Welcome to the Laboratory of Integration Services for Complex Needs (LISCN)

Patients with complex biomedical, social and psychiatric needs face multiple barriers to care, including basic needs, such as safe housing and transportation challenges. In addition, they are often navigating disparate health and social service systems. Poor communication between service providers can lead to care that is not aligned with the patient’s context leading to preventable health consequences such as increased risk of falls due to polypharmacy and medication interactions and missed opportunities for health screening.

As the population ages, the number of patients with complex needs is growing at a rapid rate. This is affecting the capacity for health systems to manage the costs and safely care for all patients. Indeed, patients with concomitant medical and mental illness are frequently the highest utilizers of acute care services from the emergency room to intensive care settings. From the perspective of patients and families, the health system appears to operate in service silos with little integration between general medicine, mental health and social service agencies. Hospitalizations often result in further disrupted care due to poor communication between hospital clinicians and the primary care and mental health clinicians who know the patient best.

There is an urgent need to re-think the way we care for patients with complex needs. Building on clinical services in the division of Medicine in Psychiatry at the University of Rochester Medical Center, LISCN seeks to study patient’s needs and priorities across the biomedical, psychiatric and social spheres and develop innovative solutions for integrated care. Listening to what matters most to patients is the first step in changing the service paradigm. LISCN brings together research expertise in prioritization and decision making, implementation and dissemination, and health services research, and builds on the the biopsychosocial approach to health first proposed by Drs. George Engel and John Romano at the University of Rochester.