Integrated Pediatric Primary Care

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We know that behavioral health impacts the physical health of a child and vice versa. Yet, many health care systems have historically treated mental and physical health separately. This fragmentation may be costly and may not lead to the best outcomes for patients.

Over the past few years, the Delaware Center for Health Innovation (DCHI) has focused on a statewide effort to integrate behavioral health in primary care. This comes with its set of challenges. Integration requires both primary care and behavioral health providers to change the way they work and deliver care. There are also barriers like restrictive payment models for behavioral health.

At Nemours, we understand a healthy pediatric patient is one with a healthy body and healthy mind. By integrating behavioral health in our twelve primary care practices in Delaware, Nemours aims to serve the whole child within the medical home.

Over the years, we have worked with our patients and families to address many questions:

Why are behavioral health providers in my primary care office?

  • Primary care providers are often the professionals who hear about parents’ developmental, behavioral and emotional concerns first.
  • Having behavioral health within the office provides faster and easier access to mental health care for children and adolescents.
  • Services can be brief (a quick meeting during the child’s medical visit) or more extensive (screening or short-term treatment).
  • Behavioral health providers include psychologists, counselors and licensed social workers.

Why do families see behavioral health professionals?

  • Families see behavioral health providers for a range of issues, including development, mood, anxiety/stress, ADHD, learning/school concerns, social skills, behavior (tantrums, acting out), family communication and recent stressful events.
  • Behavioral health providers also help families with a range of health concerns, including sleep, toilet training, chronic pain and chronic illness (diabetes, asthma, weight concerns).
  • The goal is to help kids develop good coping skills and habits and set them up for success in the future.

How are behavioral health providers different from medical doctors?

  • Providers with backgrounds in psychology, counseling and social work are experts in emotional and behavioral health. They teach kids skills to cope with things like stress, sadness and problems with friends and to establish healthy behaviors. They also help parents learn skills to be their child’s coach and advocate and to manage difficult behaviors.
  • Behavioral health providers do not prescribe medication or diagnose medical conditions. But they do work closely with primary care providers to ensure that everyone on the child’s team in the medical home comes together to give the child the best possible care.

To learn more about Nemours, we invite you to attend you the second biennial Developing and Researching Advanced Models of Integrated Primary Care (DREAM IPC) conference in Wilmington, Delaware, from September 19 to 20, 2019.

Integrated behavioral health and primary care is still considered rare. Through the DCHI, as a collective, we are happy to share our learnings in integrated primary care as we all embark on new paradigms to improve the overall health outcomes for our patients in Delaware.


Guest Authors: Dr. Meghan Lines and Cindy Bo


Meghan Lines, Ph.D. is a pediatric psychologist and Clinical Director for Integrated Primary Care Psychology at Nemours/AI duPont Hospital for Children. Residing in Delaware since 2002, Dr. Lines completed her Ph.D. in clinical psychology at the University of Delaware and her residency and fellowship in pediatric psychology at Nemours.

In her current role, she works with physicians and psychologists to expand the role of behavioral health in pediatric primary care for Nemours duPont Pediatrics clinics throughout Delaware and southeastern Pennsylvania. She holds an appointment of Assistant Professor of Pediatrics at the Sidney Kimmel Medical College of Thomas Jefferson University and is a member of the Medical Executive Committee at AI duPont Hospital for Children.


Cindy Bo

Ms. Cindy Bo has worked in healthcare strategy for over 20 years, ranging across the provider, payor and life sciences sectors. She is named by the Becker's Hospital Review in 2017, 2016 and 2015 as one of the top 130 women hospital and health system leaders to know in the United States. She is named as one of 2017 Delaware Today Top Women in Business Honorees. She is also a TEDx Speaker.

Ms. Bo is the Chief Strategy & Business Development Officer for Nemours Children’s Health System, Alfred I. duPont Hospital for Children. She is a Board Member for the Delaware Center for Health Innovation (DCHI).

Ms. Bo has earned her MBA, with high distinction and honors, from Columbia Business School and her BS, summa cum laude, from Binghamton University School of Management.

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