Practice-Based and Telemedicine-Based Collaborative Care

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Collaborative care can be practice-based or telemedicine-based depending on the needs and resources of the clinic. 

Practice-Based Collaborative Care
Practice-based collaborative care is usually implemented in larger medical clinics where there is sufficient room in the facility to house an integrated care team. In this model, the behavioral health care manager is physically located in the clinic and works with patients through both office visits and by phone.

The psychiatric consultant might have limited office hours in clinic or work with the team remotely to review caseloads and make treatment recommendations. The consultant is also typically available to the practice during usual business hours for ad hoc consultation.

Telemedicine-Based Collaborative Care
In many rural areas and in small practices, collaborative care services can be provided almost entirely via telephone from a different location.

This care is often referred to as telemedicine-based collaborative care and, in contrast to practice-based collaborative care, the behavioral health care manager is located at a different "hub" location most of the time. This allows the care manager to support smaller-sized caseloads that are managed by care teams at more than one clinic in a "hub and spoke" system. Ideally, the care manager is available to meet with their patients and each of the care teams that they work with on a regular basis in person, even though most of their time is off site.

As with practice-based collaborative care, the psychiatric consultant works remotely for caseload consultation and is also typically available by phone or video during usual business hours for ad hoc consultation.