TY - JOUR
T1 - Functional Rehabilitation
T2 - An Integrated Treatment Model for Patients with Complex Physical and Psychiatric Conditions
AU - Orme, William H.
AU - Fowler, J. Christopher
AU - Bradshaw, Major R.
AU - Carlson, Marianne
AU - Hadden, Julia
AU - Daniel, Jelani
AU - Flack, James N.
AU - Freeland, Diana
AU - Head, John
AU - Marder, Kate
AU - Weinstein, Benjamin L.
AU - Madan, Alok
N1 - Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - The health care delivery system in the United States, structured to provide single-disease care, presents unique challenges for patients with complex physical and psychiatric comorbidities. Patients in these populations are often referred to multiple specialty clinics, encounter little continuity of care or collaboration among their providers, incur high health care costs, and experience poor treatment outcomes. Given these barriers, questions remain about the extent to which siloed and fragmented care, as opposed to the complex nature of the illnesses themselves, contribute to poor outcomes. If given the opportunity to receive well-integrated, consistent, and personalized care, can patients with historically difficult-to-treat comorbid medical and mental illnesses make progress? This article describes an innovative model of care called functional rehabilitation that is designed to address existing barriers in treatment. The functional rehabilitation program seeks to disrupt the escalating effects of interacting comorbidities by offering highly collaborative treatment from a small team of clinicians, personalized interventions using a shared decision-making framework, multipronged treatment options, colocation in a large hospital system, and significant 1:1 time with patients. The article includes a case example with longitudinal outcome data that illustrates how progress can be made with appropriate programmatic supports. Future research should examine the cost-effectiveness of this model of care.
AB - The health care delivery system in the United States, structured to provide single-disease care, presents unique challenges for patients with complex physical and psychiatric comorbidities. Patients in these populations are often referred to multiple specialty clinics, encounter little continuity of care or collaboration among their providers, incur high health care costs, and experience poor treatment outcomes. Given these barriers, questions remain about the extent to which siloed and fragmented care, as opposed to the complex nature of the illnesses themselves, contribute to poor outcomes. If given the opportunity to receive well-integrated, consistent, and personalized care, can patients with historically difficult-to-treat comorbid medical and mental illnesses make progress? This article describes an innovative model of care called functional rehabilitation that is designed to address existing barriers in treatment. The functional rehabilitation program seeks to disrupt the escalating effects of interacting comorbidities by offering highly collaborative treatment from a small team of clinicians, personalized interventions using a shared decision-making framework, multipronged treatment options, colocation in a large hospital system, and significant 1:1 time with patients. The article includes a case example with longitudinal outcome data that illustrates how progress can be made with appropriate programmatic supports. Future research should examine the cost-effectiveness of this model of care.
KW - complex comorbidities
KW - difficult-to-treat conditions
KW - integrated care
KW - personalized medicine
KW - shared decision-making
KW - Comorbidity
KW - Humans
KW - Treatment Outcome
KW - Referral and Consultation
KW - Mental Disorders/therapy
UR - http://www.scopus.com/inward/record.url?scp=85129997565&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85129997565&partnerID=8YFLogxK
U2 - 10.1097/PRA.0000000000000623
DO - 10.1097/PRA.0000000000000623
M3 - Article
C2 - 35511095
AN - SCOPUS:85129997565
SN - 1527-4160
VL - 28
SP - 193
EP - 202
JO - Journal of Psychiatric Practice
JF - Journal of Psychiatric Practice
IS - 3
ER -