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Team-based Models of Care
Jennifer McWilliams, MD, MS
Team-based Models of Care are changing the delivery of psychiatric care, for children and adolescents.
The ideal Team-based Model of Care is the Patient-centered Medical Home (PCMH). The Agency for Healthcare Research and Quality (AHRQ) has delineated 5 components of PCMHs: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety improvement in services.
Telepsychiatry can be utilized in Team-based Models with youth in primary care settings to help build a PCMH. The most commonly used telepsychiatry team-based models currently include: Direct Service, Consultation, and Collaborative Care Models.
The success of Team-based Models of Telepsychiatry Care with youth depends on the strength of the working relationships established between the child and adolescent psychiatrist and providers at the patient site. Innovative approaches to relationship-building may be needed to ensure PCPs willingness to share their care of their young with telepsychiatrists.
Financial models of care are evolving to pay for Team-based Models of Care and need consideration for child and adolescent services.
McWilliams, JK. Integrating telemental health care with the patient-centered medical home model. Journal of Child and Adolescent Psychopharmacology. 2016: 26 (3):278-282.
Agency for Healthcare Research and Quality: Patient Centered Medical Home Resource Center. Available at http://pcmh.ahrq.gov. Accessed May 26, 2018.
Kriechman A, Bonham C: Telemental health in primary care. In: Telemental Health: Clinical, Technical and Administrative Foundations for Evidence-Based Practice, edited by K. Myers, C. Turvey. Waltham, MA: Elsevier, 2013. Pp 155–170.
American Academy of Pediatrics. Pediatric Integrated medicine. http://pediatrics.aappublications.org/content/pediatrics/early/2017/08/24/peds.2017-1961.full.pdf. 2017. Accessed May 20, 2018.
Kindig D, Stoddart G. "What is population health?" (PDF). American Journal of Public Health. 2003; 93 (3): 380–383.
Silverstein M, Hironaka LK, Water HJ, Feinberg E, Sandler J, Pellicer M, Chen N, Cabral H. Collaborative care for children with ADHD symptoms: A randomized comparative effectiveness trial. Pediatrics, 2015:135(4):e859-868.