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How to make an integrated care service sustainable? An interactive workshop on business model development

Authors:

Reinhard Hammerschmidt ,

Ingo Meyer,

Sonja Müller,

Lutz Kubitschke

Abstract

When developing and implementing integrated care services spanning across established organisational boundaries, decision makers frequently need to create new business models involving diverse stakeholders, both profit and non-profit. These may rely on reimbursement from statutory health and social care bodies as well as on other revenue streams. In practice, the needs of a wide range of stakeholders may need to be identified and duly balanced within the framework of what is possible, e.g. in relation to legislation and regulation. Achieving service integration within day-to-day practice therefore often requires joint planning – sometimes tough bargaining - by many stakeholders potentially concerned. Not at least, a certain amount of “looking into the future” will be necessary, that is anticipating developments, testing different service deployment scenarios and seeing how they respond to changes in patient populations, changes in reimbursement regimes and changes to other factors.

If economic modelling of service integration is to be done in an evidence-based manner, a large amount of data on economic and other impacts, both positive (benefits) and negative (costs), thus needs to be handled and systematically brought to bear on the development of an economic case for the desired service integration. Other than merely managerial staff and accountants will most likely need to be involved as well. Care professionals, IT staff, call centre personnel and others can be holders of valuable information in relation to work processes, the actual impacts of process innovation within day-to-day practices as well as acceptability new solutions by staff and/or service clients/patients. While a narrower economic viewpoint might tend to exclude such factors from a business model, they are in reality just as crucial to success as immediately monetary factors such as revenues (see for example (Meyer et al., 2011), (Goodwin and Alonso, 2014) or (Rigby, 2014)).

Taking a strictly interactive format, the workshop will enable participants to gain hands-on experiences in service related economic modelling. In particular, workshop participants will get acquainted with economic assessments through an “active learning” approach (Bonwell and Eison, 1991) enabling them to carry out their own assessment and business model development. For this purpose the so-called “Service Implementation Simulator – Integrated eCare” will be used. This tool was created in the framework of the SmartCare project (SmartCare, 2015) to support stakeholders in health and social care when it comes to establishing sustainable economic models for integrated care services currently under development. Since the Simulator is filled with data already, workshop participants can instantly delve into understanding the economic characteristics of an example case and begin modifying data to see how the sustainability model of the service reacts to changes in costs and benefits. While doing this, they will also be made acquainted with the functionalities of an open-source software tool (ASSIST) publicly available for service related business modelling and the underlying methodological assumptions (Hammerschmidt and Meyer, 2014).

In didactic regard, this approach will allow workshop participants to get into immediate contact with the content-related aspects of the assessment, while (initially) by-passing methodological questions and the need for data collection. The Simulator is provided with guidance material containing a number of lessons to be learned by the workshop participants. These lessons are designed to make the workshop participants acquainted with the open-source software tool and then to carry out a series of ever more complex tasks. These tasks take the workshop participants on a journey of first understanding how the service works in economic terms and second identifying and then solving a number of problems that were built into the service’s sustainability model. Each lesson in the guidance begins with a description of the problem, followed by a series of ever more concrete hints as to how the problem might be solved. The lessons are generally designed to be solved by working alone, but a group setting can also be used. The latter can be considered particularly useful for those lessons where no single solution exists, but there are rather alternative options, each with its own advantaged and disadvantages. Since the Simulator carries out all calculations on-the-fly, the impact of any solution on the relevant key performance measures can be checked by the workshop participants immediately and without need of feedback from a “teacher”.

References:

1- Meyer, I., Müller, S. & Kubitschke, L. AAL markets – knowing them, reaching them. Evidence from European research. In: Augusto, J. C., Huch, M., Kameas, A., Maitland, J., Mccullagh, P. J., Roberts, J., Sixsmith, A. & Wichert, R. (eds.) Handbook of Ambient Assisted Living. Technology for Healthcare, Rehabilitation and Well-being.: IOS Press. 2011.

2- Goodwin, N. & Alonso, A. Understanding Integrated Care: The Role of Information and Communication Technology. In: Meyer, I., Müller, S. & Kubitschke, L. (eds.) Achieving Effective Integrated E-Care Beyond the Silos. Hershey, PA: IGI Global. 2014.

3- Rigby, M. The Core Vision of Person-Centred Care in a Modern Information-Based Society. In: Meyer, I., Müller, S. & Kubitschke, L. (eds.) Achieving Effective Integrated E-Care Beyond the Silos. Hershey, PA: IGI Global. 2014.

4- Bonwell, C. & Eison, J. Active Learning: Creating Excitement in the Classroom AEHE-ERIC Higher Education Report No. 1. Washington, D.C.: Jossey-Bass. 1991.

5- SMARTCARE. Service Implementation Simulator – Integrated eCare. 2015. Available from: http://pilotsmartcare.eu/outcomes/service-implementation-simulator/

6- Hammerschmidt, R. & Meyer, I. Socio-economic impact assessment and business models for integrated eCare. In: Meyer, I., Müller, S. & Kubitschke, L. (eds.) Achieving Effective Integrated E-Care Beyond the Silos. Hershey, PA: IGI Global. 2014.

How to Cite: Hammerschmidt R, Meyer I, Müller S, Kubitschke L. How to make an integrated care service sustainable? An interactive workshop on business model development. International Journal of Integrated Care. 2016;16(6):A328. DOI: http://doi.org/10.5334/ijic.2876
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Published on 16 Dec 2016.

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