Collaborative Care, Community C-L
CL psychiatrists face staggering numbers of patients struggling with complex conditions at the intersection of psychiatric and medical illness. Application of CL psychiatry in the community reflects the future of consultative care in the complicated matrix that is medicine today. Traditional models cannot meet the growing need for patient care. In response, alternative care configurations have developed ranging from new expansion of collaborative care models to new ways to adapt co-located clinic concepts to new modifications in established systems. These innovations illustrate ways to broaden care delivery to reach more of our neediest patients.
Traditional models of CL psychiatry consultation result in good clinical outcomes but is limited in the number and range of individuals treated. Over the course of our symposium a panel of consultation psychiatrists will discuss their creation of newer models for care delivery.
Claire Brandon MD will review the expansion of the collaborative care consultation model from the primary care setting to a subspecialty clinic where comorbid psychopathology is high but significant barriers to prescribing and maintaining follow up exist.
Julia Ruark, MD MPH will describe the creation of a co-located addiction psychiatry clinic within an oncology clinic in response to an unsuccessful trial of collaborative care in psycho-oncology was not effective for patients with addiction comorbidities.
Hindi Mermelstein, MD will explore the development of a hybrid telemedicine clinic melding face-to face contact with remote access in a revision of the spoke and wheel framework found in many medical systems.
Each presenter will discuss the factors critical in the development and sustainability of these models, their benefits and drawbacks, as well as the lessons learned to further improve functionality and clinical outcomes. As a fellow trained in both established and newer modes of care, Chandan Khandai, MD will describe the experience of patient care in each of these systems for the next generations of CL psychiatrists.
Finally, an appraisal of the experience will prompt a discussion of the untapped potential for our specialty. CL psychiatrists improve quality of life, as well as improve care value in clinic settings. Yet we continue to face many challenges in meeting the complex needs of our patients, ensuring access and developing successful relationships with medicine providers. Review of newer models of care will provide not only an educational “how to” but can serve as a blueprint for the development of better ways to provide care, to create a more sustainable care experience and to increase our flexibility and the integration of CL psychiatry within the general medical and health care community for our future.