Integrated Care Model

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.

The primary care practice is essential to improve the care of our population, our current system is fragmented, but it does show potential for improvement. The Agency for Healthcare Research and Quality has listed some areas that will help improve our system. One is “the need for external infrastructure to help primary care practices develop quality improvement” this is done with support to the quality capacity (Agency For Healthcare Research and Quality, 2015). Quality care will include the coordination of care within the system, as well as understanding what needs the patient will have

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).

“An Integrated Physician Model is the result of a series of partnership between hospitals and physician develop overtime” (Harrison, 2016). Primarily, it is a joint venture that has become many joint ventures. In addition, all of this joint ventures are connected through congruent goals, and that is to provide different level of care to all the patients. Integrated physician model also organizing themselves to improve the cost and quality by operating under a clinical guideline. This could include acute care hospital, home care, nursing homes, affiliated medical group, primary care clinics, employed physician and any independent medical groups.

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.

It is always great to learn something new. As a Nurse Educator at the James A. Haley VA Hospital, our focus is individualized care; Therefore, we use the HATCH Model. The PEN-3 Model is not a model that I remember hearing of, but I plan to do some more research about it. Using a model that focuses on individual's culture is important. I have witnessed many issues between health care workers and the patients, and those confrontations could have been avoided if healthcare workers would be more aware of culture differences and individualized care.

Leidos Health enables better patient care by allowing healthcare providers and patients to share and access information from any location. Our healthcare consultants have deep electronic health record expertise, knowledge of the unique operations of the healthcare environment, and a legacy of large, complex systems integration experience, which allows for secure collaborative care.

- Providing individualized care.Standards are set to ensure everyone is treated in an equal way. How we care for ourselves might be different to the way another person cares for themselves.

Integration of care is possible and important because it will help the population especially the aging population. This integration of care will involve a lot of reconstruction, time, effort and some sacrifices. However, providing health care in US is a problem because the mode of delivery and the gap between health and social care, which is why integration of care is necessary.

While discussions of integrated care are not new in the United States, the research literature has largely been about blending mental and chemical health into physical health systems. Using a critical hermeneutic application of interpretive phenomenology, this study aims to address that gap by interviewing adults with serious mental illness about their experience receiving physical health services within a community mental health center. Nine individuals, five clients and four providers, interviewed for this study were selected using the critical case criterion in partnership with the community mental health center. Interviews were digitally recorded and transcribed. Data analysis was conducted within-case followed by cross-case analysis technique.

Even though there is no definite description that has been given for the integrated Delivery system, it can be said to be a collaborative networks that are interlinked with various healthcare providers that offer coordinated and vertical continuous services. The system is normally held responsible for any outcome that develops in terms of the health status and the financial risk of the population that they serve. The main concern of the integrated delivery system is to provide health care services that are patient centric but at a lower cost. The fact that there is no specific definition that is given for the IDS creates a significant challenge in creation of policies that are meant to improve the coordination of the current health care services.

The world of health care is constantly changing everyday by it changing there are less hospitals being opened than clinics. It seems as if people will rather open a clinic this a hospital in which would have all things necessary for health care. Some clinics will specialize in a certain area of health care and not all. The only good part about this is that there are some clinics that are offering emergency services. In my geographic area, there are both horizontally and vertically integrated health care systems available.

For a lot of people to “walk” in health care system can be difficulty. When patient needs help sometimes has to see primary care physician, some specialists, nurses, even though sometimes patient have to contact insurance or billing department of doctor offices. If these health care providers do not contact with each other that can be dangerous for the patient. Very often that leads in low value of care, medication errors or preventable visit in emergency room. All this make also health care more expensive. The Affordable Care Act has formed many openings for states to proposal new models of care delivery and payment” that improve health outcomes, improve patients’ experience, and reduce health care spending” (Familiesusa.org). A core piece of these new models is care

Integrated delivery service (IDS) is a coordinated, integrated system which helps in eliminating waste from unnecessary, unsafe care. This is crucial for improving quality and reducing costs. Modern healthcare system is very complex with wide variation in practices and cost of services. Also, there are dearth of guidelines, utilization and quality management, collaboration, peer review process and low accountability. All this has made healthcare more fragmented. The opposite of this fragmented care is organized, coordinated and collaborative network that: 1) link various healthcare providers, via economic, non-economic and clinical way in order to provide coordinated care and 2) is accountable, both clinically and economically for better patient