Abstract
Introduction
Extensive experience is available in implementing successful Integrated Care Programmes; however, too many initiatives are independently designed and limited in scope to a specific topic, lacking a global vision.
Policy context
Any Integrated Care Programme should arise inside a regional multi-annual roadmap, according to a long-term policy to achieve a pervasive transformation of a regional health ecosystem.
To this end, our study analysed the transformative power of 30 Service Delivery Models, previously co-produced by the Author with stakeholders engaged in the respective Integrated Care Programmes.
For each Programme, a toolkit allowed to assess the ""Transformation Index"" of the Service Model, the intrinsic deployment difficulty and the attitude to support the policy.
Highlights
Twenty-two models of our sample were considered capable of laying the foundation for any other Programme; they were assigned to three Basic Themes:
- long-term follow-up of complex chronic conditions (9 cases);
- long-term follow-up of frailty and mobility impairment (8 cases);
- short-term follow-up after a severe health-related event (5 cases).
In particular, the first two Themes can establish a collaborative atmosphere among professionals and an active participation of citizens/patients on managing their health, yielding a high Value.
The other eight cases were examples addressing Complementary Themes, classified as: remote follow-up of implanted cardiac devices, treatment of depression, and family nurse supporting physician’s e-visit; several good practices can hint many other successful Themes.
The study suggested a number of systemic principles about Programmes co-design in a national / regional Roadmap; among them:
a) an early, wide deployment of Basic Themes may allow a better harmonisation of further Programmes in the Ecosystem.
b) the strategic priority of a Programme (in a given moment, in a given local context, in a given regional Roadmap) depends on the following criteria:
- it is widely replicable, to yield a massive scaling up;
- it is modular, to allow a progressive growth;
- several other localities are mature to start deploying the related health transformation;
- costs and outcomes are measurable in the short/medium period for timely evaluation and tuning;
- in case of innovation procurement, a contribution to its outcomes can be attributed to the suppliers;
c) commercially available technologies applied to the Basic Themes usually can establish a robust platform to satisfy further additional needs;
d) some Complementary Themes could yield a high Value; however, by definition they provide less support in ecosystem building than Basic Programmes.
Transferability
These principles can be applied to any regional Roadmap:
- any Programme should be coherent with previous and future Programmes;
- existing technologies can enable significant services transformations;
- the deployment of Basic Themes could induce a massive “snowball effect”, also outside the involved jurisdictions, with a high impact on population health and Digital Market.
Conclusions
The Basic Themes support the deep transformation of organisational processes, promote a collaborative atmosphere among actors and across settings, and set up an interoperable technological backbone, in the spirit of propagating a Disruptive Health Innovation in a Health Ecosystem.
Published on
08 Apr 2022.