TY - JOUR
KW - Adult
KW - Cooperative Behavior
KW - Delivery of Health Care, Integrated
KW - Female
KW - Humans
KW - Male
KW - Mental Health Services
KW - Middle Aged
KW - Primary Health Care
KW - Program Development
KW - Questionnaires
KW - United States
KW - United States Department of Veterans Affairs/organization & administration
KW - Veterans Health
AU - M. Tai-Seale
AU - M. E. Kunik
AU - A. Shepherd
AU - J. Kirchner
AU - A. Gottumukkala
A1 - 
AB - Primary care remains critically important for those who suffer from mental disorders. Although collaborative care, which integrates mental health services into primary care, has been shown to be more effective than usual care, its implementation has been slow and the experience of providers and patients with collaborative care is less well known. The objective of this case study was to examine the effects of collaborative care on patient and primary care provider (PCP) experiences and communication during clinical encounters. Participating physicians completed a self-administered visit reconstruction questionnaire in which they logged details of patient visits and described their perceptions of the visits and the influence of collaborative care. Audio recordings of visits were analyzed to assess the extent of discussion about colocated mental health services and visit time devoted to mental health topics. The main outcome measures were the extent of discussion and recommendation for collaborative care during clinical visits and providers' experiences based on their responses to the visit reconstruction questionnaire. Providers surveyed expressed enthusiasm about collaborative care and cited the time constraint of office visits and lack of specialty support as the main reasons for limiting their discussion of mental health topics with patients. Despite the availability of mental health providers at the same clinic, PCPs missed many opportunities to address mental health issues with their patients. Ongoing education for PCPs regarding how to conduct a "warm handoff" to colocated providers will need to be an integral part of the implementation of collaborative care.
BT - Population health management
C5 - General Literature
CP - 6
CY - United States
DO - 10.1089/pop.2009.0082
IS - 6
JF - Population health management
N2 - Primary care remains critically important for those who suffer from mental disorders. Although collaborative care, which integrates mental health services into primary care, has been shown to be more effective than usual care, its implementation has been slow and the experience of providers and patients with collaborative care is less well known. The objective of this case study was to examine the effects of collaborative care on patient and primary care provider (PCP) experiences and communication during clinical encounters. Participating physicians completed a self-administered visit reconstruction questionnaire in which they logged details of patient visits and described their perceptions of the visits and the influence of collaborative care. Audio recordings of visits were analyzed to assess the extent of discussion about colocated mental health services and visit time devoted to mental health topics. The main outcome measures were the extent of discussion and recommendation for collaborative care during clinical visits and providers' experiences based on their responses to the visit reconstruction questionnaire. Providers surveyed expressed enthusiasm about collaborative care and cited the time constraint of office visits and lack of specialty support as the main reasons for limiting their discussion of mental health topics with patients. Despite the availability of mental health providers at the same clinic, PCPs missed many opportunities to address mental health issues with their patients. Ongoing education for PCPs regarding how to conduct a "warm handoff" to colocated providers will need to be an integral part of the implementation of collaborative care.
PP - United States
PY - 2010
SN - 1942-7905
SP - 331
EP - 337
EP - 
T1 - A case study of early experience with implementation of collaborative care in the Veterans Health Administration
T2 - Population health management
TI - A case study of early experience with implementation of collaborative care in the Veterans Health Administration
U1 - General Literature
U2 - 21090989
U3 - 10.1089/pop.2009.0082
VL - 13
VO - 1942-7905
Y1 - 2010
ER -