May 18, 2012
Cathie Scott & Laura Lagendyk. (2012). Contexts and Models in Primary Healthcare and their Impact on Interprofessional Relationships. Canadian Health Services Research Foundation. Retrieved from http://www.chsrf.ca/Libraries/Commissioned_Research_Reports/ScottLagendyk-April2012-E.sflb.ashx “Key Messages: Nationally and internationally, the need to effectively coordinate provision of care to meet the needs of patients and to make optimal use of resources have been identified […]
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health planning, Integrated care, Patient-centered care | No Comments
February 23, 2012
“Integrated care is essential to meet the needs of the ageing population, transform the way that care is provided for people with long-term conditions and enable people with complex needs to live healthy, fulfilling, independent lives.” The purpose of this report is to examine:
- “the case for integrated care
- what current barriers to integrated care need to be overcome
- what the Department of Health can do to provide a supporting framework to enable integrated care to flourish
- options for practical and technical support to those implementing integrated care, including approaches to evaluating its impact.
The report asserts that developing integrated care should assume the same priority over the next decade as reducing waiting times had during the last. Its core recommendations are:
- government policy should be founded on a clear, ambitious and measurable goal to improve the experience of patients and service users and to be delivered by a defined date
- patients with complex needs should be guaranteed an entitlement to an agreed care plan, a named case manager responsible for co-ordinating care, and access to telehealth and telecare and a personal health budget where appropriate
- change must be implemented at scale and pace; this will require work across large populations, significant reform and flexibility to take forward different approaches.
The report makes a constructive contribution to the debate about integrated care and will be of interest to policy-makers, health and social care commissioners, and researchers with an interest in integrated care, as well as to health and social care organisations.”
Posted in READ Portal, Reports & Papers | Tagged with Integrated care, Patient-centered care | No Comments
November 21, 2011
“Integrated health systems are considered part of the solution to the challenge of sustaining Canada’s healthcare system. This systematic literature review was undertaken to guide decision-makers and others to plan for and implement integrated health systems.
This review identified 10 universal principles of successfully integrated healthcare systems that may be used by decision-makers to assist with integration efforts. These principles define key areas for restructuring and allow organizational flexibility and adaptation to local context. The literature does not contain a one-size-fits-all model or process for successful integration, nor is there a firm empirical foundation for specific integration strategies and processes.”
Click here to read the full article
Posted in Journal Articles, READ Portal | Tagged with Canada, Decision making, Integrated care | No Comments
November 10, 2011
“In high-income countries, patients with complex care needs account for a disproportionate share of national health spending… These patients typically see multiple clinicians at different locations, making care coordination imperative. To learn more about the experiences of these “sicker adults,” a new Commonwealth Fund survey focused on patients with high care needs in 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the U.S.
Despite variation in patients’ experiences across the globe, all countries are facing similar challenges in providing effective care to sicker adults, contending with coordination gaps, lapses in communication between providers, and missed opportunities for engaging patients in management of their own care. Moreover, all countries can learn from one another, the authors conclude.
(The bottom line is) across 11 countries, adults with complex care needs who had a medical home reported fewer coordination failures with their care, including medical errors and test duplication, as well as better relationships with their doctors and greater satisfaction with care.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Chronic disease, Integrated care, Quality assessment | No Comments
October 6, 2011
“The aim of this paper is to describe the different forms of integrated care and to summarise evidence on their impact. The paper is based on a major review published by The King’s Fund (Curry and Ham 2010) and has been prepared in the light of the increased interest in integrated care arising out of the work of the NHS Future Forum and the government’s response. Key messages are:
- integrated care takes many different forms and may involve whole populations, care for particular groups or people with the same diseases, and co-ordination of care for individual service users and carers
- there is good evidence of the benefits of integrated care for whole populations, as seen in organisations such as Kaiser Permanente, the Veterans Health Administration and integrated medical groups in the United States
- there is good evidence of the benefits of integrated care for older people as seen in areas like Torbay
- there is mixed evidence of the benefits of integrated care for people with long-term conditions like diabetes and for people with complex needs
- there is evidence of the benefits of care co-ordination for individual service users and carers, especially when multiple approaches are used together
- integrated care in the NHS needs to be pursued at all levels to overcome the risks of fragmentation, and of service users ‘falling between the cracks’ of care
- policy-makers need to act on the evidence not by promoting a preferred approach but by supporting clinical and managerial leaders to adapt the ingredients of integrated care discussed in this briefing to improve outcomes for the populations they serve.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Chronic disease, Integrated care | No Comments
September 28, 2011
“In response to an increased emphasis on quality and effectiveness of care, hospitals and health systems must refocus their efforts on the broader care continuum, defined as healthcare outside the traditional hospital walls. No longer can community hospitals consider ambulatory services as separate from their core service and mission. While the ability to “own” the entire ambulatory continuum is not realistic for most community hospitals and systems, hospitals should take a leadership role in organizing the ambulatory continuum to benefit their communities.
