Integrated care: the importance of ICT in data sharing

In this post by Health IT Central it is analyzed how different experiences regarding people centered and integrated health systems have been developed across the world. Some studies have been able to identify what are the key elements to succeed when performing integrated health care; these factors are rethinking clinical models, achieving a cultural change, enforcing collaborative multidisciplinary working and improving the way patient information is shared. In this post, the author focuses on how important patient information sharing is to make integrated services experiences succeed, being a core factor in continuity of care and becoming a barrier when data sharing is not successfully achieved. According to the author’s opinion, the regulation recently approved by the European Union regarding data protection will make easier data sharing, allowing care to be delivered in a more effective and integrated manner.

Voices on person-centred care

What is person-centred care to a patient, a physician, a nurse, a hospital head of department, an industry representative and a researcher? How do these people, who all have experience of receiving or working with person-centred care, see person-centred care from their perspectives? Short film clips from the University of Gothenburg Centre for Person-centred Care - GPCC. GPCC is an in terdisciplinary research centre, established in January 2010, with the support of the Swedish government's strategic investment in health and care research. Uniquely GPCC has evaluated the effects of person-centred care in controlled studies. This has established that person-centred care is capable of enhancing the efficiency of the care process. Apart from considerable monetary savings resulting from amongst other things shorter hospital stays, significant positive effects from a patient perspective have been seen, as care is adapted to each individual person and his or her resources are made use of.

Voices on person-centred care

What is person-centred care to a patient, a physician, a nurse, a hospital head of department, an industry representative and a researcher? How do these people, who all have experience of receiving or working with person-centred care, see person-centred care from their perspectives? Short film clips from the University of Gothenburg Centre for Person-centred Care - GPCC. GPCC is an in terdisciplinary research centre, established in January 2010, with the support of the Swedish government's strategic investment in health and care research. Uniquely GPCC has evaluated the effects of person-centred care in controlled studies. This has established that person-centred care is capable of enhancing the efficiency of the care process. Apart from considerable monetary savings resulting from amongst other things shorter hospital stays, significant positive effects from a patient perspective have been seen, as care is adapted to each individual person and his or her resources are made use of.

Multi-specialty community providers and primary and acute care systems

The primary and acute care systems (PACS) model and multi-specialty community provider (MCP) model are particularly focussed on building partnerships between GP, hospital, community and mental health care organisations to build a health care system to meet their local population’s health needs.

This Conference will take a detailed look at each of these models of care. One year on from the launch of the PACS and MCP vanguard sites, it will provide an opportunity to hear from the sites and others on how are they working in practice with lessons for areas of the United Kingdom that are interested in implementing similar models for their local populations. 

Programme:

Multi-specialty community providers and primary and acute care systems

Speakers

Registration

Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil

Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes ...

Integrating terminology for integrated care

The plan is to transform a fragmented and largely uncoordinated model into a multidimensional care model that integrates social care systems with health care systems. To achieve this integration successfully, a strong conceptual framework must be constructed, in which terminology will play an important part. Since language mediates a particular vision of reality, when creating a new care model it seems important to focus on terminology. 

A “Behind-the-Scenes” Look at Interprofessional Care Coordination: How Person-Centered Care in Safety-Net Health System Complex Care Clinics Produce Better Outcomes

While the effectiveness of team-based care and wrap-around services for high utilizers is clear, how complex care clinics deliver effective, person-centered care to these vulnerable populations is not well understood. This paper describes how interactions among interprofessional team members enabled individualized, rapid responses to the complex needs of vulnerable patients.

Driving and Accelerating a ‘One System’ Response: Why COVID-19 has Shone a Spotlight on Integrated Care

ValueCare: Cork/Kerry Pilot Site

Care Coordination for Vulnerable Families in the Sydney Local Health District: What Works for Whom, under What Circumstances, and Why?

 Healthy Homes and Neighbourhoods (HHAN), an integrated care programme in the Sydney Local Health District (SLHD), seeks to address the needs of disadvantaged families through care coordination, as one of its components. This research aims to determine for whom, when and why the care coordination component of HHAN works, and establish the reported outcomes for clients, service-providers and partner organisations.

Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review

Millions of people worldwide have complex health and social care needs. Care coordination for these patients is a core dimension of integrated care and a key responsibility for primary healthcare. Registered nurses play a substantial role in care coordination.

This review draws on previous theoretical work and provides a synthesis of care coordination interventions as operationalized by nurses for complex patient populations in primary healthcare.

Barriers and Facilitators in the Uptake of Integrated Care Pathways for Older Patients by Healthcare Professionals: A Qualitative Analysis of the French National “Health Pathway of Seniors for Preserved Autonomy” Pilot Program

Integrated care is a particularly promising approach in geriatrics – a field in which the medical, psychological and social issues are often complex. The uptake of integrated care by healthcare professionals is essential but varies markedly.

