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Transcript of Linkedin Power point
![Page 1: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/1.jpg)
SYNCHRONIZATION
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llllllll
ASystemic Integration
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ppp llllllll
ofBehavioral Health
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ppp llllllll
into the Medical Continuum
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ppp llllllll
T. C. O S N E R & A S S O C I A C A T E S
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I didn’t pick my illnesses
![Page 7: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/7.jpg)
To my endocrinologist,I’m a diabetic
![Page 8: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/8.jpg)
To my PCP,I have Crohn’s
Disease
![Page 9: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/9.jpg)
To my OB-GYN,It’s a recurring
infection
![Page 10: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/10.jpg)
To my Oncologist,I have breast CA
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To my Hospitalist,I’m someone to
stabilize
![Page 12: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/12.jpg)
To the ED doc,I’ve got panic attacks
![Page 13: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/13.jpg)
What’s the one thing they
all have to deal with?
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The reason I have to see them
more than I should ?
![Page 15: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/15.jpg)
My Depression . . .
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My Depression . . .
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. . . my socialstressors . . .
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. . . and my addiction
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llllllllll
Behavioral health issues . . .
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llllllllll
. . . the pervasive co-morbidity
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By now, we’ve all seen the stats
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But we still suffer from . . .
STEREOTYPES
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“Will someonePlease get thisPsych patient
outof my ED?”
![Page 24: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/24.jpg)
A partial solution . . .
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. . . adding much needed serves
Behavioral health in Oncology
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. . . Creating medical homes
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But it’s a systems problem . . .
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Behavioral Health Integration,
like the rest of Healthcare,
has been stitchedtogether into a
Monster
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An arm here . . . . . . a leg there . . .
and last – The Brain
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Developing in silos . . .
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Independent
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Uncoordinated
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Uncooperative
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disconnected
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duplicative
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protective
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“MyProgram”
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A philosophy of integration . . .
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. . . based on new assumptions
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Behavioral Health is inclusive of promoting well-being . . .
![Page 41: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/41.jpg)
. . . preventing and intervening in harmful behaviors . . .
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. . . and the treatment of mental health and addictions disorders
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It is a primary service firstand a specialty service second
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It engages all behavioral healthmatters regardless of location
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Treatment occurs at the siteof the most frequent medical
utilization
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Treatment is synchronizedacross the medical continuum
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The systems engages with the patient rather than patients having to engage with
departments
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Behavioral heath integrationIs defined on three levels
Substance abuseand mental health
Internal integrationof core services
External integrationinto the medical continuum
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Realigning and repurposing resources
to be FTE neutral
![Page 50: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/50.jpg)
How to build an integrated service: From primary to specialty care
Assessment & ReferralAnchor Service(licensed SW/Registrar/Hybrid ClinicianCall Center/Database-EMR/Inter-departmental)
From routine to acute
Embedded Hybrid PracticesIn Primary Care
Embedded Hybrid Practicesin Specialty Care(cardiology, oncology, endocrinology, etc.)
Reprogramming of BHUandRealignment of psychiatry
Realignment of existingHospital-base outpatientinto hybrid MH/CD programs
Hospital-based Behavioral Health
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All integration effortsboth in internal and externalbegin with the developmentof the Hybrid Clinician
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Creating . . .
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Creating . . .
E T H O S
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As every Marine is a rifleman . . .
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. .. every clinician is a Hybrid
![Page 56: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/56.jpg)
Hybrid Clinician profile
• Licensed Masters – level Clinician in social work, psychology or marriage/family
• Licensed or Certified Alcohol/Drug Counselor
• Conceptual/systems thinker
• Flexible team player
• Strong diagnostic skills
![Page 57: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/57.jpg)
Hybrid Clinician profile
• Experienced in different levels of care
• Entrepreneurial
• Desire to be more than just “a therapist”
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Hybrid Clinician skillset
• Knows the entire system
• Functions at any level of care
• Interventionist: CBT/SFBT/MI
• High Risk case management
• Utilization management
• Registrar
![Page 59: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/59.jpg)
Hybrid Clinician skillset
• Versed in Lean Principles
• Certified in Primary Behavioral Health Care
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Financial sustainability is achieved
through existing payment mechanisms
and creative partnershipswith payers
![Page 61: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/61.jpg)
Creating an organic system .
