Global approaches to integrated care: Best practices and ongoing innovation.

Abstract

The integration of behavioral health in primary care is critical for addressing worldwide concerns for access to, and quality of, health care services for physical and mental health promotion, prevention, and disease management. Clearly, promoting knowledge exchange internationally is critical to progress. In late 2015, the American Psychological Association convened an interdisciplinary summit on global approaches to integrated health care, bringing together 82 health care professionals (nurses, primary care physicians, psychologists, psychiatrists, and social workers) and scholars from diverse disciplines in medicine, psychology, economics, health policy, public health, and demography; participants came from 10 countries. The Global Summit provided an opportunity to share best practices and innovation in patient-centered integrated health care internationally. In this article, Global Summit participants from different countries reflect on the Editor's note. This article developed from a presidential initiative of the 2015 APA president, Barry S. Anton, which led to an interdisciplinary summit on global approaches to integrated health care convened by APA in November 2015.

Screening for Psychological Distress and Risk of Cardiovascular Disease and Related Mortality

“…Integrated primary care offers one promising clinical service delivery model, which includes psychological distress assessment and management, and can be adapted for CVD prevention 80–83. Besides benefiting patients, this model could be financially advantageous for single-payer and managed care systems alike 84,85. In the US, health policy should be informed by robust randomized clinical trials and links to meaningful benchmarks including quality of life and reduced health care expenditures; those trials to date concerning psychological risk and CVD lag millions of dollars behind investments in understanding biomedical factors—and cannot catch up.…”

Pediatric integrated primary care as the foundation for healthy development across the lifespan.

“…Importantly, where possible, future research in IPC—including that regarding training—should be interprofessional. This will be aided by agreement regarding terminology, outcomes, and metrics (Kearney et al, 2019). Electronic medical records (Institute of Medicine, 2015) and quality improvement initiatives (Kearney et al, 2019) should be exploited for better understanding of progress in promoting healthy development and preventing behavioral health conditions.…”

“…This will be aided by agreement regarding terminology, outcomes, and metrics (Kearney et al, 2019). Electronic medical records (Institute of Medicine, 2015) and quality improvement initiatives (Kearney et al, 2019) should be exploited for better understanding of progress in promoting healthy development and preventing behavioral health conditions. Advances in biological, behavioral, and environmental measures of exposure to ACES and toxic stress will allow more fine-tuned assessment of impact.…”

“…Long-term steps should include addressing financial and other barriers to cross-disciplinary educational opportunities, allowing for Interprofessional Education (IPE) and its components to be coordinated across disciplines. Participants at a global summit led by APA recommended moving IPE earlier in training, providing longitudinal experiences, and tying to specific learning outcomes/interprofessional competencies (and accreditation where appropriate; Kearney et al, 2019). The Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA) joint Center for Integrated Health Solutions (Hoge, Morris, Laraia, Pomerantz, & Farley, 2014) and the Interprofessional Education Collaborative (IPEC, 2016) have recently updated core interprofessional competencies for pediatric and adult primary care, respectively, and APA has compiled a curriculum for interprofessional training (APA, 2016).…”

Effectiveness of Person-centred Integrated Care for Community-dwelling People With Hypertension and Diabetes in High-income Countries: Protocol for a Systematic Review and Meta-analysis

“…In order to respond to the challenges associated with chronic diseases and address the complexities of managing multi-morbidities, efforts have been made globally to promote better-integrated care through strengthening the coordination and cooperation among health systems, health professionals, patients and their caregivers (11,12). Person-centred integrated care has been proposed by the World Health Organization as a global strategy to improve health outcomes, enhance quality of patient care and reduce high-cost hospitalization for populations (13).…”