Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States.

In 2021, the National Academy of Science, Engineering, and Medicine Committee on Implementing High-Quality Primary Care published its recommendations to expand the provision of high-quality primary care in the USA. These include paying for primary care teams to care for people, ensuring that high-quality primary care is available, training primary care teams where people live and work, and designing information technology that serves the patient, family, and care team. Many of these recommendations echo those of prior calls for action, including the Institute of Medicine's 1996 report.

Clinically Feasible Stratification of 3-Year Chronic Disease Risk in Primary Care: The Mental Health Integration Risk Score.

Background: Depression is a common illness that imposes a disproportionately large health burden. Depression is generally associated with a higher prevalence of chronic disease risk factors and may contribute to higher chronic disease risk.

Objective: This study aimed to create and validate sex-specific Mental Health Integration Risk Scores (MHIRS) that predict 3-year chronic disease diagnosis.

The association of antidepressant and statin use with death and incident cardiovascular disease varies by depression severity.

Depression has been reported to be associated with a greater risk of death and cardiovascular disease (CVD); however, the impact of antidepressants (ADM) on CVD risk remains controversial. Statin use is known to decrease CVD risk. Whether the use of these medications together affects CVD risk has not been studied.

Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost.

Importance: The value of integrated team delivery models is not firmly established.

Objective: To evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs.

Design: A retrospective, longitudinal, cohort study to assess the association of integrating physical and mental health over time in TBC practices with patient outcomes and costs.

[Integrated care delivery system for mental illness: A case study of Intermountain Healthcare (USA)].

Background: Mental health is a public health priority among chronic diseases in France and the United States. Although there is room for progress in France, the experience of Intermountain Healthcare (IH), Utah, in the United States can provide convincing experimental data.

Aim: To identify the lessons learned from IH clinical integration of mental health specialists in primary care practices called "Mental Health Integration" (MHI) which might be useful in France.

Computerization of Mental Health Integration complexity scores at Intermountain Healthcare.

Intermountain Healthcare's Mental Health Integration (MHI) Care Process Model (CPM) contains formal scoring criteria for assessing a patient's mental health complexity as "mild," "medium," or "high" based on patient data. The complexity score attempts to assist Primary Care Physicians in assessing the mental health needs of their patients and what resources will need to be brought to bear. We describe an effort to computerize the scoring.

Mental health integration: normalizing team care.

This article examines the impact of integrating mental health into primary health care. Mental Health Integration (MHI) within Intermountain Healthcare has changed the culture of primary health care by standardizing a team-based care process that includes mental health as a normal part of the routine medical encounter. Using a quantitative statistical analysis of qualitative reports (mixed methods study), the study reports on health outcomes associated with MHI for patients and staff.

Cost and quality impact of Intermountain's mental health integration program.

Most patients with mental health (MH) conditions, such as depression, receive care for their conditions from a primary care physician (PCP) in their health/medical home. Providing MH care, however, presents many challenges for the PCP, including (1) the difficulty of getting needed consultation from an MH specialist; (2) the time constraints of a busy PCP practice; (3) the complicated nature of recognizing depression, which may be described with only somatic complaints; (4) the barriers to reimbursement and compensation; and (5) associated medical and social comorbidities. Practice managers, emergency departments, and health plans are stretched to provide care for complex patients with unmet MH needs.

Excessive Drinking in Young Women: Reducing harm through quality improvement.

The growing problem of binge drinking among young women is one that must be dealt with at a societal level, says (doi: 10.1136/bmj.39520.

Mental health integration: rethinking practitioner roles in the treatment of depression: the specialist, primary care physicians, and the practice nurse.

Although primary care provides the majority of mental health care, lack of time and documented economic benefit make it difficult for healthcare delivery systems to proactively implement effective treatment strategies for the growing disability of depression. Current care delivery models are inadequate and inefficient, leading to provider and consumer exhaustion, as well as significant gaps in care and poor outcomes. This publication describes a quality improvement pilot demonstration called "mental health integration" (MHI) that has been successful in realigning resources, enhancing clinical decision making, measuring the impact and building a business case to determine what actually is the value added for quality.

Can mental health integration in a primary care setting improve quality and lower costs? A case study.

Objective: To describe the successful implementation of an evidence-based, integrated quality improvement mental health program in a primary care setting.

Summary: Intermountain Healthcare (IHC) has aligned resources around a conceptual framework that emphasizes clinic and community accountability, family and consumer health focused on recovery rather than disease, and enhanced decision making through partnerships and automation. The mental health integration system includes an integrated team led foremost by the patient and family with vital defined roles for primary care providers, care managers, psychiatrists, advanced practice registered nurses, support staff, and the National Alliance for the Mentally Ill.

Evaluation of "depression in primary care" innovations.

Key stakeholders and executive decision makers in health care system require clear and convincing data of the value of chronic illness care models for the primary care treatment of depression. Well-conceived and conducted evaluations provide this necessary information. This case study describes the experience of a large, nonprofit health care system's experience with implementing and evaluating a quality improvement program for integrating depression management into primary care.

Rebuilding Family Relationship Competencies as a Primary Health Intervention.

The authors present Relationship Competence Training (RCT), which is an organized conceptual framework developed by them for assessing a family's ability to mobilize their relational support in times of distress. RTC is a process of studying family relationship patterns and how these patterns influence family health. The RTC model is described as a method of promoting mental health as a part of everyday family health, which is suitable for health care providers working in a wide variety of environments who have in common the desire to offer continuity and value in promoting the health of the families under their care.