{"id":4729,"date":"2016-06-21T00:00:00","date_gmt":"2016-06-21T06:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2016\/06\/21\/the-right-model\/"},"modified":"2023-03-06T10:03:48","modified_gmt":"2023-03-06T17:03:48","slug":"the-right-model","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/the-right-model\/","title":{"rendered":"The right model"},"content":{"rendered":"
<\/div>

Countless times Dr. Richard Lamb, a UCHealth internal medicine physician who has served the Sterling, Colo., community for 42 years, recognized an underlying behavioral health issue affecting the physical health of his patients. But it wasn\u2019t until recently that he began to see significant results from his efforts to address these issues \u2014 and he credits that with the recent integration of a psychotherapist into his practice.<\/p>\n

Front row from left: Dr. Dianne Haas, LPC; Catina Pendleton, care manager; Nicole Showalter, PA; Vickie Beamer, front office; Lori Fehringer, LPN; and Diane Calvert, manager of clinic operations. Back row from left: Dr. Richard Lamb; Thomas Soper, DO; DeeAnn Christopher, LPN; Lisa Souders, MA; Olivia Smith-Lopez, front office; and Teresa Stieb, LPN.<\/figcaption><\/figure>\n

\u201cI had patients who were not making headway with their medical problems,\u201d Lamb said. \u201cThey weren\u2019t able to make the changes we asked of them because of their behavioral health problems. And it was happening more than we thought.\u201d<\/p>\n

In 2013, UCHealth Internal Medicine in Sterling<\/a>, part of Colorado Health Medical Group, UCHealth’s provider group, \u00a0became part of Comprehensive Primary Care<\/a>, a four-year multi-payer initiative established by the Centers for Medicare and Medicaid Services to strengthen primary care. Under the program, clinics try different care models to determine which improves patient access, cost, coordination and engagement. For example, some participants chose to integrate pharmacy services, but Sterling went a different direction.<\/p>\n

\u201cWe started looking at integration of behavioral health,\u201d said Clinic Manager Diane Calvert<\/a>. \u201cWhat would it look like if patients could be taken care of by their primary care physician but be provided integrated mental health \u2014 the two doctors working alongside each other to treat the entire patient?\u201d<\/p>\n

That\u2019s where Dr. Dianna Haas<\/a> came in.<\/p>\n

Haas, a professional counselor, had a private practice in the Sterling community for 14 years and also was the mental health therapist for Valley School District in Sterling. With her community background, strong interest in mental health disorders, experience with substance abuse counseling and training in play and other cognitive behavioral therapies, she was a great fit for the clinic\u2019s new model.<\/p>\n

\u201cIn private practice, I would take into consideration how something like diabetes affected my patient\u2019s mood, but I would only be treating them to improve their depression,\u201d Haas said. \u201cSo, there would be two different people taking care of two different things. I just can\u2019t see doing it that way anymore.\u201d<\/p>\n

In February, Haas moved into the office with Lamb, internal medicine physician Dr. Thomas Soper<\/a>, psychiatric nurse practitioner Rachel Griffin and physician assistant Nicole Showalte<\/a>r.<\/p>\n

Haas continues with her practice but has transitioned her patients into the clinic, and she leaves openings in her schedule to allow for \u201cwarm handoffs\u201d from the providers.<\/p>\n

\u201cA person sees me and we do a depression screening,\u201d Lamb said. \u201cIf we feel it\u2019s needed, Haas is right there for me to introduce the patient to. We try to plan for a warm handoff \u2014 a quick 10 to 15 minutes for them to get acquainted and for the patient to decide if they want to follow up. It\u2019s non-threatening and gets the patient comfortable with Haas.\u201d<\/p>\n

It also demonstrates the physician\u2019s support of mental health \u2014 a key component, Haas said.<\/p>\n

\u201cSuccess depends on how the primary care physician encourages the patient to participate,\u201d she said. \u201cDoctors have a big impact on whether someone will accept mental health services. The warm handoff works really well, and we are trying to develop the language because it can be scary for a person, even a doctor, to say, \u2018We need to talk to a mental health specialist.\u2019 There is still that stigma. But we are seeing success.\u201d<\/p>\n

Despite what Lamb first predicted about the integration, he said he\u2019s seeing bigger improvements in his patients, especially those with chronic depression, than he did before.<\/p>\n

\u201cTo be honest, I was a bit skeptical,\u201d he said. \u201cI didn\u2019t realize that we had so many people who needed mental health services. \u2026 I didn\u2019t think we\u2019d keep her busy, and that is just not the case. They really should have this in every clinic.\u201d<\/p>\n

Lamb said the new model has provided better coordination and communication between himself and Haas because of the handoff and shared electronic records.<\/p>\n

\u201cBefore, I felt like I was sending someone into a black hole,\u201d he said about referring a patient to mental health services. \u201cThere was a disconnect between the primary care physician and the mental health clinic. I wouldn\u2019t know what medications my patient was on, who or when they visited, or even if they went.\u201d<\/p>\n

Haas see the benefits on her end, too.<\/p>\n

\u201cWe can look at assessments, plan, and diagnosis with the same records,\u201d she said. \u201cWe can both see how our patient is progressing and what follow-up might be needed. \u2026 There is this expectation from the patient that they know they are being taken care of.\u201d<\/p>\n

The clinic\u2019s registered nurse care manager, Catina Pendleton<\/a>, also plays a big role in the total care concept. One of her jobs is to follow up with patients who are most at risk to see how they are doing. She follows up with patients at the provider\u2019s request, or after a patient\u2019s name appears on the daily emergency room and hospitalization reports that she receives.<\/p>\n

Until Haas arrived, Pendleton would follow up with physical health issues, such as recording the blood pressure of a patient who recently had a heart attack. But now, she keeps Haas\u2019s patients on her radar too, checking on them \u2014 sometimes daily \u2014 to see if they need anything. She can sometimes make up to 20 calls a day, she said.<\/p>\n

\u201cI\u2019m the go-between,\u201d she said. \u201cWe are all learning this new process \u2014 the physical and mental sides \u2014 but we are treating the whole person. I think it\u2019s a great service, and I think we picked the right model.\u201d<\/p>\n

\n

UCHealth has integrated mental health into other primary care clinics as well. Though not stationed full time at the clinics, UCHealth\u2019s Mountain Crest Behavioral Health providers are available at UCHealth Family Medicine in Windsor and in Greeley, UCHealth Cancer Center, UCHealth Internal Medicine on Snow Mesa Drive and UCHealth Internal Medicine on Prospect Avenue in Fort Collins as well as at the Horsetooth Office of Associates in Family Medicine. The A.F. Williams Family Medicine Clinic at University of Colorado Hospital has provided integrated behavioral health care since 2012<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Countless times Dr. Richard Lamb, a UCHealth internal medicine physician who has served the Sterling, Colo., community for 42 years, recognized an underlying behavioral health issue affecting the physical health of his patients. But it wasn\u2019t until recently that he began to see significant results from his efforts to address these issues \u2014 and he […]<\/p>\n","protected":false},"author":2164,"featured_media":2854,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[113,259],"class_list":["post-4729","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-behavioral-health","tag-internal-medicine"],"acf":[],"yoast_head":"\nThe right model - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Countless times Dr. Richard Lamb, a UCHealth internal medicine physician who has served the Sterling, Colo., community for 42 years, recognized an underlying behavioral health issue affecting the physical health of his patients. 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