Implementing integrated behavioral health: Testing associations between shared clinical time and space and provider...

Area of Science:

• Primary Care Medicine
• Health Services Research
• Behavioral Health Integration

Background:

• Behavioral health provider (BHP) availability is crucial for integrated care in primary care settings.
• Limited research exists on how BHP availability impacts physician adoption of integrated behavioral health (IBH) services.

Purpose of the Study:

• To examine the association between shared clinical time and space with a BHP and physician referrals for IBH services.
• To assess the impact of shared space on the proportion of warm handoffs within total behavioral health referrals.

Main Methods:

• A quasi-experimental study conducted in two family medicine outpatient clinics.
• Data collected over four months from 2,847 patients using electronic health record chart reviews.
• Analysis involved Poisson regression and general linear modeling to assess referral patterns and warm handoffs.

Main Results:

• Greater shared time and space between BHPs and physicians significantly correlated with a higher number of IBH referrals.
• Increased schedule overlap was associated with a greater proportion of warm handoffs, with a 1-unit increase in overlap linked to a 110% rise in warm handoff likelihood.

Conclusions:

• Shared physical and temporal proximity between BHPs and physicians is a key factor in effective integrated care.
• This exploratory study provides initial evidence supporting the benefits of co-location for IBH services.