Whether doing traditional referral or using any of the more advanced treatment/referral models outlined here, Patient Tools is a great solution for consistent, reliable and cost-effective detection.

Better Detection
One of the core requirements for Integrated Behavioral Health (IBH) is the ability to consistently, reliably and cost-effectively detect patients with psychosocial problems.  Consistent detection is best done using an annual protocol (initial visit, annual physical) to screen for issues and then performing in-depth assessment when indicated by the screening results, or for patients with previous problems, or as determined by the PCP.  For reliable detection, use standard, validated questionnaires such as the PHQ-9 or Duke Health Profile for screening and the QPD or full PHQ for in-depth assessment.  To be cost-effective, use Patient Tools automation where the patient self-administers electronically, taking the workload off the staff.  This level of detection and detail, supports appropriate medication, treatment and/or referral for any of the treatment models outlined below.

Behavioral Health Care Manager (BHCM)  Models
Rather than each PCP maintaining a referral network for mental health issues, it has been shown to be cost-effective, especially in larger or networked organizations, to provide a single point of contact for the PCP to hand off patients for case management of their psychosocial issues.  These types of implementations are designed to improve referral effectiveness and are often registry-based, employing Disease Management techniques for education and follow-up.  While these types of models streamline the referral process, its still referral, and not as effective as engaging the patient in the Primary Care setting. 

Diagnosis, Assessment, Referral and Treatment (DART) Models
A higher level of integration that engages the patient in the Primary Care setting is the co-located DART or Triage therapist.  When the PCP has identified a patient with psychosocial issues, they hand them off to the DART therapist for in-depth assessment and diagnosis.  If appropriate, the DART therapist can treat the patient with medications or Brief Intervention therapies or for more severe problems, refer and consult with a psychologist or psychiatrist for treatment.  The major advantage of this model is that the initial diagnosis and treatment is at least co-located in the Primary Care setting reducing the typically high rate of "no shows" associated with referrals.

Behavioral Health Consultant (BHC)  Models
A BHC combines the integrated aspects of a DART with a large component of collaboration as part of the medical team.  The PCP remains the primary provider, consulting with the BHC around medications, courses of treatment or referral.  The BHC generally works with the patient in the same exam room as the PCP, sometimes jointly, doing diagnosis, Brief Intervention therapy when appropriate and covering a broader scope of behavioral issues (pain management, obesity, missing rehabilitation sessions, etc).  This type of model has the benefit of making behavioral health part of normal health, building on the trust the patient has already developed with the PCP.  This works particularly well in rural settings and is being mandated for many federally operated or funded organizations.

Telemedicine Models
In many rural or frontier settings, there simply is not a BH professional available, so many programs and grants are being setup around patients teleconferencing from the Primary Care office to a BH professional at a central location.  Using Patient Tools to detect and initially assess electronically, works well making the patient information instantly available at the central location.

Please Contact Us to learn more or discuss how Integrated Behavioral Health might work in your setting.