APPENDICES
A Federally Qualified Health Center concept is used to operate the extensive network of community health clinics that make up Long Island Select Healthcare Inc. At 8 locations around Suffolk County, New York, we offer Article 16 and 28 clinic services. Providing clients with primary care at home and virtually is the mission of Long Island Select Healthcare (LISH), a healthcare business. According to Article 28, LISH offers comprehensive care, which includes diagnostic and therapeutic work, medical care specializations, dental consultations, chronic care management techniques, behavioural health, and specialized therapeutic techniques.
The vision of LISH: transforming healthcare by uniting resources and communities to assist people in realizing their most tremendous potential.
The mission of LISH is- Ensure that everyone has access to high-quality, all-encompassing healthcare while considering each patient’s particular requirements and ability.
Abbreviations
LISH-Long Island Select Healthcare
DSRIP-Delivery System Reform Incentive Programme
BIH-Behavioral Health Providers
Introduction
LISH is a healthcare organization that provides home and virtual primary care to the client. LISH incorporates both physical and virtual services. Through their patient portal, it is possible to gain direct access to medical information, consultations with medical providers, and secure appointments with other medical services. Long Island locations include; Central Islip along 159 Carleton avenue, which offers services from 8a.m in the morning to 6p.m in the evening, Manorville at 221 North Sunrise Highway, East Mainstreet Riverhead, 75 Landing Meadow Road Smithtown, port Jeff and Hauppauge. LISH’s mission is to provide access to comprehensive care through respecting unique abilities and patients’ needs throughout their lifetime. The vision is the transformation of healthcare through bringing resources and communities together to realize the full potential of individuals.
Under Article 28, LISH provides comprehensive care, including diagnostic work and treatment, medical care specialties, dental consultations, chronic care management practices, behavioural health, and therapeutic specialization practices. Through the information I got from the medical superintendent, LISH participates in the 340B program that entails an agreement that limits the piece manufacturers may impose on certain covered entities for covered drugs administered in the outpatient department. LISH offers occupational and physiotherapy through the New York state office of individuals living with developmental disabilities governed by Article 16. The organization is a federally qualified entity that offers comprehensive and preventive healthcare focusing on medically underserved or unserved people, low-income individuals, and sub-recipients of the Suffolk Care Delivery System Reform Incentive Programme (DSRIP) to uphold the delivery of medical care for uninsured people and medical aid beneficiaries.
The medical superintendent took me through the organizational structure. Staff at LISH include physicians and surgeons, audiologists, management, directors, administrative assistants, and receptionist. The receptionist offers the first service as the patient visit the facility. Behavioural care specialists asses the patient’s habits and aspects that affect their physical and mental health. Dental care specialist deals with oral health, and gynecologist deals with reproductive health. Audiologist deals with hearing disabilities, while administrative assistants are responsible for the day-to-day running and integration in the healthcare facility.
Model Identification and Evaluation
The model of integration used is collaborative. The medical superintendent informed me that LISH had implemented a systematic approach to patient care, including for patients with mental disorders like depression, through integrating care managers and consultant psychiatrists available online and in the facility. Primary care physicians oversee the patient, referring to proactive management of conditions like chronic diseases to specialists. The patient portal avails a harmony of activities that the practitioners can do in one place. This includes a patient review of medical records, a request for review of medical records, or current education. Request or review lab tests and diagnostic reports. View of referrals and demographic information. These aspects of collaborative care track patient registry, treatment to target, and measurement-based practice (Bauer et al., 2018). In coordinated care, trained primary care providers and embedded specialists (BIH) offer evidence-based treatment, especially for psychiatric patients, supported by frequent psychosocial case consultations and treatment adjustments for patients who are showing no improvement (Hartley et al., 2020). The availability of a patient portal on the LISH website for mental health management and consultation with the request of lab forms and medical fills evidences collaborative care at LISH. The availability of various healthcare professionals in one setting allows them to provide quality care by minimizing referrals. Coordinated care also brings about equality between healthcare professionals participating in the management team, facilitating strong verbal and written communication for better management of patients (Braut et al., 2022). Moreover, the participation of the different providers and patient ensures patient-centeredness that brings about better governance.
On the other hand, through the medical superintendent’s guidance, I noted differences in professional training approach to therapy between a specialist and a general practitioner. Professional barriers may hinder the full collaboration of practitioners in the management team. Any team communication breach may be a setback to the whole process. Although the collaborative model seeks to bring about proper flow of information and integration between providers in managing the patient, this may not be realized due to the LISH’s model that brings about different departments to operate as a unit. The disadvantage is that the roles may not be clear-cut, bringing about professional conflict. There may be barriers to the flow of information, or a different approach to care from various departments may fail to realize all patient needs. This collaborative model applied by LISH is ineffective.
Model Impact
The collaborative care model is recommended as one of the best practices in mental health (Kilbourne et al., 2018). LISH practices of availing physical and online consultation in one platform increase efficiency in consultation and reduce duplicate assessment. Patients with limited access to mental health encounter the problem of a lack of follow-up. However, the team tracks patients in a registry in collaborative care by enacting population-based care. This mode provides accountable care where providers get rewarded for clinical outcomes, not only for services. LISH’s team-based care is built upon a familiar location offering physical and mental health care. Through their respect for the unique abilities of patients in their lifetime, the team mandates to measure patient goals and clinical outcomes using evidence-based tools. Through their efficient collaborative care, LISH has received recognition in Suffolk county in the management of patients with autism. One of the five elements of coordinated care, accountable care that follows the pay-for-performance principle, requires payment to practitioners for outcomes.
However, this has not been fully realized due to low reimbursements, an area to improve. Other areas include payer models that discourage integrated care can undergo redesigning and shift toward value-based reimbursements. Integration of digital mental health systems in clinicians will also improve workflow. The operational management of LISH ensures that the financial department meets the clinical department’s financial needs, thereby providing quality care. The operation management also ensures cohesion between the departments and a working platform.
Conclusion
Since collaborative care is the desired health approach model, collaborative partnerships can be enhanced by encouraging collaboration within and between provider teams and service sectors to deliver care. In LISH, cooperation between the different departments can be improved by conducting physical meetings on clinical cases. Practitioner education on data and measurement would enhance their understanding of mental population health, risk factors, and patterns of care. This will improve and consolidate the approach and avoid confusion. Lish can also improve on plans for care continuity. This will prepare for changing the clinical and social needs of people with mental health conditions.
For future success, organizations need to build existing relationships. Once patients establish a current relationship, they tend to be their services for years. Furthermore, the organization can develop skills and roll out roles of different practitioners in the setting to avoid overlap of duties. Finally, leveraging more people to use digital applications for healthcare management as an extension of public health management will improve wellness and health due to the widespread use of mobile phones.
References
Bauer, A. M., Iles-Shih, M., Ghomi, R. H., Rue, T., Grover, T., Kinsler, N., … & Katon, W. J. (2018). Acceptability of mHealth augmentation of Collaborative Care: A mixed methods pilot study. General hospital psychiatry, 51, 22–29.
Braut, H., Øygarden, O., Storm, M., & Mikkelsen, A. (2022). General practitioners’ perceptions of distributed leadership in providing integrated care for elderly chronic multi-morbid patients: a qualitative study. BMC health services research, 22(1), 1-12.
Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, p. 102, 103490.
Kilbourne, A. M., Beck, K., Spaeth‐Rublee, B., Ramanuj, P., O’Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018). Measuring and improving the quality of mental health care: a global perspective. World Psychiatry, 17(1), 30–38.
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