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A New Sub-Specialty And The Development Of Its Workforce Via Technology

Posted By Neftali Serrano, Thursday, January 28, 2010
Updated: Friday, June 10, 2011

I started about 4 years ago as the result of the most obvious difficulty I was facing in developing a primary care behavioral health service (PCBH) at a Federally Qualified Health Center (FQHC) in Chicago, IL: I couldn't find anyone to hire on.

Fortunately this was also the time when iTunes and other Mac software were providing a unique opportunity to technology novices like me - the ability to reach large numbers of people with websites, blogs and podcasts. My goal was to, at the very least, contribute to the growing web presence of PCBH and in so doing perhaps stimulate students and early career professionals to consider developing skills in this area. Remember that at the time a search of PCBH related terms yielded a whole lot of nothing - at least not that which was relevant to PCBH and certainly not to the model of care I was working in, Behavioral Health Consultation (with one exception being Dr. Blount's website,

So, even more so today technology must play a role in developing a workforce. As a consultant to clinics in various states I know there are jobs out there - some of which simply need to be created by knocking on the door of the clinic. My current position as director of a PCBH program at an FQHC in Madison, WI started out just that way. There was no job posting - I just knocked on the door and said: "I can do this. Do you want me to do it here?" And 4 years later we have a robust PCBH program with 3 other staff psychologists. The point being that we need to develop workers with skills and predisposition to work in integrated care models. At present most everyone requires retraining.

So, I'm open to ideas. What role can technology play in developing the workforce? I think we're going to have to think outside the box on this one. For example, one of the things I do to train folks is use video-conferencing software to provide training/ supervision. Another is the use of GoogleDocs where trainees in other cities post their SOAP notes and I provide commentary to refine writing and case conceptualization skills. But we have to think scale here, especially with the likely expansion of primary care via the health reform legislation. In about 8+ years in PCBH I've managed to train nearly 40 professionals, but even if all of us did the same we would not meet the need for BHCs.

I would consider the following functions as core to any future technological approaches to training:

  • Facebook-type networking ease
  • A means of rapidly disseminating data from small centers/ clinics to incrementally move evidence-base (think quick and easy form submission)
  • Video/Text education modules from experts that help categorize types of PCBH and identify core components
  • Web-based video-conferencing to rapidly connect professionals in mini-conferences (think Skype, but within the one portal where data from the mini-conferences can be housed and archived)
  • Potential for hosting larger forums for audiences that can check in for a live-stream conference and also interact with presenters
  • PCBH Wikipedia-like article section where contributors refine concepts over time
  • Q&A Forums
  • Marketplace for professionals to shop for more intensive consultation, supervision, books, proprietary PDF downloads, etc.

The basic idea, I think, is to be able to duplicate what we all get at the annual CFHA conference for 365 days of the year, and be able to share data and knowledge in incremental and economically efficient ways. There are hundreds of conversations we all have with each other that others would benefit from and many small projects and data collection efforts that have value, especially in aggregate. If this makes sense to you, I'd love to hear from you. What other ideas do you have?

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