While any integrated model is going to rely on the expertise of a team of providers, flexibility to address more patient needs with single practitioners is key. Under the supervision of licensed MDs or DOs, physician assistants and nurse practitioners are in a prime position to deliver this flexibility.
In a more formalized mental health treatment setting featuring complex cases, NPs require credentials to act as psychiatric mental health nurse practitioners (PMHNP). But in primary care settings, NPs can become frontline caregivers to those with depressive disorder, anxiety disorder and ADHD. NPs can boost their impact in mental health care with CME conferences that feature perspectives on mental health in primary care settings.
PAs are also qualified to treat mental health cases within the primary care environment without specialized credentials. However, depending on the type of care being delivered, it may be best to hire, or support the credentialing of, a PA with an NCCPA Psychiatry CAQ.
Take a Longitudinal Perspective
Depending on your position within your healthcare organization, you may have a lot of control over how quickly you can start providing integrated services, or none at all. The true operational and cultural transition required for integrative care won’t happen overnight. Here are some ways to start the process:
- Incorporate population health perspectives. Psychosocial care models like integrative care depend on not only understanding the biology of illness but systemic risks that contribute to it. Get in front of patients’ health issues before they lead to illness. For instance, discuss the risks of black mold with lower-income patients who live in regions prone to it.
- Consider your patients’ mental health. Poor mental health is not only a contributing factor to physical illness but is a key aspect of treatment compliance and patient outlook. Try expanding your patient intake interviews to include more questions about mental health.
- Accept a wider range of patients. After years of shrinking, the primary care scope of practice is expanding to new areas. Ask prospective patients what services they have access to. If your primary care clinic is their only provider, be open to meeting their other needs.
- Perform point of care testing. An important facet of the integrative care model is in-house and same-day testing services using highly-functional and cost-effective technologies. Patients who have to travel to a separate facility for testing see their costs rise and their continuity of care diminished.