Collaborative Care Improves Psychiatric Treatment in Primary Care
A collaborative care system which employed weekly online case consultations with psychiatrists, was associated with improved diagnosis and treatment of psychiatric disorders among rural primary care physicians, according to the results of a recent study.
“The collaborative care model of integrated care has a large evidence base supporting its effectiveness in treating behavioral health disorders in primary care. National policy efforts and new billing codes for bundled payment have increased the model’s dissemination, but this complex model requires substantial effort to implement,” the authors explained.
In order to investigate the effectiveness and feasibility of employing such a system, the researchers conducted a qualitative study involving interviews with clinical and nonclinical staff from 3 rural primary care facilities in Washington state which were using the collaborative care model for the treatment of psychological disorders. Using this information, they developed a conceptual model of training through telepsychiatric consultation, which they pilot-tested at a university hospital-based clinic before revising their guides.
Overall, 17 participants completed interviews.
“We found that primary-care doctors involved in this collaboration got better at diagnosing, prescribing, and working as a team,” said lead author Dr. Morhaf Al Achkar, associate professor of family medicine at the University of Washington School of Medicine, in a press release.
The results also identified specific benefits of the system, including fidelity of the care process, team resilience amid member turnover, and enhanced capacity for quality improvement methods.
“Weekly systematic case reviews using telepsychiatric consultation served both as a model for patient care and as a training and workforce development strategy in rural primary care sites delivering collaborative care. These are important benefits to consider in implementing the collaborative care model of behavioral health integration,” the researchers concluded.
—Michael Potts
References:
- Al Achkar M, Bennett IM, Chwastiak L, et al. Telepsychiatric consultation as a training and workforce development strategy for rural primary care. Ann Fam Med. 2020;18(5):438-445. DOI: 10.1370/afm.2561
- An effective way to increase capacity for mental health. News release. UM Medicine. September 14, 2020. https://newsroom.uw.edu/news/effective-way-increase-capacity-mental-health