Prepare the Infrastructure in Your Setting

Educate Patients and Families About Integrated Ambulatory Care

Integrated primary care or integrated ambulatory care is a change in the way care is provided for many patients. For this reason, it is important to help patients and families understand integration—your organization’s rationale for offering integrated behavioral health, the benefits to patients and families, and how the experience of care may change for patients.

When patients understand the link between mind and body and the problem of fragmented care, they are more likely to communicate a behavioral health need to their provider and become advocates for the benefits of integrated care. Informed patients will use the integrated system rather than segregating their medical concerns from their stress or behavioral health concerns. Patients will come to expect integrated care as a standard of care, which will help drive widespread adoption of integrated care.

North Star

The setting takes every opportunity to help patients see how integrated care benefits them. Patients expect that integrated behavioral health care is a standard of quality care.

What is the North Star?

The North Star

The North Star reflects ideal practices of an integrated behavioral health and ambulatory care setting. The North Star can act as a goal or guide toward your desired state of integration.

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How Do You Do It?

To gain patient understanding and support for integrated care, you should educate and engage patients about the benefits of an integrated practice. An effective way to do this is to develop and implement a setting-wide outreach plan. Engage providers and staff in this plan as they are key players in developing patient understanding of integrated care. By speaking positively with patients about the behavioral health provider and integrated services, practice staff can help overcome any stigma still associated with behavioral health diagnoses.

An outreach plan has two key goals: orienting patients to integrated ambulatory care and encouraging patients to actively participate in their integrated care.

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Develop orientation materials to introduce patients and families to the value and benefits of integrated ambulatory care. This involves flyers, posters, and repeated messages from providers and staff. Use the following approaches to encourage patients to expect behavioral health to be integrated into their care:

  • Explain the benefits of integrated ambulatory care using a range of common examples that patients will easily recognize.
  • Explain how providers incorporate behavioral health expertise into their workflow—what the patient can expect during visits, scheduling, and contacts between visits. Describe the roles of the members of the care team and explain how they collaborate.
  • Post materials on your setting’s online patient portal or Web site and make them available in the practice.
  • Provide tip sheets that teach providers how to talk with their patients about integrated care.
    • Tip sheets can help providers recognize opportunities to enhance patient understanding of the relationships between physical and behavioral health and the value of integrated workflows.
    • Consider including the following ideas in your tip sheets:
      • Collect psychosocial information along with medical information as part of the evaluation of any problem.
      • Note that stress (or depression or anxiety) may be a contributing factor when describing the differential diagnosis to the patient.
      • Consider a “trial” of behavioral health care to reduce the impact of the patient’s underlying problem while you are investigating it.
      • Introduce behavioral health services as part of the practice’s normal protocol for the patient’s problem.
      • Consider describing a patient’s problem using words that leave etiology open (e.g., distress, pain, struggle) when behavioral and physical factors might be involved.

Useful Resource(s) for Educating Patients and Families About Integrated Primary/Ambulatory Care

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For patients to receive the greatest benefit from integrated care, they must actively communicate symptoms to their providers, remain engaged throughout their care, and ask questions about their care. By doing the following, you can encourage patients to be engaged in their care:

  • Provide a tip sheet for patients on questions to ask their provider:
    • Include questions that directly relate to care integration.
    • Post the tip sheet on the setting’s online patient portal or Web site so patients can come to appointments prepared to be engaged in their integrated care.
  • Invite patients and family members to ask about the symptoms of behavioral health conditions and the challenges in overcoming them.
  • Share patient stories of integrated care experiences. Sharing patients’ experiences can help set patient expectations regarding integration of care and its benefits.

To further engage patients, include them in the design and improvement of the practice. Consider starting a patient advisory group and inviting patients to actively participate. A patient advisory group, which includes patients and caregivers, can help you develop an outreach plan and can provide useful feedback on the materials developed. Through active participation, patients can develop a better understanding of the conversations and materials intended to engage them in their own care.

How Others Are Doing It

  • MaineHealth created short videos to share patients’ and families’ experiences with mental health disorders in primary care settings. In these videos, patients and family members describe their struggles and what they wish they had known when they began navigating primary and integrated care settings for behavioral health treatment.

    In addition, MaineHealth featured a patient’s experience with the Mental Health Integration Program in a series of reports created to highlight different programs offered by MaineHealth. Read the patient’s story in MaineHealth’s Community Health Impact Series.

Useful Resource(s) for Encouraging Patients to Ask Questions About Their Care

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What Not to Do

  • Don’t assume patients know or understand the benefits of receiving integrated care.
  • Don’t assume patients understand how integration functions in your setting.
  • Don’t lecture or talk down to patients while trying to convince them to embrace integrated care. Instead, make it easier for them to recognize the benefits and engage them in these changes in the practice.
  • Don’t use a script that sounds hollow and staged for educating patients on integration. Instead, help each provider and staff member find his or her own words for informing patients during visits about the benefits of integrated care.

Contribute

The Playbook includes many examples of how sites have implemented specific aspects of integration. If you would like to contribute, please send us your example of how your organization educates patients and families about integrated primary (or integrated ambulatory) care.

Send Us Your Example

Resources

Integrated Care Rack Card

An example of a rack card that describes how integrated care can help with patients’ emotional needs.

Source: MaineHealth
Behavioral Health Services Brochure

An example of a brochure that provides patients with information about integrated behavioral health care.

Source: Hahnemann Family Health Center
What Families Want from Primary Care

This brochure includes tips for providers on creating a setting that encourages conversations about mental health.

Source: National Alliance on Mental Illness
MaineHealth Community Health Impact Series

This report highlights the Mental Health Integration Program at MaineHealth by featuring a patient’s experience.

Source: MaineHealth
Questions to Ask Your Doctor

This patient resource includes questions to ask before, during, and after an appointment.

Source: AHRQ
8 Important Questions

A list of eight questions patients should ask with rationales for why each question is important.

Source: No Health Without Mental Health

Community

Do you have a question or a story to share? Connect with the Academy Community!

The Academy Community is an online community that brings together individuals and practices that are interested and committed to delivering comprehensive, integrated health care.