Designing a workflow for behavioral health integration

The newly updated "BHI Workflow Guide" offers best practices and tools on crafting an efficient and effective integrated workflow, enabling primary care providers and their care teams to overcome key barriers to operationalizing integrated behavioral health (BH) care in their practice.

This is part of AMA’s broader efforts to empower health care organizations to overcome obstacles to accessible and equitable treatment for their patients’ behavioral, mental and physical health needs.

Strategies to design workflow

Workflows may look different depending on the practice setting, current staffing, and overall financial considerations; however, general sequences of actions are often consistent. Adjust to fit identified practice needs and available resources.

Approaching workflow design requires practices and systems to consider key questions, such as:

• Staffing: What kind of administrative and clinical staff does the practice need?
  • Key factors include patient demographics, financial considerations and practice setting, as well as daily operations, clinical care and data/record management needs.
• Handoffs: How, and at what frequency, will the staff discuss behavioral health caseloads?
• Protocols for crisis: Who develops and maintains a referral list with contact information for higher-level care?
• Technology: How and under what circumstances will telehealth be used, if at all, to deliver behavioral health care?
• Billing and coding: Are appropriate codes available in the electronic medical record system?
• Patient and staff feedback: How is patient and staff feedback collected and used to iterate on and improve the behavioral health integration workflow?

The guide provides sample workflows (PDF) and an editable plan (PDF) to help practices and systems create their own workflow that works best for them and their patients.

Working from the general to the specific

High-level design includes:

• Identifying and engaging patients
• Identifying and initiating treatment
• Managing treatment plan and tracking
• Proactively adjusting treatment

Specifics are also detailed, with sample checklists provided for use. Physicians and practices are asked to consider staffing and training, any available technology, billing and coding procedures, active crisis protocols, and both patient and staff feedback.

Download the AMA's "BHI Workflow Guide" (PDF) for primary care physicians and health systems to learn more about creating an effective workflow for addressing the behavioral health needs of their patients.

• 7 keys to an efficient integrated behavioral health care workflow
• Establishing efficient workflows
• BHI Compendium for physician practices and health systems
• BHI Collaborative webinar series
• AMA STEPS Forward® toolkit "BHI Into Primary Care"
• BHI in physician practices
• Strategic behavioral health guides for patient care

With an increased number of people reporting worsening mental health in recent years, it is imperative that people are aware of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) telephone program.

People experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress can call, chat or text 988, and speak to trained crisis counselors. The national hotline is available 24 hours a day, 7 days a week.

The previous National Suicide Prevention Lifeline phone number (1-800-273-8255) will continue to be operational and route calls to 988 indefinitely.