Digital Technologies as a Catalyst for Change towards Integrated Care Delivery

2016 ◽  
Vol 5 (2) ◽  
pp. 31-49 ◽  
Author(s):  
Lutz Kubitschke ◽  
Ingo Meyer ◽  
Sonja Müller ◽  
Kira Stellato ◽  
Andrea Di Lenarda
Keyword(s):  
Integrated Care ◽  
Care Delivery ◽  
Digital Technologies ◽  
Lessons Learned ◽  
End User ◽  
Working Models ◽  
Research Activities ◽  
Implementation Approach ◽  
Care Systems ◽  
Different Levels

The quest for more integrated care is not in itself new, but recent technology developments have nourished hopes that application of advanced digital solutions can make a major contribution to better joined-up care delivery, in particular to those suffering from chronic conditions. However, in contrast, with an enormous breadth of research activities, few instances of routine application of integrated eCare have yet emerged. This raises the question whether the concept of digitally-supported care delivery is indeed a present-day reality transforming traditionally separated care systems or just a hyped-up vision of what could be. Based on a review of recent evidence, including lessons learned from pilot implementations in different countries, the authors argue that the inherent properties of digital technologies do not by themselves lead to better-integrated care delivery. Rather, a reasonable implementation strategy needs to take account of the fact that desired end user support is not delivered by such technologies alone, but by socio-technical systems. An implementation approach that pays simultaneous attention to the stakeholders involved, to the particular working models of the different care actors, and to the technologies to be employed is shown to considerably increase the likelihood of achieving positive impacts on different levels, even if risks and uncertainty cannot be completely avoided.

The maturity of integrated care systems: lessons learned in using the SCIROCCO tool across Europe

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
A Pavlickova ◽  
D Henderson ◽  
CA Alexandru ◽  
T Alhambra
Keyword(s):  
Integrated Care ◽  
Lessons Learned ◽  
Care Systems

scholarly journals Can Integrated Care Help in Meeting the Challenges Posed on Our Health Care Systems by COVID-19? Some Preliminary Lessons Learned from the European VIGOUR Project

2020 ◽  
Vol 20 (4) ◽  
Author(s):  
Sonja Lindner ◽  
Lutz Kubitschke ◽  
Christos Lionis ◽  
Marilena Anastasaki ◽  
Ursula Kirchmayer ◽  
...  
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Care Systems

Cross-border value-based innovation procurement in health systems: the Euriphi Project

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Fera ◽  
M Di Ciano ◽  
G Gorgoni
Keyword(s):  
Integrated Care ◽  
Unmet Needs ◽  
Care Delivery ◽  
Public Procurement ◽  
Rapid Diagnosis ◽  
Open Market ◽  
Horizon 2020 ◽  
Adoption Of Innovation ◽  
Care Systems ◽  
Definition Of

Abstract The EU Coordination and Support Action, under Horizon 2020 “Innovation in Healthcare”, aims at the adoption of innovation in health and care systems and advancing procurement of innovation practices. In response to this initiative, a consortium of 25 leading organizations in procurement and health care has been created. Among the project partners, AReSS Puglia, in collaboration with InnovaPuglia (public provider of Apulian system), analysed and exploited the best integrated solution to adopt in the Health and Care system. The EURIPHI project has successfully contributed to address common unmet needs and shortcomings in the current care delivery by using value-based innovation procurement for Public Procurement of Innovation Solutions and Pre-Commercial Procurement in the field of rapid-diagnosis of infectious diseases and integrated care. Regions, providers and procurers joined the effort to map the unmet needs and to have a broader view on demands for innovative solutions for rapid diagnosis for infectious disease and integrated care. After the definition of unmet needs and, therefore of procurement objectives, the EURIPHI consortium organized two Open Market Consultations with the industry, one in the field of rapid diagnosis and in integrated care. Two ecosystems have been created to ensure the sustainability of the project's results the EURIPHI Health & Social Care Regions Network and Value Based Procurement Community of Practice. Puglia Region is at the forefront of the two, together with other relevant healthcare stakeholders across Europe. The needed reform of health and care systems in Europe requires the adoption of innovation and integrated solutions. One way forward is to rethink procurement policies. A positive transformation in this area definitively is to elevate procurement practices towards an approach that awards the value offered by innovation or integrated solution.

The maturity of integrated care systems: lessons learned in using the SCIROCCO tool across Europe

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
A Pavlickova ◽  
D Henderson ◽  
CA Alexandru ◽  
T Alhambra
Keyword(s):  
Integrated Care ◽  
Lessons Learned ◽  
Care Systems

Do All Roads Lead to Rome?

