March 3, 2022
Premera conducts an annual provider survey about the coordination between primary care practitioners (PCPs) and behavioral health practitioners (BHPs). Screening for behavioral health disorders often happens during a primary care office visit and is
a widely recognized standard of care.
A telephone survey of PCPs in all service areas is conducted by Pacific Market Research. For the 2021 survey, the majority or 95% of the respondents were MDs and DOs, the other 5% consisted of ARNPs and PAs. Key findings include:
Integrated Behavioral Health Services
2 of 5 (42%) of PCPs have integrated behavioral health services in their clinics. Of those who have integrated BH services, 87% use a collaborative care model and 69% of the PCPs stated they use the primary care behavioral health (PCBH) model.
Electronic Medical Record (EMR) Use
We asked PCPs about their use of electronic medical records (EMRs). 89% of PCP organizations use EMRs and 88% of PCPs reported they use EMRs regularly. Only 41% of the PCP respondents stated they use the same EMR as their Behavioral Health colleagues,
but 95% of those PCPs use the EMR to review their patient’s behavioral health (BH) records. Among the 59% of PCPs who do not use the same EHR as their BH colleagues, 72% are able to obtain BH records from another source. 28% of the PCPs stated they
had no access to BH records from other sources.
PCP Referrals to BH Practitioners
PCPs were asked, “When you diagnose
depression, anxiety, ADHD, substance abuse, or an eating disorder, how often do
you usually or always refer to a BH practitioner or facility?” PCPs refer eating disorders (77%) and substance use (73%) more often than for ADHD (44%), depression (38%), and anxiety (38%). For those PCPs who do not refer, 96%, (+2% from previous
year) stated they manage those patients’ conditions within their practice.
Frequency of Screening
Practitioners screen at least annually for depression (99%), anxiety (96%), substance abuse (95%), eating disorders (61%), and ADHD (61%). For their patients with diabetes, 89% of PCPs reported they screen for depression at least once yearly, 8% screen
“sometimes,” while 2% of PCPs stated they “never” screen their patients with diabetes for depression.
When screening for depression, 89% of PCPs screen by clinical interview, and 83% screen using a standardized depression instrument, a PHQ or GAD-7.
Areas for Improvement – Patient Safety
After a patient has been seen by a BHP, or admitted for BH services, only 56% of surveyed PCPs stated they “usually or always” receive a discharge summary back for an in-patient hospital stay. Only 39% reported they receive a report from a BH
practitioner, and 32% reported they receive a summary report from an out-patient facility.
We encourage all BH practitioners to collaborate with their PCP colleagues. Sharing information about the patient’s treatment plan and prescribed medications improve coordination and safety for patients accessing behavioral healthcare services.