Clinical Integration: The Promise and the Path

摘要

The phrase "integrated care" has several meanings. Here we use "integrated care" in one specific sense: better coordinating behavioral health services with medical and surgical services. There are other meanings of this term, though different, that are generally consistent with our usage: e.g., placing other scientifically-based professionals in the medical surgical setting, e.g., nutritionists and dentists. However, there are some usages that are not consistent with our general thrust: e.g., placing non-scientifically based "alternative medicine" in primary care. Alternative medicine is a domain that has both gold and chaff, and until properly controlled studies separate the effective elements from the unhelpful or even iatrogenic elements, we do not endorse this sort of "integration".Cummings, Cummings, and Johnson (1997) have provided a graphical representation of the range of possible coordination.Thus integration can range from activities (in the order of less to more integration) such as a referral call for information exchange, to meetings to discuss