JoAnna Garza, UTRGV-SOM
Deepu George, Primary Care & Community Medicine ISU, UTRGC School of Medicine
Lupita Hernandez, The University of Texas Rio Grande Valley
Using a design thinking framework, this presentation describes the implementation of Primary Care Behavioral Health (PCBH) through three core processes: building an empathy map of the user, developing and testing prototypes, and learning through rapid iteration (“fail fast”). Across each phase, we highlight how clinical, operational, and financial decisions were informed and refined in real time, while acknowledging the ongoing nature of growth and improvement in integrated care.
We will describe how creating an empathy map of the users of PCBH, encompassing patients, medical providers, behavioral health clinicians, and administrative staff, served as a foundation for clinical and operational decision-making. Attendees will learn how open, honest, and sometimes difficult conversations with clinic staff informed workflow refinement in real time, supporting role clarity, provider buy-in.
Clinically and operationally, we will share strategies used to increase access to same-day behavioral health visits embedded within routine primary care workflows. This includes enhancements to warm handoffs. These approaches reduce barriers to care, normalize behavioral health within primary care, and improve engagement for patients who may not otherwise access specialty mental health services.
From a financial perspective, we will address local alternatives for billing and revenue cycle beyond traditional fee-for-service models. Attendees will learn about our collaboration with revenue and billing teams to work toward developing a flat-fee payment option for underinsured and uninsured patients.
Participants will leave with concrete, actionable strategies for applying design thinking principles to implement and sustain integrated behavioral health services that are clinically effective, operationally feasible, and financially sustainable in real-world primary care settings.
An introduction to design thinking process guide. The D School @ Stanford. (n.d.). https://web.stanford.edu/~mshanks/MichaelShanks/files/509554.pdf
Reiter, J. T., Dobmeyer, A. C., & Hunter, C. L. (2018). The Primary Care Behavioral Health (PCBH) model: An overview and operational definition. Journal of Clinical Psychology in Medical Settings, 25, 109–126.
Robinson, P. J., & Reiter, J. T. (2025). Behavioral Consultation and Primary Care: A Guide to Integrating Services. Springer.