Sept. 6, 2016 Europe Practice

Piloting integrated health networks to improve type 2 diabetes care in Andorra

Primary care nurse-physician teams were introduced to lead new diabetes health networks, with the aim of connecting providers across sectors and strengthening primary care gatekeeping; collaboration with stakeholders in the early design stages of the initiative encouraged multistakeholder buy-in from the outset; updated evidence-based care pathways published in a guidebook helped streamline and standardize care; extensive patient education and coaching on self-management skills enabled patients to engage in their own care; pragmatic intermediary solutions were found to address pressing challenges; for example, implementing paper medical records carried by the patient to counter poor communication between providers in the absence of an electronic information system.

Sept. 7, 2016 Europe Practice

Integrating occupational therapy into cancer care in the Netherlands

Reade – an organization specializing in rehabilitative care – introduced a package of services specifically tailored to the needs of cancer patients and cancer survivors; support from Reade’s management in developing protocols and negotiating with national-level actors was essential for the implementation of the initiative; providers within Reade were brought together to apply their skills to treating the complex needs of cancer patients and survivors. Providers work in multidisciplinary teams to enable the delivery of more comprehensive care; initiative leaders built strong working relationships with external providers. This helped bring other providers on board with Reade’s new care concept and generate referrals; a national occupational therapy network supported knowledge sharing and enabled the wider dissemination of lessons learned by the initiative.

Oct. 4, 2016 Europe Practice

Exploring new provider-payment models to incentivize performance improvements in Hungary

The Care Coordination Pilot was launched in 1999 to explore ways to improve the coordination and quality of health services. Under the pilot, Care Coordinator Organizations (run by health providers from general practices or polyclinics) acted as virtual fund holders for capitation-based health care budgets within their local catchment areas; carefully chosen financial incentives guided performance improvements by rewarding efficiency, incentivizing preventive care and encouraging treatment in lower-level settings; empowering professionals with new responsibilities helped to overcome provider dissatisfaction; extensive data collection supported analysis and comparison of local organizational arrangements.