Integrated Health Care at Cherokee Health Systems

2017 ◽  
Author(s):  
Parinda Khatri ◽  
Gregg Perry ◽  
Frank deGruy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Health Systems ◽  
Multiple Roles ◽  
Public Health Services ◽  
School Based ◽  
East Tennessee ◽  
Behavioral Services ◽  
Primary Care Clinicians

Cherokee Health Systems (CHS) has provided health care throughout east Tennessee for over 50 years. This chapter describes its innovative model of integrated care. CHS offers primary and some specialty medical care, comprehensive behavioral services, dental, pharmacy, school-based, social, and public health services, all within a deeply integrated, comprehensive system of clinics and care settings. Each patient has a team of clinicians and staff that is constituted to deal with that patient’s needs, but usually includes primary care clinicians, behavioral health clinicians (including psychiatrists, if appropriate), clinical pharmacists, care managers, and others working as a team. CHS makes extensive use of telehealth, particularly for psychiatric consultation, pharmacy counseling, primary care, and specialty medical consultation. Psychiatrists operate in multiple roles, including as primary clinicians, consultants to primary care and other behavioral health clinicians, team leaders, and educators. CHS is a growing, financially stable system that continues to expand across east Tennessee.

Mental Health Care of Children and Adolescents: A Guide for Primary Care Clinicians

2018 ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Children And Adolescents ◽  
Primary Care Practice ◽  
Care Practice ◽  
Primary Care Clinicians

This indispensable resource provides vital guidance for integrating mental health care into your everyday primary care practice. https://shop.aap.org/mental-health-care-of-children-and-adolescents-a-guide-for-primary-care-clinicians-paperback/

scholarly journals Amalgam Phase-Down Part 1: UK-Based Posterior Restorative Material and Technique Use

2020 ◽  
pp. 238008442097865
Author(s):  
O. Bailey ◽  
C.R. Vernazza ◽  
S. Stone ◽  
L. Ternent ◽  
A.-G. Roche ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
United Kingdom ◽  
Response Rate ◽  
Restorative Material ◽  
Publicly Funded ◽  
Total N ◽  
The United Kingdom ◽  
Primary Care Clinicians ◽  
Current Provision

Introduction: A European Union amalgam phase-down has recently been implemented. Publicly funded health care predominates in the United Kingdom with the system favoring amalgam use. The current use of amalgam and its alternatives has not been fully investigated in the United Kingdom. Objectives: The study aimed to identify direct posterior restorative techniques, material use, and reported postoperative complication incidence experienced by primary care clinicians and differences between clinician groups. Methods: A cross-sectional survey was distributed to primary care clinicians through British dentist and therapist associations (11,092 invitations). The questionnaire sought information on current provision of direct posterior restorations and perceived issues with the different materials. Descriptive statistical and hypothesis testing was performed. Results: Dentists’ response rate was 14% and therapists’ estimated minimum response rate was 6% (total N = 1,513). The most commonly used restorative material was amalgam in molar teeth and composite in premolars. When placing a direct posterior mesio-occluso-distal restoration, clinicians booked on average 45% more time and charged 45% more when placing composite compared to amalgam ( P < 0.0001). The reported incidences of food packing and sensitivity following the placement of direct restorations were much higher with composite than amalgam ( P < 0.0001). Widely recommended techniques, such as sectional metal matrix use for posterior composites, were associated with reduced food packing ( P < 0.0001) but increased time booked ( P = 0.002). Conclusion: Amalgam use is currently high in the publicly funded sector of UK primary care. Composite is the most used alternative, but it takes longer to place and is more costly. Composite also has a higher reported incidence of postoperative complications than amalgam, but time-consuming techniques, such as sectional matrix use, can mitigate against food packing, but their use is low. Therefore, major changes in health service structure and funding and posterior composite education are required in the United Kingdom and other countries where amalgam use is prevalent, as the amalgam phase-down continues. Knowledge Transfer Statement: This study presents data on the current provision of amalgam for posterior tooth restoration and its directly placed alternatives by primary care clinicians in the United Kingdom, where publicly funded health care with copayment provision predominates. The information is important to manage and plan the UK phase-down and proposed phase-out of amalgam and will be of interest to other, primarily developing countries where amalgam provision predominates in understanding some of the challenges faced.

scholarly journals Patient Views of Behavioral Health Providers in Primary Care: A Qualitative Study of 2 Southeastern Clinics

2019 ◽  
Vol 7 (4) ◽  
pp. 527-533
Author(s):  
Aubry N Koehler ◽  
Grisel Trejo ◽  
Joanne C Sandberg ◽  
Brittany H Swain ◽  
Gail S Marion ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Care Delivery ◽  
Behavioral Health Care ◽  
Patient Care Team ◽  
Care Team ◽  
Care Practice ◽  
Health Providers ◽  
Integrated Behavioral Health

Background: Limited research is available around patient experience of integrated behavioral health care in primary care settings. Objective: We sought to identify the major themes through which patients described their integrated behavioral health care experiences as a means of informing and improving clinic processes of integrated health care delivery. Methods: We captured viewpoints from 16 patients who experienced an integrated behavioral health care model from 2 primary care clinics and completed at least 3 visits with a behavioral health provider (BHP). Using grounded theory analyses, we coded and analyzed transcriptions for emergent themes. Analysis: The interview process yielded 3 major themes related to the BHP including (a) the BHPs’ clinic presence made behavioral health care more convenient and accessible, (b) BHPs worked within time and program limitations, and (c) BHPs helped with coping, wellness, and patient-care team communication. Conclusion: The BHPs serving in a large primary care practice and a Federally Qualified Health Center played an important role in connecting patients with behavioral health care and improving care team collaboration, both in terms of communication within the team and between the team and the patient/family.

Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

2018 ◽  
Vol 58 (2) ◽  
pp. 213-225 ◽  
Author(s):  
David J. Kolko ◽  
Eunice Torres ◽  
Kevin Rumbarger ◽  
Everette James ◽  
Renee Turchi ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Integrated Care ◽  
Primary Care Physicians ◽  
Empirical Literature ◽  
Health Providers ◽  
Pediatric Health ◽  
Care Experience ◽  
Pediatric Health Care

This study reports on a statewide survey of medical and behavioral health professionals to advance the knowledge base on the benefits and obstacles to delivering integrated pediatric health care. Surveys distributed in 3 statewide provider networks were completed by 110 behavioral health specialists (BHSs) and 111 primary care physicians (PCPs). Survey content documented their perceptions about key services, benefits, barriers, and needed opportunities related to integrated care. Factor analyses identified 8 factors, and other items were examined individually. We compared responses by specialty group (BHS vs PCP) and integrated care experience (no vs yes). The findings revealed differences across domains by specialty subgroup. In several cases, BHS (vs PCP) respondents, especially those with integrated care experience, reported lower benefits, higher barriers, and fewer resource requests. The implications of these results for enhancing care integration development, delivery, training, and research are discussed along with the study’s limitations and empirical literature.

scholarly journals Depression In Primary Care: Bringing Behavioral Health Care Into The Mainstream

2005 ◽  
Vol 24 (1) ◽  
pp. 271-276 ◽  
Author(s):  
Harold Alan Pincus ◽  
Jeanine Knox Houtsinger ◽  
John Bachman ◽  
Donna Keyser
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Behavioral Health Care
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