From our practices to yours: Key messages for the journey to integrated behavioral health

Background: the historic,cultural separation of primary care and behavioral health has caused the spread of integrated care to lag behind other practice transformation efforts. the advancing care together study was a 3-year evaluation of how practices implemented integrated care in their local contexts; at its culmination,practice leaders (innovators) identified lessons learned to pass on to others. methods: individual feedback from innovators,key messages created by workgroups of innovators and the study team,and a synthesis of key messages from a facilitated discussion were analyzed for themes via immersion/crystallization. results: five key themes were captured: (1) frame integrated care as a necessary paradigm shift to patient-centered,whole-person health care; (2) initialize: define relationships and protocols up-front,understanding they will evolve; (3) build inclusive,empowered teams to provide the foundation for integration; (4) develop a change management strategy of continuous evaluation and course-correction; and (5) use targeted data collection pertinent to integrated care to drive improvement and impart accountability. conclusion: innovators integrating primary care and behavioral health discerned key messages from their practical experience that they felt were worth sharing with others. their messages present insight into the challenges unique to integrating care beyond other practice transformation efforts.