The Practice Integration Profile: Rationale, development, method, and research.

Abstract

Insufficient knowledge exists regarding how to measure the presence and degree of integrated care. Prior estimates of integration levels are neither grounded in theory nor psychometrically validated. They provide scant guidance to inform improvement activities, compare integration efforts, discriminate among practices by degree of integration, measure the effect of integration on quadruple aim outcomes, or address the needs of clinicians, regulators, and policymakers seeking new models of health care delivery and funding. We describe the development of the Practice Integration Profile (PIP), a novel instrument designed to measure levels of integrated behavioral health care within a primary care clinic. The PIP draws upon the Agency for Health care Research & Quality's (AHRQ) Lexicon of Collaborative Care which provides theoretic justification for a paradigm case of collaborative care. We used the key clauses of the Lexicon to derive domains of integration and generate measures corresponding to those key clauses. After reviewing currently used methods for identifying collaborative care, or integration, and identifying the need to improve on them, we describe a national collaboration to describe and evaluate the PIP. We also describe its potential use in practice improvement, research, responsiveness to multiple stakeholder needs, and other future directions. (PsycINFO Database Record

Measuring the integration of primary care and behavioral health services

“…The AHRQ's Integration Academy has developed an Atlas of Integrated Behavioral Health Care Quality Measures . Unfortunately, none of these resources have been psychometrically tested, leaving the field without a validated, reliable, measure of primary care and behavioral health integration …”

“…16 Unfortunately, none of these resources have been psychometrically tested, leaving the field without a validated, reliable, measure of primary care and behavioral health integration. 17…”

Integrating Behavioral Health and Primary Care (IBH-PC) to improve patient-centered outcomes in adults with multiple chronic medical and behavioral health conditions: study protocol for a pragmatic cluster-randomized control trial

“…Practices are ineligible if they are already undergoing, or plan to undergo, another QI initiative similar to the IBH-PC intervention or if they already have an advanced level of BH integration as evidenced by a total Practice Integration Profile score (PIP) above 75. The PIP is a survey of 30 items completed by primary care providers and staff about their own practice used to measure practice level integration [26,27].…”

“…The Practice Integration Profile (PIP) is a survey of 30 items completed by primary care providers and staff about their own practice [26,27]. It provides a total integration score and 6 domain scores: practice workflow, clinical services, integration methods, case identification, patient engagement, and workspace arrangement and infrastructure.…”

Beyond Co‐Location: Development of a School Health Integration Measure*

“…With regards to cross-sector integration, the introduction of behavioral health services into primary care settings provides direct insight into the development of a validated tool by which to measure the degree of integration of services. [20][21][22][23] In addition, documentation of efforts to bring mental health services into schools describes important insights into integration across the education and health sectors. [24][25][26] For SBHCs specifically, however, beyond an aspirational idea, it is unclear how to operationalize the concept of integration for both clinics and their partner schools.…”