Overview of Presentation

1. Overview of Presentation • Overview of the VISN 16 PCMH Program • Description of PCMH models • VISN 16 PCMH program outcomes • The Rest of the Story

2. South Central VA Health Care Network—VISN 16

3. VISN 16 PCMH • All ten sites participated • Implementation of PCMH in at least one clinic in each VAMC • Option of implementing: • Care Management through TIDES • Co-located integrated care • Facilitation at the Network Level

4. Scope and Clinical Roles:Co-Located Integrated Model • Usually consists of a prescribing provider and therapist team • Same Day visits • See All Comers – with few restrictions on diagnosis • Become part of the Primary Care Team • 15-45 min structured assessment • Medication and/or brief Psychotherapy • Consultation with Primary Care Providers • Chronic Severe patients referred to Specialty MH

5. Scope and Clinical Roles • Care Manager Model • MDD, Alcohol Use • Patient Education • Symptom and Side Effect tracking • Brief, Structured intervention • Consultation/Weekly Supervision • Primary Care Physician • Team Psychiatrist

6. Key TIDES Features • Focus is on patients with depressive disorders • Mostly telephone • Much appreciated by patients • CPRS/VistA tools based • Emphasis on patient self-management support • Initial decisions and prescribing primarily in primary care • Strong ties to mental health supervision

7.  Mt Vernon CBOC Tulsa CBOC Oklahoma City  Ft. Smith CBOC Little Rock Shreveport Jackson Care Manager Alexandria Co-Located  Pensacola CBOC Biloxi New Orleans Houston VISN 16 PCMH Programs

8. PCMH Provider Workload(June 2007 – May 2008) TOTAL 8,129 13,940

9. Uniques seen in PCMH 10% 9% 91% 90%

10. PCMH Uniques Monthly

11. MH Consults per Quarter

12. Program Evaluation • VISN 16 PCMH Program • Received 5.3% of the FTEE supported nationally • Comprised 9.44% of PCMH productivity to date