The IBHPC study was an implementation and dissemination project funded by the Patient Centered Outcomes Research Institute (PCORI), of which the goal was to enhance the integration of behavioral health into the primary care setting. The University of California San Diego Lewis Family Medicine Clinic embarked on an ambitious plan to study how to best approach the care of patients deemed “high-utilizersâ€
- Describe the clinical, operational, and financial challenges associated with the implementation and sustainability of an interdisciplinary clinic.
- Identify appropriate clinical outcome measures related to patient centered interdisciplinary care.
- Describe how to use a metric and registry driven process to identify a specific patient population (i.e., high utilizer) using electronic health record (EHR) system.