Over the past two decades, the community hospital strategy for ambulatory care has generally been bifurcated: either a joint venture with physicians, while trying to build or maintain volumes or competing with physician-invested ambulatory services, often losing volumes rapidly. Strategy was driven by revenue, profits and efficiency.”
Click here to read the full article
Posted in Mass Media Articles, READ Portal | Tagged with Integrated care | No Comments
September 23, 2011
“Many forces are driving the trend in hospital acquisition of physician groups, from the need to strengthen physician-hospital alignment to new payment systems that will cut fees and lower reimbursement. But simply acquiring a physician practice doesn’t guarantee financial success for hospitals.”
“Achieving financial objectives requires effective management of the practice-based behaviors, processes, and tools that affect the revenue stream. But hospitals and health systems face several challenges in managing the revenue cycle performance of the physician groups they acquire. To begin with, hospitals and physician practices are separate entities with goals, practices, and standards that are often very different from each other. The challenges that result from such differences—such as differences in culture, policies, tools, and processes—can be alternately clear cut and hard to grasp. Without a solid understanding of what makes each entity “tick,” achieving the financial targets a hospital sets for a physician practice can be an exercise in futility. “
Click here to read the full article
Posted in Journal Articles, READ Portal | Tagged with Economics, Hospital administration, Integrated care | No Comments
September 14, 2011
“Shared service practices involve the integration of service activities across various areas of an organization, or across different organizations, into a single entity. The main purpose of shared services is to improve efficiencies and help manage costs. A shared service can be defined as “the concentration or consolidation of functions, activities, services or resources into one stand-alone unit. The one unit then becomes the provider to several other client units within the organization.”
Shared service practices are used in both the public and private sectors, and are more commonly seen in larger and more complex organizations. There are various shared service models that can be adopted, with each offering its own benefits and concerns. Governments in the United States, Australia, the United Kingdom, and Ireland have successfully implemented shared service initiatives. In response to the increasing demands placed on health care funding, several Canadian jurisdictions, namely Ontario, British Columbia with Alberta as a partner, and New Brunswick, have introduced new approaches to coordinate and integrate the procurement of services and supplies required by their health care systems.
The intent of these “health shared service” models is to maximize the value of expenditures in health care through more efficient practices in the management of resources. The goal is to generate savings that can be reinvested into respective provincial health care systems.”
The UBC Centre for Health Care Management has offered two seminars on Shared Services. Visit Creating Value Through Shared Services or Patient Services Consolidation to learn more.
Click here to read the full article.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Cost effectiveness, Funding, Integrated care, Patient-centered care | No Comments
June 20, 2011
“This position paper analyzes the challenge of health services fragmentation, proposes a conceptual and operational framework for understanding IHSDNs, presents public policy instruments and institutional mechanisms to develop integrated networks, and proposes a “road map” for implementing IHSDNs in the Americas. The document focuses on the integration of the health services delivery function, and as a result it does not address mechanisms to integrate the health systems functions of financing and/or insurance. Furthermore, it does not address in detail the mechanisms to integrate programs targeting specific diseases, risks and populations (vertical programs) into health systems.”
Posted in READ Portal, Reports & Papers | Tagged with Health care reform, Implementation process, Integrated care, Policy | No Comments
June 17, 2011
“Most Americans get their health care in small physician practices. Yet, small practice settings are often unable to provide the same range of services or participate in quality improvement initiatives as large practices because they lack the staff, information technology, and office systems. One promising strategy is to share clinical support services and information systems with other practices. New findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians suggest smaller practices that share resources are more likely than those without shared resources to have advanced electronic medical records and health information technology, routinely track and manage patient information, have after-hours care arrangements, and engage in quality monitoring and benchmarking. This issue brief highlights strategies that can increase resources among small- and medium-sized practices and efforts supported by states, the private sector, and the Affordable Care Act that encourage the expansion of shared-resource models.”
Posted in Journal Articles, READ Portal | Tagged with Integrated care, Primary health care | No Comments
