Virtual integrated primary care teams: Recommendations for team-based care.

Abstract

Introduction: Integrated primary care teams are increasingly relying upon virtual care, including both telehealth and team members who are teleworking, due to the COVID-19 pandemic. This shift to virtual care can present challenges for the coordination and provision of team-based care in primary care. The current report uses extant literature on teams to provide recommendations to support integrated primary care teams, including behavioral health providers, in adapting to and sustaining virtual team-based care. Method: We used the Seven C's framework by Salas and colleagues (2015) to organize our findings and recommendations, focusing on coordination, cooperation, cognition, and communication. Results: Integrated primary care teams may benefit from tending to both implicit and explicit forms of coordination and the use of debriefs to improve team coordination. Given the potential challenge of trust in a virtual team, documentation of care coordination and reexamination of how feedback is provided to primary care providers may benefit team cooperation. Sharing team goals and crosstraining on specific aspects of team processes, such as communicating essential information to behavioral health providers for a warm handoff, may improve the cognition of the team. Teams may also benefit by findings ways to incorporate informal communication into the workflow and using closed-loop communication to decrease missed communications. Discussion: This report provides initial This article was published Online First November 4, 2021.

Integrated behavioral health education using simulated patients for pediatric residents engaged in a primary care community of practice.

“…We propose that the development of a unique community identity emerges in medical professionals whose CoP is the integrated medical home (Wald, 2015). The results of our study suggest that application of the CoP framework could strengthen future interdisciplinary teaching about collaborative practice, as previously demonstrated in other graduate medical education settings (Clark et al, 2017; Lees & Meyer, 2011; Mitzel et al, 2021; Powers et al, 2020; Roberts et al, 2012; Sterrett et al, 2015).…”

Virtual Patient to Support Inter Professional Education and Inter Professional Collaboration

“…This virtual patient is very useful to practice working conditions in the future, where all work is based on the internet. As Mitzel, Funderburka, Buckheita, Gassd, Shepardson, and Edelman (12) finds that future work will have to build virtual integrated primary care teams and provide evidence-based recommendations to optimize virtual care.…”

From challenge to opportunity: COVID-19 and the evolution of virtual mental health care.

“…Following the process of deinstitutionalization in the 1950s, the ideal of readily and equitably accessible community-based mental health services has been fleeting. Models of effective delivery that have been successful typically involve integrated care models as described by Mitzel and colleagues in this issue (Mitzel et al, 2021). However, many of these models have not been sustainable or generalizable for a variety of reasons (Sunderji et al, 2018).…”

“…In particular, what continued or further adaptations are needed to make this transition durable and sustainable? For example, Mitzel and colleagues (Mitzel et al, 2021) describe the challenges associated with ensuring successful "warm handovers" in the context of a virtual care team. As they discuss, this can be mitigated by establishing workflows incorporating frequent contact between care team members and existing virtual solutions (e.g., secure chat applications).…”

“…In the middle of the second year of this global pandemic, early evidence supports the feasibility and adequacy of virtual mental health care and its unique advantages. As Mitzel and colleagues review in this issue (Mitzel et al, 2021), virtual care is associated with improved access to behavioral health providers and increased cost-effectiveness of their services compared to conventional in-person services. Furthermore, virtual care teams can take advantage of the elimination of physical distance to communicate more effectively and in a timelier manner.…”