“One stop shop” care improves outcomes

The typical patient’s journey through the healthcare system is extraordinarily fragmented. From siloed data and repetitious check-in questions to dozens of phone calls and multiple appointments in offices across town from one another, navigating even the most routine care needs can be a dizzying challenge.

Healthcare leaders are working hard to reduce many of the systemic and technical barriers that make coordinated care so difficult, but there are still more strategies to try.  

The co-location of different clinical care providers and non-clinical services may just be the jumpstart that some organizations need to create a more streamlined and effective patient experience.

What is co-location?

Co-location is when different healthcare services, such as primary care, behavioral healthcare, and dental care, are housed in the same physical location. While the services may not be fully integrated with one another, their positioning in the same building or on the same campus may make it easier for patients to access more of the care they need.

Co-location makes it easier for individuals with common socio-economic challenges, such as transportation access or limited time away from jobs and family, to engage with multiple providers at the same time and in the same place.  

Creating a “one-stop shop” for clinical care needs reduces barriers to access and encourages holistic care. Adding non-clinical services, such as social workers, legal counsel, job training, or a food pantry can further enhance the delivery of holistic, person-centered care.

Does co-location work?

There is growing evidence that co-location has a positive impact on patients, especially when dental care, behavioral healthcare, and/or mental healthcare services are tied into the primary care environment.  

For example, a recent study of the Department of Veterans Affairs found that people who were treated for diabetes and mental health illnesses were more likely to remain adherent to their medications and less likely to no-show to appointments when their clinical and mental health services were co-located.

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However, the benefits of physical proximity may be further enhanced by more robust clinical relationships between co-located services. A separate study indicates that collaborative care between mental health and primary care is even more effective: while co-location improved depression screening scores by 14 percent, sites that engaged in collaborative care improved scores by 33 percent.  Both strategies represent significant improvement over baseline non-integrated, physically separate providers.

What should providers consider?

Co-location is a promising strategy for patient care, but it does come with its challenges. Office space isn’t always available while building or renting a new campus to accommodate multiple providers can be prohibitively expensive.

Organizations that are interested in co-location must also meet state and federal guidelines, such as CMS guidance on co-location between hospital entities. These document outlines rules around staffing requirements and compliance with the wide variety of CMS regulations governing hospital operations.

For providers with the space and budget to expand their on-site offerings, consider investing in clear wayfinding tools for patients. For example, shared waiting rooms should have easy-to-understand signage about where to register for the right provider, and websites should include mobile-friendly campus maps and staff directories.

Providers should also be certain that all entities located on the campus have a shared vision for success. It’s important to be transparent about what services have established business and clinical relationships, but it’s equally important to have up-to-date contact information available for less integrated services to facilitate the patient journey.

As providers seek new ways to address socioeconomic and behavioral health issues alongside primary care, co-location of clinical and non-clinical services may be the way forward. Creating a coordinated, patient-friendly health hub has the potential to improve care access, enhance coordination, and reduce the fragmentation of the care experience so all individuals get the holistic, person-centered attention they need to live healthier lives.

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.