Organizational Assessment Toolkit
(OATI)
for Primary and Behavioral Healthcare Integration
March 17, 2014
Developed by Center for Integrated Health Solutions
in partnership with MTM Associates, Inc. (David Lloyd) and
ZiaPartners, Inc. (Ken Minkoff, MD and Christie A. Cline, MD, MBA)
Slides for today’s webinar are
available on the CIHS website at:
www.Integration.samhsa.gov
under About Us/Webinars
Today’s Presenter
Kenneth Minkoff, MD
Senior Systems Consultant
ZiaPartners, Inc.
kminkov@aol.com
What is the purpose of OATI?
To help any type of health or behavioral
health program, organization, partnership,
or system to develop integrated care
capability to improve care, lower costs, and
save lives.
Who is OATI designed for?
OATI is designed to support an entire
organization making progress, and any
program in the organization, NOT just a
specialty primary health/behavioral health
program.
This includes:
• Primary care providers of any type
• Behavioral health providers of any type (including MH,
SA, ID/DD, BI)
• Organizations working independently or with partners
• Organizations working toward PCMH certification, as
well as those who are not
• Organizations with any resource base or funding model
• Organizations just beginning, and those further along
Key concepts that inform OATI
• Organization-wide assessment and
improvement
• Bidirectional integration of PH and BH services
(PHBHI)
• Customer-oriented continuous quality
improvement (CQI)
Concept 1:
Organization-wide assessment and
improvement
Premise: Individuals with co-occurring PH and BH needs
(including trauma) are an expectation in all programs.
• These individuals have poorer outcomes and higher
costs.
• Therefore, all programs need to improve their
capability to deliver integrated services.
• OATI is designed to help any organization and any
program make progress.
Concept 2:
Bidirectional PHBHI
Integration
• Individuals and families with PH and BH needs work
with a team that addresses both types of needs at the
same time.
• This “product” of integrated care can be delivered in
many ways, in many settings.
Key processes in producing
bidirectional PHBH integration
• Organizational culture focused on high quality
customer service for people with PH/BH issues.
• Transforming all policies, practices, programming, and
financing to support integration.
What is integration?
• A process over time for the whole organization
• Fully articulated customer-oriented CQI process, not a
“project”
• More than just a referral partner, co-location, or merger
• More than hiring special staff
• More than achieving special certification (e.g., PCMH)
• More than a particular tool, diagnosis, process (e.g.,
SBIRT) or program (e.g., IMPACT)
• Involves multiple series of rapid cycle changes over time
Concept 3:
Customer-oriented CQI
• Customer experience first
• Progress not perfection – achievable improvements
over time
• Continuous cycles of change (Plan-Do-Study-Act)
The four core OATI tools are used to frame a CQI process.
OATI also includes a CQI Reference Guide that provides
basic “how-to” info on improving integration.
Integration and PCMH certification
OATI provides a crosswalk with the six major NCQA
Standards Focus Areas (PCMH 1-6).
OATI illustrates how each area connects to improving
PHBH integration.
1. Enhance access and
continuity
2. Identify and manage
populations
3. Plan and manage care
4. Provide self-care support
5. Track and coordinate
care
6. Measure and improve
performance (QI)
The five major sections of the OATI
1. Introduction
2. The four major assessment tools
3. Customer-oriented CQI reference guide
4. Addendum: Optional tools and change
management materials
5. Appendix: References and PHBHI resources
Section 2:
The four major assessment tools
• Designed to be used in order, but each can
stand alone.
• Best positioned within a vision-driven, organized
change process.
Section 2:
The four major assessment tools
1. Partnership Checklist:
Assessing need for partner, and next steps in
more effective partnerships
Section 2:
The four major assessment tools
2. Executive Walkthrough:
Assessing and improving the “customer
experience” of individuals with PH/BH needs
Section 2:
The four major assessment tools
3. Administrative Readiness Tool (ART):
Assessing and improving key administrative
practices and processes (open access, data
collection, billing and revenue collection, etc.)
necessary for integration
Section 2:
The four major assessment tools
4. COMPASS-PH/BH:
Assessing and improving clinical policies,
procedures and practices that support
successful delivery of integrated care in any
program.
Section 3:
CQI Reference Guide
• Includes introduction to change management,
change teams, rapid cycle change, and PDSA
cycles.
• Illustrates concrete, practical application of CQI
(PCMH 6) to common improvement areas for
programs and organizations.
• Includes optional organizational QI capacity
assessment tool (QI-IQ).
Common starting places for change
(matched to PCMH focus area)
Creating a Relationship (PCMH 1)
• Customer service (welcoming, hope, and engagement)
• Facilitating integrated access
• Improving “rate of return” (continuity)
Seeing the Issues (PCMH 2)
• Screening and identification
• Integrated assessment documentation
Common starting places for change
(matched to PCMH focus area)
Providing Helpful Care (PCMH 3)
• Integrated care planning & stage-matched interventions
• Implementation of collaborative care & disease
management protocols
Providing Cost-effective Care (PCMH 4)
• Maximizing revenue flow for integrated care delivery
• Improving outcomes for high utilizers
Common starting places for change
(matched to PCMH focus area)
Providing Helpful Care (PCMH 3)
• Integrated care planning & stage-matched interventions
• Implementation of collaborative care & disease
management protocols
Providing Cost-effective Care
• Maximizing revenue flow for integrated care delivery
• Improving outcomes for high utilizers
Common starting places for change
(matched to PCMH focus area)
Supporting Self-care (PCMH 4)
• Implementing self-management skills training
• Providing access to peer health coaching and recovery
support
Working as a Team (PCMH 5)
• Information sharing
• Cross-consultation, collaboration and teamwork
Common starting places for change
(matched to PCMH focus area)
Building a Capable Workforce (PCMH-All)
• Workforce development
Section 4:
Optional tools and materials
Includes the following:
• Strategic planning tool (SPIN)
• Project management tools and matrices
• Program improvement planning tools
Use these if you find them helpful.
Section 5:
References and resources
• Includes an array of practical material that has
been gathered by the Center for Integrated
Health Solutions.
• Examples include references, screening tools,
clinical tools, program references, integrated
care materials, helpful links.
Have fun improving integration
in YOUR program or organization!!!
For More Information…
Additional Resources
For More Information…
Contact Information
Questions? SAMHSA-HRSA Center for Integrated Health Solutions
integration@thenationalcouncil.org
Thank you for joining us today.
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