Partnerships in primary care. December 1, 2015 Kristen Swafford, PhD, RN, CNS

Transcription

1 Partnerships in primary care December 1, 2015 Kristen Swafford, PhD, RN, CNS

2 Promote effective communication with primary care audience Elevator speech SBAR Address HIPAA misconceptions Discuss the use of new tools and resources Introduce Collaborative-Integrative Models Agenda

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4 How do physician s think? How do they prioritize information? How is their role unique? Know your audience

5 How will you know? Compelling, evidencebased information Immediately applicable Tangible services and products Physicians American Psychiatric Association American Geriatrics Society Gerontological Society of America Portal for Online Geriatrics Education Nursing Harford Center for Geriatric Nursing Excellence National Gerontological Nursing Association ConsultgeriRN.org What do they need?

6 - 20 seconds or less Finish with a question: Is there someone in your office that would be a good fit? Do you think your providers would benefit from a discussion about? Could we schedule a time to talk further about this? Include: Practice, practice, practice! Elevator Speech

7 Write your own

8 Use Motivational Interviewing concepts and strategies Express empathy Weigh pros/cons Prepare for resistance, meet with nonresistance Foster self-efficacy Connecting

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10 CMS Comprehensive Primary Care Initiative Participants Screening for Clinical Depression and Follow Up Plan Primary-Care-Practice/k9im-rfs2 Participants of OHSU-ECHO Psychiatric Medication Management Telehealth project Where the door may already be open

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12 Coordinated Care Organizations Oregon State University, College of Pharmacy, Department of Drug Use Research and Management Acumentra Health Know your allies

13 For more information See printed materials for details Acumentra Health Contacts: Susan Yates Miller Jody Carson, RN, MSW, CPHQ This material was prepared by HealthInsight, the Medicare Quality Innovation Network-Quality Improvement Organization for Nevada, New Mexico, Oregon and Utah, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-G OR 11/5/15 13

14 Making the case for integrated care Aging Demographics Talking Points

15 ituation ackground ssessment or Analysis ecommendation Standardizing Communication

16 : Situation Identify yourself and your role Identify patient information Describe the issue

17 : Background May include Primary physical diagnoses or physical symptoms Medications and recent changes Primary behavioral symptoms Pertinent housing issues ADL function Social network issues What s been done recently Who s involved

18 In your professional opinion, what do you think is going on? What is missing? What is the problem? : Assessment/Analysis

19 What would you like to see happen next? What do you need from the person you re talking to? : Recommendation

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21 rts/issue_briefs/2014/rwjf409991

22 HIPAA typically should not serve as a legal impediment to robust health information exchange among physical and behavioral health providers. (RWJF brief, 2014) HIPAA Barrier?

23 Thus, records relating to substance abuse diagnosis or treatment provided in a mental health facility, or in a primary care physician s office, are not subject to the Part 2 regulations. (RWJF brief, 2014) Part 2 Regulations Barrier?

24 rstanding/special/mhguidancepdf.pdf

25 Oregon Health Authority: Behavioral Health Information Sharing Advisory Group OP-Sept2015-meeting-materials.pdf

26 Tangible Tools

27 Geriatric Substance Use Module

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29 Geriatric Substance Use Module

30 Alternatives to the 2015 Beers Criteria medications Potentially high-risk drugs Drug-disease interaction Medications that cause Anxiety Medications that cause Depression Differential Diagnosis in Geriatric Behavioral Health Physical conditions and Depression Components of Geriatric Brief Intervention Table /Alcohol and Drug Interaction Table Tools and Resources

31 Geriatric Anxiety Module

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33 Geriatric Anxiety Module

34 Suicide Prevention Geriatric Depression Bipolar Disorder or Severe Mental Illness Modules to come

35 Geriatrics At Your Fingertips, 2015 Hard copy Mobile app AGS app - igeriatrics Resources to consider

36 Collaborative Care

37 Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. March 2013

38 Become familiar with evidence based models in primary care-behavioral health integration IMPACT (Unutzer, 2008) PROSPECT (Unutzer, 2006) Where to find more information: nrepp.samhsa.gov integration.samhsa.gov Integrationacademy.ahrq.gov Collaborative Care

39 Thank you

40 Heath B, Wise Romero P, and Reynolds K. (2013). A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. Unutzer, J., Harbin, H., Schoenbaum, M., & Druss, B. (2013). The Collaborative Care Model: An Approach for Integrating Physical and Mental Health Care in Medicaid Health Homes. Medicaid Brief. Park, M., & Unützer, J. (2011). Geriatric depression in primary care. Psychiatric Clinics of North America, 34(2), Unützer, J., Tang, L., Oishi, S., Katon, W., Williams, J. W., Hunkeler, E.,... & Langston, C. (2006). Reducing suicidal ideation in depressed older primary care patients. Journal of the American Geriatrics Society, 54(10), Skultety, K. M., & Rodriguez, R. L. (2008). Treating geriatric depression in primary care. Current Psychiatry Reports, 10(1), References

41 Slide 4: weavermachine.com Slide 7: directyourownlife.wordpress.com/2012/01/ Slide 8: NaRCAD.org Slide 15: news.sjhlex.org Slide 16: theguardian.com Slide 18: shutterstock.com Slide 19: marthagiffen.com Slide 20: quoteimg.com Slide 26: northerntool.com Slide 34: inboundsales.net Slide 36: stage2planning.com Images credits