What does it take to make integrated care work?: A ‘cookbook’ for large-scale deployment of coordinated care and telehealth. A personalised approach that will benefit patients in your organisation.

Evidence on integrated care is not only needed to show which interventions work, but also to understand how organisational processes affect these interventions. Therefore, evidence from large-scale implementations is especially important. In October 2015, the consortium of the EU-funded programme 'Advancing Care Coordination and Telehealth Deployment' (ACT) published a ‘cookbook’ of good practices, focusing on the structural and organisational drivers as well as barriers to large-scale deployment of care coordination and telehealth in five European regions. The report centres on chronic patients and elderly people, giving recommendations regarding staff engagement,  patient adherence, risk stratification and programme assessment. The report does not only look at health outcomes, but also economic outcomes such as the total cost per patient and the transition of resources towards primary care. An example of good practice from the Northern Netherlands is the programme Embrace. A core element of Embrace is the work of multidisciplinary teams led ...

Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist.

The WHO mHealth Technical Evidence Review Group developed the mHealth evidence reporting and assessment (mERA) checklist to improve the reporting of mobile health (mHealth) interventions.The development process for mERA consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot testing the checklist. The guiding principle for the development of these criteria was to identify a minimum set of information needed to define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features), to support replication of the intervention. The paper presents the resulting 16 item checklist and a detailed explanation and elaboration for each item, with illustrative reporting examples. Through widespread adoption, it is expect that the use of these guidelines will standardise the quality of mHealth evidence reporting, and indirectly improve the quality of mHealth evidence.

How do we know? An assessment of integrated community case management data quality in four districts of Malawi

The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) proyects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, adn to suggest ways to improve data quality. 

This data quality assessment illuminates where an otherwise strong M&E system for iCCM fails to ensure some aspects of data quality. Prioritizing data management with documented protocols, additional training and approaches to create efficient supervision practices may improve iCCM data quality. 

A new paradigm on health care accountability to improve the quality of the system: four parameters to achieve individual and collective accountability

Healthcare systems the world over are facing significant financial pressures and growing demands for services. Many nations have therefore set common goal of improving the population´s health, the quality of the outcomes, and the containment of costs. So, these changes in the health care systems´priorities have set the ground for an interdisciplinary approach necessary to assess the activities of health care professionals and, in general, of health care systems. 

How to assess and prepare health systems in low- and middle-income countries for integration of services—a systematic review

Despite growing support for integration of frontline services, a lack of information about the pre-conditions necessary to integrate such services hampers the ability of policy makers and implementers to assess how feasible or worthwhile integration may be, especially in low- and middle- income countries (LMICs). This article adopted a modified systematic review with aspects of realist review, including quantitative and qualitative studies that incorporated assessment of health system preparedness for capacity to implement integrated services. 

Integrated Care Regulation, Assessment, and Inspection – A Collaborative Learning Journey

Over the past ten years, the design and implementation of integrated health and social care organisations and systems has occurred across several continents. These models of care have implied the adoption of new approaches to their organization and governance. As a result, many countries have begun to focus specifically on the regulation, assessment and inspection of integrated care. This editorial argues that there is both an opportunity and a need to share the successes and challenges from these experiences and to promote methods for collaborative learning.

Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols.

Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation.

From self-assessment to knowledge transfer and improvement in integrated care: How to engage voluntary sector in the provision of integrated care?

Integrated care is a recognised solution to address the challenge of ageing population. Hence, it is important to commit to opportunities that increase the readiness and capacity of regions to implement integrated care. Knowledge transfer has been greatly recognised as an effective enabler to access existing evidence and learning on integrated care. It encompasses a very broad range of activities to support mutually beneficial collaborations between the interested stakeholders. 

Maturity Model in Practice – SCIROCCO self-assessment tool

The SCIROCCO self-assessment tool is an online self- assessment tool with an objective to assess a region’s readiness for integrated care. It builds on the conceptual Maturity Model for Integrated Care developed by the B3 Action Group on Integrated Care of the European Innovation Partnership on Active and Healthy Ageing.

• Understand the strengths and weaknesses of their regional context for integrated care  and inform national, regional and local policy-makers about potential areas of  improvement;
• Adopt and transfer integrated care good practices by identifying their maturity  requirements and requirements for the potential transferability and scaling-up;
• Facilitate multi-stakeholder dialogues on progress towards the implementation and  delivery of integrated care;
• Facilitate twinning and coaching activities that help regions and organisations to better  understand the local conditions that enable the successful deployment of integrated care

The SCIROCCO tool can be accessed online by using the following link ...

Patient autonomy in the consultation: How signalling structure can facilitate patient-centred care

This paper explores how patient autonomy may be supported or undermined in doctor-patient interactions through sharing information about what is to happen in the consultation. Doctors use a variety of verbal signalling behaviours with multiple functions. As well as sharing information, these behaviours regulate patient agency in the consultation.

Research in Integrated Care: The Need for More Emergent, People-Centred Approaches

The International Foundation for Integrated Care (IFIC) recently celebrated its 20^th International Conference (ICIC20) through a virtual event that brought together patients and carers, academics, care professionals, NGOs, policy-makers and industry partners from across the global integrated care community. The International Journal for Integrated Care (IJIC) used this opportunity to host a workshop on published research in integrated care, specifically to reflect on the quality of existing scientific enquiry. A lively discussion on the current state of integrated care research concluded that there remained significant shortcomings to current methodologies – for example, in their ability to provide the depth of understanding required to support the knowledge needed to best inform policy and practice, particularly when addressing people-centredness. In part, the debate recognized how the nature of existing research funding, and prevailing attitudes and preferences towards certain research methodologies, were partly to blame (as has been noted by IJIC previously). The ...

The impact of the Covid-19 pandemic on primary health care utilization: an experience from Iran

The Covid-19 pandemic affected the performance of Primary Health Care (PHC) worldwide. This study was performed to investigate the impact of the Covid-19 pandemic on the utilization of PHC in Iran. Covid-19 Pandemic has affected the performance of Iranian PHC at the beginning and overall, has a negative consequence on utilization of services. Preparedness to respond to pandemics and develop programs and interventions is necessary to cover the weaknesses of the PHC.