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News & Research Column

Posted By Matthew P. Martin, Thursday, August 4, 2016


Welcome to the fourth edition of the CFHA News and Research Column, a new series of posts that highlight recent developments in the field of collaborative and integrated care. Check back for additional reports.


Texas Lawmakers Focus on Integrated Care

The state of Texas is in a state of mental health crisis. Part of the problem is a shortage of mental health professionals. The Select Committee on Mental Healthwas specifically createdto tackle the issue. In June, the committee — headed by Rep.Four Price, R-Amarillo— met to discuss on how the state wants to take a holistic approach regarding mental health treatment. The committee heard from experts on insurance and criminal justice mental health professionals including Dr. William Lawson at Dell Medical School. His goal is to get more minority mental health providers into the underserved areas of Texas.He says integrated care is key.

"We now know that early intervention can actually change the trajectory of what happens with folks who develop a mental disorder,” said Dr. Lawson.

Family-Oriented Program in England Partners Nurses with Patients

The Family Integrated Care program, at St. James’ Hospital in Leeds, England, empowers parents to take control of their baby’s care by being given the skills to become more involved and build confidence. Parents are coached by nurses on feeding and changing as well as taking regular observations and giving medication. Rates of breastfeeding at discharge from hospital have doubled to nearly 60 per cent and the length of stay has been reduced by up to nine days in babies born up to 10 weeks early. Infections and complications also seem improved.

Collaborative Care in Various Special Populations

· Pharmacy: New push for more pharmacy collaborative care

· Patients with disabilities: Occupational therapists collaborating with other services

· Substance Use, Serious Mental Illness: call for more integrated services

· Women’s Health: International group calls for stronger integration of services to improve health outcomes among adolescent girls and young women

· Dental Care: Oral health screening for kids in Colorado medical office

Integrated Care is Not Sustainable

The latest NHS Financial Temperature Check survey out of England of more than 200 finance directors shows that just 16% were ‘very or quite confident’ that their organization could deliver a sustainable integrated care service for the period up to March 2021. Paul Briddock, director of policy at HFMA, said: "The scale of the NHS deficit continues to reach unparalleled levels, and it is unlikely the provider position will be in balance at the end of 2016-17, as originally planned.

"Our report confirms that while finance directors are feeling the pressures of the current financial situation, many also feel like short-term gains such as cash injections and non-recurrent savings are merely storing up more problems for the future.”

Mobile Clinics Could Revolutionize Health Care

A senior Annapolis doctor says that just four mobile clinics could revolutionize healthcare for rural Nova Scotians — and they will come cheap.

Dr. Ken Buchholz, a former senior physician advisor with the Department of Health, estimated that four fully-equipped trailers plus their support vehicles would cost just over $1 million. This is the same average price tag as a single bricks-and-mortar collaborative care clinic that the government plans to roll out across the province.

"Nova Scotia was once a leader in the country with this mobile health model, but it fell victim to fiscal restraint and a lack of vision by health department officials. Perhaps it is time to revisit the notion of mobile healthcare, but this time with an open mind and a more positive approach,” said Buchholz.


· Meta-analysis of collaborative care for anxiety: Collaborative care seems to be a promising strategy for improving primary care for anxiety disorders, in particular panic disorder. However, the number of studies is still small and further research is needed to evaluate the effectiveness in other anxiety disorders.

· Checklist for family meetings: Researchers developed the Family Meeting Behavioral Skills Checklist (FMBSC) to measure advanced communication skills of fellows in family meetings of critically-ill patients based on a literature review and consensus of an interdisciplinary group of communications experts. The FMBSC demonstrated internally consistency and structural validity in assessing advanced communication skills.

· Collaborative care in Nigeria: It is feasible to scale up mental health services in primary care settings in Nigeria, using the WHO Mental Health Gap Action Programme Intervention Guide and a well-supervised cascade-training model. This format of training is pragmatic, cost-effective and holds promise, especially in settings where there are few specialists.

· Collaborative Care in HCV Clinics: Depression collaborative care resulted in modest improvements in HCV patient depression outcomes. Future research should investigate intervention modifications to improve outcomes in specialty hepatitis C virus treatment clinics.

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