The Role of Integrative Care in Advancing the Science of Patient-Centered CareDate: June 8, 2017
According to Global Health Advances in Health and Medicine, integrative medicine is a care approach that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. While some people may have doubts about integrative medicine and wonder if it’s here to stay, the real question is how quickly it will become the standard method of patient care and in which form it will be available.
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How Integrative Care Works
Integrative care is personalized and addresses the entire person — mind, body and spirit. The concept is driven by asking questions and seeks to administer more natural and less invasive care solutions. The concept of integrative care constantly is evolving and being improved. Integrative care practitioners are personally committed to exploring and developing new treatment options. Through integrative care, patients are empowered to develop healthy behaviors and skills for use on a daily basis. Integrative care strategies may include mind-body therapies, nutritional guidance, meditation, resilience training, massage therapy, acupuncture and herbal/nutritional medicine.
A recent survey of 29 integrative care centers found that this approach to patient care is most effective in the treatment of a number of medical conditions, including cancer, chronic pain, gastrointestinal disorders, depression/anxiety and stress.
Forms of Integrative Care
In this pervasive model of integrative care, the patient’s primary care provider and the integrative physicians and practitioners work closely together.
Administered to patients with a specific condition, this model of integrative care calls for the integrative practitioner to provide and manage care services for the duration of the treatment.
In this model, care is offered to patients throughout their entire lifespan. The integrative care center usually employs family practice doctors, interns, nursing practitioners and pediatricians who usually are trained in integrative medicine.
Benefits of Integrative Care
Integrative care increases patient-practitioner trust and cooperation, and trust leads to improved care and lower per capita costs of health care, etc. In the survey of 29 integrative care centers, most of the respondents committed to conducting integrative care research on a regular basis.
Provider Education Programs
The key to success in integrative care lies in provider education. This step is achieved through teaching and designing medical and nursing school curricula. Continuous medical education programs are also incredibly helpful. Most integrative care providers offer fellowships and host regional and national conferences for practitioners. Providers also offer certification and credentialed positions, such as yoga instructors and integrative health coaches.
Collaboration is one of the main benefits of integrative care, which is an important factor in achieving clinical success. For example, education and integrative care services should include family members, who also should be included in practitioner visits.
Integrative care also helps promote healthy habits and lifestyles. These outcomes can be attributed to health coaching, lifestyle change programs and wellness programs that are geared towards prevention.
It is important to note that integrative care is efficient, effective and inexpensive, which is largely due to the fact that treatment is simplified to ensure all care services are properly monitored and managed by the care providers.
Due to the simplicity of processes, costly errors — such as in transcription, ordering, dispensing and administration — associated with unclear pathways are eliminated.
Integrative Care Models
There are three main types of integrative care models: Screening, Brief Intervention and Referral to Treatment (SBIRT) model; Primary Care Behavioral Health model; TEAMcare and Collaborative Care model.
With the SBIRT model, a patient presenting with substance abuse initially is screened to identify the severity of the condition. If a patient’s condition is deemed too complex for the primary care clinic to deal with, the patient is referred to a specialty care provider.
The main objective of SBIRT is to treat patients with mild to moderate substance abuse issues, as well as to identify patients with higher acuity addictions and refer them to specialized clinics. This model arose because of two main reasons: high rates of substance abuse issues were prevalent in the primary care model, and poor access to specialized care for patients affected by substance abuse.
Benefits of SBIRT Model
The SBIRT model has greatly improved the efficiency of identifying patients experiencing substance abuse issues in primary care and emergency departments. It also has led to early identification and treatment of substance abuse, as well as a reduction in health care costs.
Primary Care Behavioral Health Model
In this model, the primary care clinician works alongside a behavioral health consultant to provide immediate or near-immediate intervention care to the patient. This integrative care model emerged as a result of frustrating barriers faced by patients and clinicians seeking mental health services. The main goals of this model are to improve access to mental health care and increase medical provider satisfaction, as well as to improve patient outcomes. Additionally, the benefits of this model often result in increased frequency of employing screening tools, a reduction of referrals to specialized care centers from primary care centers, reduced reliance on antidepressant medication and high acceptance rate among patients with strong therapeutic alliance.
TEAMcare and Collaborative Care Model
In this model, the primary care provider offers treatment that involves a care manager and a consulting psychiatrist. This particular system incorporates onsite screening protocols and occasional mental health support. The model emerged in response to mediocre management of patients suffering from depression in primary care facilities. The primary goal of the collaborative care model is to improve the tracking of patient outcomes using an algorithm and offering the support of a consulting psychiatrist to a primary care clinician.
Benefits of collaborative Care Model
The collaborative care model has resulted in an improvement in outcomes among patients suffering from depression. It also has led to a significant reduction in the total medical cost expenditures.
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