The objective of the present study of healthcare professionals was to identify barriers to and facilitators of commitment to integrated care for seniors.

Measuring Older Peoples’ Experiences of Person-Centred Coordinated Care: Experience and Methodological Reflections from Applying a Patient Reported Experience Measure in SUSTAIN

While several evaluation studies on (cost-)effectiveness of integrated care have been conducted in recent years, more insight is deemed necessary into integrated care from the perspective of service users.

In the context of a European project on integrated care for older people living at home (SUSTAIN), this paper shares the experience and methodological reflections from applying a Patient Reported Experience Measure (PREM) on person-centred coordinated care -the P3CEQ- among this population.

What are the priorities for the future development of integrated care? A scoping review

“Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC literature, whilst valuable, has become extensive and wide-ranging to such a degree that knowing what is most important in IC is a challenge. This study aims to address this issue.

Interventions to Improve Clinical Coordination between Levels: Participatory Experience in a Public Healthcare Network in Xalapa, Mexico

Coordination of care can be improved through an intervention or a combination of several ones. In addition, it is recommended to encourage the active involvement of professionals in the design, implementation and assessment of coordination mechanisms. The involvement of professionals in designing the interventions, as well as institutional support and reflexive methods for training, all decisively improved clinical coordination between levels.

Integrated Maternal Care Strategies in Low- and Middle-Income Countries: A Systematic Review

Ineffective organisation of care leads to increased morbidity and mortality in neonates and their mothers. We aimed to identify and describe strategies used in low- and middle-income countries that attempt to deliver coherent, coordinated, and continuous services (i.e., integrated care) and how the various strategies affect the organisation of care.

Person-centred care to prevent hospitalisations – a focus group study addressing the views of healthcare providers

The primary healthcare sector comprises various health services, including disease prevention at local level. Research shows that targeted primary healthcare services can prevent the development of acute complications and ultimately reduce the risk of hospitalisations. While interdisciplinary collaboration has been suggested as a means to improve the quality and responsiveness of personal care needs in preventive services, effective implementation remains a challenge.

The World Health Organization (WHO) Integrated Care for Older People (ICOPE) Framework: A Narrative Review on Its Adoption Worldwide and Lessons Learnt

The World Health Organization (WHO) recently published guidelines on the implementation of a new Integrated Care for Older People (ICOPE) framework in 2017–2019. It is an integrated care framework for the screening, assessment, and management of intrinsic capacity (IC) declines. We aimed to examine where the early adopters of ICOPE are across the world, how these study teams and sites plan to apply the framework or have applied it, and the lessons learnt for future adopters. We systematically searched electronic medical and social sciences databases and grey literature published between 31 October 2017 and 31 March 2022. Records were systematically selected using precise inclusion criteria. There were 18 ICOPE study teams and sites across the 29 selected records. Of the 18 study teams and sites, seven were in the development stage, seven conducted feasibility studies, and four have commenced implementation of interventions that applied the ICOPE framework. Future ICOPE ...

How can skill-mix innovations support the implementation of integrated care for people with chronic conditions and multimorbidity?

• The increasing and changing demands of complex patients (with chronic conditions and multimorbidity), combined with growing workloads and shortages of primary care providers, demand the reorganization of services for more patient-centred and more efficient care.
• Reorganizing health and social care services to integrate care requires that the health workforce adopt “skill-mix changes” including reskilling; a different approach to sharing tasks and roles; and improved coordination.
• Skill mix changes typically involve innovative re-allocation of tasks between professions; new supplementary roles; and/or the introduction of greater teamworking and flexibility.
• The most promising skill-mix innovations for improving integration of care of patients with complex needs are:

(1)    Shifting tasks and roles to achieve new divisions of work with advanced practitioners (nurses and pharmacists) taking on management of aspects of care and coordinating processes in close collaboration with physicians.

(2)    Relocation of care to other settings for example to nurse-led clinics or patients ...

Nursing Care Coordination in Primary Healthcare for Patients with Complex Needs: A Comparative Case Study

Despite nurses’ substantial role in care coordination, few education programs exist to better support them in this role. Identification of a set of core care coordination activities across heterogeneous care coordination programs would facilitate the development of a standard of practice. We sought to examine care coordination activities across two care coordination programs in Family Medicine Groups in Quebec, and their relationship to the program design.

Continuity of Care and Coordination of Care: Can they Be Differentiated?

Both care continuity and coordination are considered essential elements of health care system. However, little is known about the relationship between care continuity and coordination. This study aimed to differentiate the concepts of care continuity and coordination by developing and testing the reliability and validity of the Combined Outpatient Care Continuity and Coordination Assessment (COCCCA) questionnaire under the universal coverage health care system in Taiwan from a patient perspective.