2014 ◽  
pp. 22-40
Author(s):  
Lutz Kubitschke ◽  
Ingo Meyer ◽  
Sonja Müller
Keyword(s):  
Service Delivery ◽  
Integrated Care ◽  
Chronic Conditions ◽  
Care Provision ◽  
Pilot Projects ◽  
Working Models ◽  
Care Practices ◽  
Framework Conditions ◽  
Innovation Approach ◽  
Different Levels

The call for better joined-up service delivery, particularly to those suffering from chronic conditions, traces back as far as into the 1950s. However, a disjointed care provision split into multiple service silos prevails. In the present chapter, the authors present lessons from practice, particularly from two recent pilot projects, INDEPENDENT and SmartCare, to show what can be achieved through the use of ICT-supported, integrated care and to show how it can be achieved under given framework conditions. The guiding question is which roads will actually lead to Rome and which will not. By simply adding ICT to current care practices one will most likely not end up with better care. Rather, the authors argue that a multi-pronged innovation approach needs to be pursued, one that simultaneously pays attention to the stakeholders involved, to the particular working models of the different care actors, and to the technologies to be employed. Using such an approach is shown to considerably increase the likelihood of achieving positive impacts on different levels, even if risks and uncertainty cannot be completely avoided.

scholarly journals Skills building seminar: Capacity-building for implementing integrated care

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
◽  
Keyword(s):  
Knowledge Management ◽  
Capacity Building ◽  
Integrated Care ◽  
Real Life ◽  
Scaling Up ◽  
Healthcare Systems ◽  
Added Value ◽  
European Regions ◽  
Care Systems ◽  
Different Levels

Abstract Rationale The significance of integrated care as a means for improving health outcomes and effectiveness and sustainability of health and care systems is widely acknowledged. Integrated care is a central element in many on-going or planned healthcare system reforms, however, the main challenge remains of how to build relevant capacity and know-how for the successful implementation of integrated care. Capacity-building is both the foundation and aspiration of SCIROCCO Exchange EU Health Programme funded project. The project aims to facilitate access to tailored, evidence-based support and improvement planning by recognising different staring points, or levels of maturity of healthcare systems in Europe. Objectives This round table aims to explore different levels of local maturity and capacity to implement integrated care in three European regions; Basque Country, Flanders and Poland. The workshop will be a practical opportunity to dispute what actions and activities should be prioritised in these regions in order to improve their capacities for the adoption and scaling-up of integrated care. The workshop also aims to raise awareness about different levels and mechanisms of capacity-building support for integrated care that exists at European level. In particular, the workshop will feature SCIROCCO Exchange Knowledge Management Hub as one of the capacity-building tools and its application in the real-life settings. Added value Sharing learning more widely will help to build sustainable integrated care systems and tackle the risks of people working in isolation or re-inventing the wheel. Format of the workshop The workshop will consist of two keynote presentations, providing necessary background into the existing European policies, programmes and initiatives to support the adoption and scaling-up of integrated care. The introductory presentations will then follow by three snapshot presentations of 5 minutes featuring the main findings on the maturity and capacity of three European regions to implement integrated care. In the second part of the meeting, the participants will have the opportunity to discuss interactively with the representatives of the regions the use of SCIROCCO Exchange Knowledge Management Hub in the real-life settings, its added value and implications of the outcomes for future actions and improvement planning. The ultimate objective is to stimulate the discussion and knowledge on how to address the existing difficulties in implementing integrated care. Key messages Integrated care is considered as fundamental element driving transformation of healthcare systems. The challenge remains how to address different levels of capacities to implement integrated care. SCIROCCO Exchange can facilitate the access to capacity-building support that is needed for transition and/or improvement of existing systems for the adoption and scaling-up of integrated care.

scholarly journals Rapid Implementation of a Complex, Multimodal Technology Response to COVID-19 at an Integrated Community-Based Health Care System

2020 ◽  
Vol 11 (05) ◽  
pp. 825-838
Author(s):  
Andrew J. Knighton ◽  
Pallavi Ranade-Kharkar ◽  
Kimberly D. Brunisholz ◽  
Douglas Wolfe ◽  
Lauren Allen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Tracking System ◽  
Health Care Systems ◽  
Care Quality ◽  
Lessons Learned ◽  
Leadership Role ◽  
Surge Capacity ◽  
Care Systems

Abstract Background The rapid spread of severe acute respiratory syndrome coronavirus-2 or SARS-CoV-2 necessitated a scaled treatment response to the novel coronavirus disease 2019 (COVID-19). Objective This study aimed to characterize the design and rapid implementation of a complex, multimodal, technology response to COVID-19 led by the Intermountain Healthcare's (Intermountain's) Care Transformation Information Systems (CTIS) organization to build pandemic surge capacity. Methods Intermountain has active community-spread cases of COVID-19 that are increasing. We used the Centers for Disease Control and Prevention Pandemic Intervals Framework (the Framework) to characterize CTIS leadership's multimodal technology response to COVID-19 at Intermountain. We provide results on implementation feasibility and sustainability of health information technology (HIT) interventions as of June 30, 2020, characterize lessons learned and identify persistent barriers to sustained deployment. Results We characterize the CTIS organization's multimodal technology response to COVID-19 in five relevant areas of the Framework enabling (1) incident management, (2) surveillance, (3) laboratory testing, (4) community mitigation, and (5) medical care and countermeasures. We are seeing increased use of traditionally slow-to-adopt technologies that create additional surge capacity while sustaining patient safety and care quality. CTIS leadership recognized early that a multimodal technology intervention could enable additional surge capacity for health care delivery systems with a broad geographic and service scope. A statewide central tracking system to coordinate capacity planning and management response is needed. Order interoperability between health care systems remains a barrier to an integrated response. Conclusion The rate of future pandemics is estimated to increase. The pandemic response of health care systems, like Intermountain, offers a blueprint for the leadership role that HIT organizations can play in mainstream care delivery, enabling a nimbler, virtual health care delivery system that is more responsive to current and future needs.

