J Am Board Fam Med
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Comparative Study Observational Study
Clinician Staffing, Scheduling, and Engagement Strategies Among Primary Care Practices Delivering Integrated Care.
To examine the interrelationship among behavioral health clinician (BHC) staffing, scheduling, and a primary care practice's approach to delivering integrated care. ⋯ Practices' approaches to PCC-BHC staffing, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context. Practice leaders, educators, clinicians, funders, researchers, and policy makers must consider these factors as they seek to optimize integrated systems of care.
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Comparative Study Observational Study
Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.
This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. ⋯ Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with clinicians, should intentionally design EHR products that support integrated care delivery functions, such as data documentation and reporting to support tracking patients with emotional and behavioral problems over time and settings, integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions such as depression, and improved registry functionality and interoperability. This work will require financial support and cooperative efforts among clinicians, EHR vendors, practice assistance organizations, regulators, standards setters, and workforce educators.
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Comparative Study Observational Study
Preparing the Workforce for Behavioral Health and Primary Care Integration.
To identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. ⋯ Insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. Until the training capacity grows to meet the demand, practices must put forth considerable effort and resources to train their own employees.
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This study reports REACH (the extent to which an intervention or program was delivered to the identified target population) of interventions integrating primary care and behavioral health implemented by real-world practices. ⋯ REACH of integrated care interventions differed by practices' method of assessing patients. Measuring REACH is important to evaluate the extent to which integration efforts affect patient care and can help demonstrate the impact of integrated care to payers and policy makers.
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Iowa has the highest average radon concentrations in the nation, with an estimated 400 radon-induced lung cancer deaths each year. Radon is the second leading cause of lung cancer death overall. The objectives of this study were (1) to educate the population attending a family medicine office about the dangers of radon, (2) to encourage homeowners to test for radon, (3) to work with the community to identify resources for mitigation, and (4) to assess the utility of working with a local family medicine office as a model that could be adopted for other communities with high home radon concentrations. ⋯ Four of 5 homes tested had elevated radon levels. This family medicine office/university collaborative educational model could be useful for educating patients about other environmental dangers.