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practices in Lancaster County, WellSpan
Family & Pediatric Medicine - Rothsville,
WellSpan Family & Sports Medicine -
Cocalico in Reinholds, and WellSpan Family
Medicine - Meadowbrook in Leola-as well
as a WellSpan practice in Lebanon and five
other WellSpan practices in York County.
The Shared Care program works to
support family practice physicians, who
historically see about half of all behavioral
health concerns, said Dale Brickley, Senior
Director of Innovation and New Service
Development at WellSpan Philhaven.
Sometimes family practice physicians
see patients who have somewhat complex,
ongoing medication needs and end up referring those patients to a psychiatrist for their
medication management. Because of the
regional and national shortage of providers,
that can often delay treatment.

"The goal is to
decrease the
people who are
on waiting lists for
a higher level of
care," Brickley said.
Nationally, nearly one in five people has
behavioral health issues and more than half
of them do not get treatment, according to
figures from Mental Health America. And
the demand for treatment is expected to
increase as the stigma about behavioral health
treatment decreases and rates of depression
increase with social media pressures, the
uncertain times we live in, and the lack of
community. This all occurs as a federal government report projects the supply of workers
in selected behavioral health professions will
be 250,000 workers short of the projected
demand in 2025.
Shared Care offers a team of WellSpan
Philhaven experts, which includes a psychiatrist, a therapist, and two care navigators, to
WellSpan primary care physicians. Primary

care physicians can reach out to the team
via the patient's electronic health record, an
email, or a phone call.
Most of the time, the Shared Care team
will be able to provide enough information
or support that the physician can manage
the patient's issues, either with the proper
medication or even a brief, on-the-spot
therapeutic visit.
"This keeps more routine behavioral
health patients in primary care rather than
sending them for unnecessary specialty
care," said Brickley, who likens it to primary
care physicians who manage their patients'
routine blood pressure problems rather than
sending them to a specialist.
The Shared Care program has seen more
than 500 patients since it was launched a
little more than a year ago. Most of those
patients have stayed with their primary care
physician for their behavioral health care, or
eventually returned there after getting their
medications adjusted. Patients and doctors
like it, Brickley said.
"Sometimes we get someone in who we
have tried to treat with medication, and
we need to try something different and
we don't know what the next step is," said
Zachary Geidel, M.D., of WellSpan Family
& Sports Medicine - Cocalico. "It's nice
to have the ability to discuss that with the
psychiatrist and patient together. It's a
co-management strategy.
"If you try to refer them to a psychiatrist,
it may be a two- to three-month wait. The
patient is left to hang on and still has issues
going on. This creates a nice bridge between
the primary care world and the behavioral
health world that allows quick and easy
access. We are able to initiate treatment a
lot quicker."
Jaclyn Hepworth, a physician assistant at
WellSpan Family & Pediatric Medicine -
Rothsville, reached out to the Shared Care
team for consultation about a new patient
who had recently moved to Lancaster County
and needed support for ongoing behavioral

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health issues, some of which were urgent. The
patient was struggling and was not taking
medications, which the patient previously
had not tolerated well, or getting therapy.
Hepworth was able to quickly get help in
managing the patient's needs. The patient
had hope for the first time in a long time,
Hepworth said.
The process is efficient and is better
equipping family practice providers to treat
behavioral health issues in their offices in the
future, she said."We can call and say we have
a question about things such as medication
side effects or dosages," Hepworth said. "I
am learning through this program."
The Shared Care program is just one
way that WellSpan Philhaven is working
to address the need for behavioral health
care in the region. Other efforts include
an increased use of technology, including
telepsychiatry services, which allow a psychiatrist to remotely check in with patients
in other WellSpan Philhaven offices, and
a mobile application called myStrength,
which offers digital tools to patients to help
them maintain well-being and resilience and
manage stress and anxiety.
WellSpan also has invested in training
programs, providing start-up funding
to Lebanon Valley College to establish a
master's in counseling psychology degree
program starting in 2020. WellSpan will offer
internships and practicum opportunities for
students in the program.



Lancaster Physician Fall 2019

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