scholarly journals Artificial Intelligence and Behavioral Science Through the Looking Glass: Challenges for Real-World Application

2020 ◽  
Vol 54 (12) ◽  
pp. 942-947
Author(s):  
Pol Mac Aonghusa ◽  
Susan Michie
Keyword(s):  
Climate Change ◽  
Artificial Intelligence ◽  
Machine Learning ◽  
Behavior Change ◽  
Behavioral Science ◽  
Lessons Learned ◽  
Learning Approaches ◽  
Intervention Evaluation ◽  
Research Activities ◽  
Behavior Change Interventions

Abstract Background Artificial Intelligence (AI) is transforming the process of scientific research. AI, coupled with availability of large datasets and increasing computational power, is accelerating progress in areas such as genetics, climate change and astronomy [NeurIPS 2019 Workshop Tackling Climate Change with Machine Learning, Vancouver, Canada; Hausen R, Robertson BE. Morpheus: A deep learning framework for the pixel-level analysis of astronomical image data. Astrophys J Suppl Ser. 2020;248:20; Dias R, Torkamani A. AI in clinical and genomic diagnostics. Genome Med. 2019;11:70.]. The application of AI in behavioral science is still in its infancy and realizing the promise of AI requires adapting current practices. Purposes By using AI to synthesize and interpret behavior change intervention evaluation report findings at a scale beyond human capability, the HBCP seeks to improve the efficiency and effectiveness of research activities. We explore challenges facing AI adoption in behavioral science through the lens of lessons learned during the Human Behaviour-Change Project (HBCP). Methods The project used an iterative cycle of development and testing of AI algorithms. Using a corpus of published research reports of randomized controlled trials of behavioral interventions, behavioral science experts annotated occurrences of interventions and outcomes. AI algorithms were trained to recognize natural language patterns associated with interventions and outcomes from the expert human annotations. Once trained, the AI algorithms were used to predict outcomes for interventions that were checked by behavioral scientists. Results Intervention reports contain many items of information needing to be extracted and these are expressed in hugely variable and idiosyncratic language used in research reports to convey information makes developing algorithms to extract all the information with near perfect accuracy impractical. However, statistical matching algorithms combined with advanced machine learning approaches created reasonably accurate outcome predictions from incomplete data. Conclusions AI holds promise for achieving the goal of predicting outcomes of behavior change interventions, based on information that is automatically extracted from intervention evaluation reports. This information can be used to train knowledge systems using machine learning and reasoning algorithms.

Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

2021 ◽  
pp. 104973232199864
Author(s):  
Nabil Natafgi ◽  
Olayinka Ladeji ◽  
Yoon Duk Hong ◽  
Jacqueline Caldwell ◽  
C. Daniel Mullins
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Lessons Learned ◽  
Community Members ◽  
Community Based ◽  
Care Community ◽  
Care Experience ◽  
National Initiative

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

Securing the future of statistics in Africa through National Strategies for the Development of Statistic

2020 ◽  
Vol 36 ◽  
pp. 15-25
Author(s):  
Ben Kiregyera
Keyword(s):  
Ad Hoc ◽  
Lessons Learned ◽  
Global Level ◽  
African Countries ◽  
Implementation Challenges ◽  
Statistical Systems ◽  
Development Agendas ◽  
Different Levels ◽  
Statistical Development

Adoption of development agendas at different levels – national, regional, continental, and global level – has led to an unprecedented increase in demand for official statistics. This increase has not only brought to the fore a litany of challenges facing National Statistical Systems (NSSs) in Africa but also it has created opportunities for strengthening statistical production and development. This paper underscores the need for countries to take full advantage of these opportunities and increase investments in statistics, undertake data innovation, and expand and diversify data ecosystems, leveraging on the foundations of the data revolution for sustainable development and in line with current international statistical frameworks. The paper posits that these improvements will not happen coincidentally nor through ad hoc, piecemeal and uncoordinated approaches. Rather they will happen through more systematic, coordinated and multi-sectoral approaches to statistical development. The National Strategy for the Development of Statistics (NSDS) is presented as a comprehensive and robust framework for building statistical capacity and turning around NSSs in African countries. The paper unpacks the NSDS; elaborates the NSDS processes including; mainstreaming sectors into the NSDS, the stages of the NSDS lifecycle and the role of leadership in the NSDS proces; highlights NSDS extension; presents the design and implementation challenges, and the key lessons learned from the NSDS processes in Africa in the last 15 years or so.

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