Integrated Care: A Case Study

Health Information Exchange (HIE) has become a major component in today’s healthcare. Health information exchange provides a secure way for providers to appropriately access and electronically share a patient’s medical information. Therefore, reducing duplicate testing, minimizing medication errors and providing a link among electronic health records (EHR) in order to provide quality healthcare.

Vertically integrated health care system that I have chosen is the Veterans Administration (VA) it's accountable for a large patient population for military veterans. As stated, The Veterans Health Administration is America’s largest integrated health care system with over 1,700 sites of care, serving 8.76 million Veterans each year (VA.GOV). The services that's provided to veterans is health care, rehabilitation, employment, education, home loan guaranties, and life insurance coverage. VA control costs by buying in bulk and control costs by engaging in a deep, single-source relationship with each patient. The Assistant Secretary for Management oversees all resource requirements, development and implementation of agency performance measures,

Physical health and behavioral health care are typically delivered in separate settings by different providers, often with little collaboration and coordination. This fragmented health care delivery system leads to care deficiencies, specifically for individuals with mental and physical health co-morbidities (Enthoven, 2009). Individuals with mental and substance abuse disorders may die decades earlier than the average person — often from untreated and preventable chronic diseases (Substance Abuse and Mental Health Administration [SAMSHA], 2017). Evidence indicates that the health care system is improving care delivery for members with co-morbidities through the integration of physical and behavioral health care (Enthoven, 2009).

Incorporated treatment for co-occurring disorders has not been examined broadly, and the field needs to think about various intercessions and blends of interventions, ideally in controlled trial settings. Due to the limited research, it is particularly critical to think about models of care incorporating medical, mental health and substance abuse treatment regardless of whether in medical, behavioral health or substance abuse program setting. Most research and program improvements have concentrated on patients with co-occurring disorders extreme substance abuse issues and acute mental health illness. It is additionally significant to inspect the impacts of incorporated treatment intercessions and models on patients with

which sets out the future for health and care services in Morecambe Bay through a population

An integration of care study was conducted by a Doctor of Behavioral Health Intern at Michael R. Zent (MRZ)Healthcare Clinic in Phoenix, Arizona. MRZ is a reverse co-located integrated medical and behavioral clinic that provides services to about 4000 children and 4000 adults annually. MRZ provides laboratory, pharmacy, behavioral and physical health services together under one roof. The clinic utilizes an integrated electronic health record to document the treatment of members. The focus of the integration of care study was to understand and assess the barriers and challenges of the integration of care methodology at MRZ.

Mathew is now participating in both individual and treatment group. After several months of work building his self-esteem and confidence, at the end of this reporting period Mathew agreed that it was time that he joined the treatment group. Mathew had some challenges with impulse control, pornography viewing, and failing to report pertinent treatment related issues, but overall his progress is considered satisfactory.

According to AHRQ (2008) care coordination is an associated concept that represents the transition among two particular care settings. It encompasses the collaboration of providers and health plan administrators through a variation of care settings to ensure optimal patient care (p. 6). Therefore, respectable care outcomes are in need of admirable coordinated communication among providers. The lack in connectivity between providers in the health care system has risen to the national consciousness. According to Wolfe (2001), the Institute of Medicine (IOM) report emphasizes that health care quality suffers because of the lack in effective treatments and insufficient health care delivery systems that fail to exploit these treatments. Disjointed

In order to be properly prepared for an outage in the magnitude of what transpired to the CareGroup network, systems and process control may have prevented this unfortunate event from occurring. Instituting a preventive approach to network functionality and security, along with a contingency plan to deal with failures or breaches to the system should have been in place.

These efforts include early intervention, appropriate treatment, use of medications, and suicide prevention. The AAFP being in great support of integrated health care continue to struggle with the rates of reimbursements and continues to advocate for proper payment structures to enable them to support and implement the integrated process into their own private practices. The Affordable Care Act specified that Medicaid payments for primary care services would be at Medicare levels for primary care physicians in 2013 and 2014. Since then this provision has expired and instead of implementing new payment proposals the Center for Medicare and Medicaid services reverted to rates that proved to be lower than those most state Medicaid payors. (Blackwelder,

Throughout the career of a Viterbo University Student Nurse, one sees a variety of clinical settings to enrich one’s own knowledge base and skills practice to ultimately become a well- rounded and exceptional nurse. One of the experiences that we are able to have is to be a part of the Caring Clinic at the Salvation Army. In this setting we care for a population of impoverished and homeless individuals to assess blood pressures, health history, and do a mental health screening. This setting is like no other in the sense of we go to where the individuals that need our help instead of them coming to us. I have learned how it takes a special kind of nurse and group of student nurses to make the Caring Clinic happen to provide care and advocate

“CARE USA’s program expenses in 2013 totaled more than $514 million” ("CARE FAQs") after providing necessary supplies to globally provide for their cause. To obtain this quantity of funding and commodities, the organization is helped funded from governmental agencies, “…the European Union and the United Nations.” ("CARE FAQs.") However, the organization is additionally funded by proceeds that are donated to them yearly from “…thousands of individuals, U.S corporations, foundations, and other organizations...” ("CARE FAQs.") Ultimately, these great commodities help promote the potential the organization has into achieving their mission of providing permanent relief to suffering communities.

Every person’s experience with trauma is unique and requires a care plan that is individualized to address the client’s specific needs throughout the recovery process. When preparing a care plan for 9-year-old Daria, it is important that a professional identify the type of trauma or violence experienced. Daria is the only child of Sam and Jenny, and was sexually assaulted by her father, Sam, in 2015. Her mother was charged with failure to protect Daria, resulting in both parents moving through the criminal justice system. Daria is currently in DCF custody, was placed in a foster home with 3 other children and does not go to her school or see her friends anymore. She has refused to talk about the abuse and occasionally struggles with episodes of lashing out and/or disinterest in activities, conversation, or eating. I believe Daria has experienced trauma from the sexual assault, displacement from her mother and friends, and moving through the social welfare system. Identifying the potential traumas Daria has experienced will assist in creating a comprehensive, multifaceted care plan.

There were several indicators that Beverly was unfit for duty such as staff reported the smell of alcohol on her breath, the unexcused absences, and increase in medication errors. Management is aware that disciplinary problems generally do not go away, they get worse if ignored. When employees are suspicious of being chemically impaired, management needs to collect and record objective data (Marquis & Huston, 2017). In this scenario, the supervisor took time to investigate the problem by waiting to witness the issue directly. By waiting this prevented a quick response that could be influenced by incomplete information, assumptions or personal emotions. The supervisor did the right thing by sending Beverly home after the confrontation and scheduling

Over the past decade hospitals have incurred immense transformation, from the advent of the Affordable Care Act to bundled payments. In response to this reform, hospitals are consolidating to create larger health systems with broader services and strategies to combat economic pressures and regulatory concerns. The principle goal of a health system merger or acquisition is to capitalize on their investment and create a high performing efficient hospital that promotes streamlined care across disciplines. Between 2009 and 2012, the number of mergers and acquisition deals occurring per year nearly doubled from 50 in 2009 to 94 in 2012 (Egan, Kerns, Bartz, & Cassels, 2013). However, while the numbers of consolidations increase, data suggests that