Models of Integration

Six Levels of Collaboration/Integration (Core Descriptions)

COORDINATED
Key Element: Communication
Level 1
Minimal Collaboration
Level 2
Basic Collaboration at a Distance
Behavioral health , primary care and other healthcare providers work:
In separate facilities where they:

  • Have separate systems
  • Communicate about cases only rarely and under compelling circumstances
  • Communicate, driven by prover need
  • May never meet in person
  • Have limited understanding of each other’s roles
In separate facilities where they:

  • Have separate systems
  • Communicate periodically about shared patients
  • Communicate, driven by specific patient issues
  • May meet as part of larger community
  • Appreciate each other’s roles as resources

 

CO-LOCATED
Key Element: Physical Proximity
Level 3
Basic Collaboration Onsite
Level 4
Close Collaboration Onsite with Some System Integration
Behavioral health , primary care and other healthcare providers work:
In same facility not necessarily same offices, where they:

  • Have separate systems
  • Communicate regularly about shared patients, by phone or e-mail
  • Collaborate, driven by need for each other’s services and more reliable referral
  • Meet occasionally to discuss cases due to close proximity
  • Feel part of a larger yet ill-defined team
In same space within the same facility, where they:

  • Share some systems, like scheduling or medical records
  • Communicate in person as needed
  • Collaborate, driven by need for consultation and coordinated plans for difficult patients
  • Have regular face-to-face interactions about some patients
  • have a basic understanding of roles and culture

 

INTEGRATED
Key Element: Practice Change
Level 5
Close Collaboration Approaching an Integrated Practice
Level 6
Full Collaboration in a Transformed/Merged Integrated Practice
Behavioral health , primary care and other healthcare providers work:
In same space within the same facility (some shared space), where they:

  • Actively seed system solutions together or develop work-a-rounds
  • Communicate frequently in person
  • Collaborate, driven by desire to be a member of the care team
  • Have regular team meetings to discuss overall patient care and specific patient issues
  • Have an in-depth understanding of roles and culture
In same space within the same facility, sharing all practice space, where they:

  • Have resolved most or all system issues, functioning as one integrated system
  • Communicate consistently at the system, team and individual levels
  • Collaborate, driven by shared concept of team care
  • Have formal and informal meetings to support integrated model of care
  • Have roles and culture that blur or blend