--- title: "Implementation of collaborative care in the VA. | Sutter Health" description: "This case study examines the effects of collaborative care on patient and primary care provider experiences and communication during clinical encounters." url: "https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Implementation of collaborative care in the VA. # A case study of early experience with implementation of collaborative care in the Veterans Health Administration. Tai-Seale M, Kunik ME, Shepherd A, Kirchner J, & Gottumukkala A. _Popul Health Manag. 13(6):331-7. doi: 10.1089/pop.2009.0082. Epub 2010 Nov 19._ 2010-12-01 ## Abstract Primary care remains critically important for those who suffer from mental disorders. Although collaborative care , which integrates mental health services into primary care , has been shown to be more effective than usual care , its implementation has been slow and the experience of providers and patients with collaborative care is less well known. The objective of this case study was to examine the effects of collaborative care on patient and primary care provider (PCP) experiences and communication during clinical encounters. Participating physicians completed a self-administered visit reconstruction questionnaire in which they logged details of patient visits and described their perceptions of the visits and the influence of collaborative care . Audio recordings of visits were analyzed to assess the extent of discussion about colocated mental health services and visit time devoted to mental health topics. The main outcome measures were the extent of discussion and recommendation for collaborative care during clinical visits and providers' experiences based on their responses to the visit reconstruction questionnaire. Providers surveyed expressed enthusiasm about collaborative care and cited the time constraint of office visits and lack of specialty support as the main reasons for limiting their discussion of mental health topics with patients. Despite the availability of mental health providers at the same clinic, PCPs missed many opportunities to address mental health issues with their patients. Ongoing education for PCPs regarding how to conduct a "warm handoff" to colocated providers will need to be an integral part of the implementation of collaborative care . [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/?term=A+Case+Study+of+Early+Experience+with+Implementation+of+Col) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Psychotropic medication discussions in older adults' primary care office visits: So much to do, so little time.](https://www.sutterhealth.org/research/publications/psychotropic-med-discussions-in-older-adults-in-pc-1055312596) Ahn S, Tai-Seale M, Huber C Jr, Smith ML, Ory MG. Aging Ment Health. 15(5):618-29. doi: 10.1080/13607863.2010.548055. 2011 Jul 01 - Publication ### [Two-minute mental health care for elderly patients: inside primary care visits.](https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643) Tai-Seale M, McGuire T, Colenda C, Rosen D, Cook MA. J Am Geriatr Soc. 55(12):1903-11. 2007 Dec 01 - Publication ### [Patient and physician race and the allocation of time and patient engagement efforts to mental health discussions in primary care: an observational study of audiorecorded periodic health examinations.](https://www.sutterhealth.org/research/publications/pt-md-race-empathy-mental-health-primary-care-1055312353) Foo PK, Frankel RM, McGuire TG, Zaslavsky AM, Lafata JE, Tai-Seale M. J Ambul Care Manage. doi: 10.1097/JAC.0000000000000176. \[Epub ahead of print\] 2017 Mar 27 - Publication ### [New Era Of Patient Engagement](https://www.sutterhealth.org/research/publications/new-era-of-patient-engagement-1055312777) Tai-Seale M. Health Affairs website. 2013 Feb 06 - Publication ### [Balancing digital information-sharing and patient privacy when engaging families in the intensive care unit.](https://www.sutterhealth.org/research/publications/digital-info-sharing-pt-privacy-families-icu-1055312450) Brown SM, Aboumatar HJ, Francis L, Halamka J, Rozenblum R, Rubin E, Sarnoff Lee B, Sugarman J, Turner K, Vorwaller M, Frosch DL; Privacy, Access, and Engagement Task Force of the Libretto Consortium of the Gordon and Betty Moore Foundation. J Am Med Inform Assoc. pii: ocv182. doi: 10.1093/jamia/ocv182. \[Epub ahead of print\] 2016 Mar 16 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Implementation of collaborative care in the VA."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550#medicalscholarlyarticle","name":"A case study of early experience with implementation of collaborative care in the Veterans Health Administration.","headline":"Implementation of collaborative care in the VA.","abstract":"Primary care remains critically important for those who suffer from mental disorders. Although collaborativecare, which integrates mental health services into primary care, has been shown to be more effective than usual care, its implementation has been slow and the experience of providers and patients with collaborativecare is less well known. The objective of this casestudy was to examine the effects of collaborativecare on patient and primary care provider (PCP) experiences and communication during clinical encounters. Participating physicians completed a self-administered visit reconstruction questionnaire in which they logged details of patient visits and described their perceptions of the visits and the influence of collaborativecare. Audio recordings of visits were analyzed to assess the extent of discussion about colocated mental health services and visit time devoted to mental health topics. The main outcome measures were the extent of discussion and recommendation for collaborativecare during clinical visits and providers' experiences based on their responses to the visit reconstruction questionnaire. Providers surveyed expressed enthusiasm about collaborativecare and cited the time constraint of office visits and lack of specialty support as the main reasons for limiting their discussion of mental health topics with patients. Despite the availability of mental health providers at the same clinic, PCPs missed many opportunities to address mental health issues with their patients. Ongoing education for PCPs regarding how to conduct a \"warm handoff\" to colocated providers will need to be an integral part of the implementation of collaborativecare.","description":"This case study examines the effects of collaborative care on patient and primary care provider experiences and communication during clinical encounters.","keywords":["Health Services","Mental Health"],"datePublished":"2010-12-01","url":"https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"DOI","value":"10.1089/pop.2009.0082"}],"sameAs":["https://doi.org/10.1089/pop.2009.0082"],"isPartOf":{"@type":"Periodical","name":"Popul Health Manag"},"author":[{"@type":"Person","name":"Tai-Seale M"},{"@type":"Person","name":"Kunik ME"},{"@type":"Person","name":"Shepherd A"},{"@type":"Person","name":"Kirchner J"},{"@type":"Person","name":"Gottumukkala A"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Mental Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Mental+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550#breadcrumblist"}}} ```