Embed infrastructure
rather than a service
![Page 62: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/62.jpg)
Creating an organic system .
Embed infrastructure
rather than a service
Hybrid skillsets –
No Wrong Front Door
![Page 63: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/63.jpg)
Creating an organic system .
Hybrid skillsets –No Wrong Front Door
Treatment is synchronizedand flows through
the system
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Creating an organic system .
Treatment is
synchronizedand flows through
the system
![Page 65: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/65.jpg)
ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
Single Hospital System
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
![Page 66: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/66.jpg)
ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
Single Hospital System
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
SpeciallyTrainedHybrid
Clinicians
![Page 67: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/67.jpg)
ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
Single Hospital System
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
PreviouslyUnidentified
Psych Drivers
![Page 68: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/68.jpg)
ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
Single Hospital System
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
PreviouslyUnidentified
Psych Drivers
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
Single Hospital System
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Integrate intoSystemPCPs &
Specialties
![Page 70: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/70.jpg)
ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
Single Hospital System
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Integrate intoSystemPCPs &
Specialties
![Page 71: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/71.jpg)
Challenges & Hurdles
“You can’t do that”
![Page 72: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/72.jpg)
Challenges & Hurdles “Our system is too big”
![Page 73: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/73.jpg)
Challenges & Hurdles “You can’t do it all at
once”
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Challenges & Hurdles “What about HIPAA”
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Challenges & Hurdles
“We can’t afford additional FTES”
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F
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Fi
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Fir
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Firs
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First
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First S
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First St
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First Ste
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First Step
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First Steps
Diagnose the System
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First Steps
Diagnose the System
“If you want to truly understand something (like your organization), try to change it”
Kurt Lewin
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First Steps
Diagnose the System
• the Infrastructure
• the Culture
• the Continuum connectivity
• its nimbleness
• current employee fit
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Diagnose the System
• the Infrastructure
• the Culture
• the Continuum connectivity
• its nimbleness
• current employee fit
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Identify administrator
and physician Champions!
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Identify administrator
and physician Champions!
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![Page 92: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/92.jpg)
Train 1st generation Hybrids and their leader.
(Hybrid boot camp)
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Educate Payers regarding the model
and haveHybrids credentialed
on all panels
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Engage Finance for all Proper Support
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Engage IT for all Proper Support
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Identify PCP/SpecialtyBeta Sites
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Then . . .
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Tell the story
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Tell the story
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Tell the story
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First Steps are bothsequential and simultaneous
efforts
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Playing in old Yankee Stadiumwhile building
New Yankee Stadium
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Single Hospital System
![Page 104: Linkedin Power point](https://reader033.fdocuments.us/reader033/viewer/2022051707/58ed74ae1a28aba8218b464f/html5/thumbnails/104.jpg)
ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Single Hospital SystemOne
Department
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Single Hospital SystemOne
DepartmentOne Identity
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Single Hospital SystemOne
DepartmentOne IdentityMultifaceted
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Single Hospital SystemOne
DepartmentOne IdentityMultifaceted
Revenue generating
Across the
Continuum of Care
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Single Hospital SystemOne
DepartmentOne IdentityMultifaceted
Revenue generating
NoWrongDoor
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ICU
PCP PCP
PCPPCP
PCPPCP
SpecSpec
SpecSpec
Spec Spec
SPECIALTYMED/SURG
EDBHU
SpecialtyMentalHealth
SpecialtyMentalHealth
A&RC.C.
Supplemented by billable
Web-basedCBT
Web-basedCBT
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What it is and what it does . . .
• Embeds infrastructure, not just a service
• Coordinates systems rather than clinicians
• Delivers treatment where the patients are
• Reduces stigma and impacts compliance
• Impacts costs
• Not the typical Hub & Spoke system