Lessons in Not Reinventing the Wheel: What MLP Can Learn from Other Integrated Care Models
Originally posted by the National Center for Medical-Legal Partnerships, July 23, 2014.
As someone who recently helped start a medical-legal partnership (MLP) in Philadelphia, I have found that there are important lessons to be learned about integrating services, not just from other MLPs, but from our healthcare partners themselves who already embrace other models of interprofessional, collaborative care. After working my way through Phase I of the 2014 MLP Toolkit, I wanted to offer two additional pieces of advice to anyone starting an MLP:
- Mine a potential health care partner’s internal landscape and history for examples of service integration, whether successful or not. Indeed, advice and technical assistance from the National Center for Medical-Legal Partnership (NCMLP) and from other MLPs will be essential to your planning and implementation processes. However, it’s critical to dedicate equal attention to unpacking the history and experiences of the place where you plan to integrate legal advocates and learn all you can from their past attempts at service integration. As Phase I of the MLP Toolkit mentions on page 6, “Addressing psychosocial and care coordination needs have been increasingly accepted as critical to improving health, and both social workers and patient navigators have been integrated into the healthcare team at most healthcare institutions.” Leveraging these types of experiences, lessons learned, and best practices will likely streamline your integration process, making it more efficient and effective. They have lessons to teach MLPs, and an individual healthcare institution’s personal history with these types of projects may inform their willingness to partner with legal services.
- Explore websites and publications authored by thought leaders from organizations in parallel movements like Collaborative Family Healthcare Association (CFHA), which was established around the same time as the first medical-legal partnership at Boston Medical Center. Just as NCMLP espouses the importance of fostering relationships across disciplines to “build a better healthcare team,” CFHA “envisions seamless collaboration between psychosocial, biomedical, nursing, and other healthcare providers, and views patient, family, community, and provider systems as equal participants in the healthcare process.” To get started, I recommend reading a recent blog post on interprofessional integration processes by Dan Marlowe, PhD, LMFT on CFHA’s website.
Medical-legal partnership and all other “strains” of integrated care delivery should not be considered as ends in themselves; rather, they are iterative processes, deeply dependent on thoughtful cultivation of trusting, equitable relationships. These critical relationships should be made horizontally and vertically, within and across organizations and movements, as we strive together to achieve the healthcare Triple Aim. And making use of existing infrastructure and familiar operational procedures is a strategic way for MLP practitioners to anticipate and answer institutional resistance to integrating legal advocates.
*Maggie Eisen is the Director of Medical-Legal-Community Partnership at Philadelphia Legal Assistance. Their medical-legal partnership works with the Philadelphia Department of Public Health, Ambulatory Health Services Division.