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Reading: Integrated Care – how to negotiate the Challenges among different Stakeholders


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Integrated Care – how to negotiate the Challenges among different Stakeholders


Rachelle Kaye ,

Assuta Medical Centers, IL
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Ofer Chen,

Samason Assuta Ashdod Hospital, IL
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Keren Scheter Azulay,

Maccabi Healthcare Services, IL
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Reut Ron

Assuta Medical Centers, IL
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Overcoming Integration Failure Through Negotiation – A Workshop for Doers and Planners

. "CONNECARE; A Bridge Over Troubled Waters"

How to resolve conflicts of interest that prevent integrated care – an interactive workshop to generate solutions for shared dilemmas, based on real-life experience.                  

Background: Learnings from a real life integrated healthcare venture: a new general hospital (Samson Assuta Ashdod, Israel) with an integrated care vision, in partnership with a healthcare insurer and provider of community healthcare services (Maccabi) and social services, supported by an H2020 project – CONNECARE -  aimed to create and implement a digitally supported integrated care model. Why is moving from vision to reality so difficult? What are the main obstacles and challenges? How can we overcome the diverse and conflicting interests and perspectives of the major stakeholders?

Aims and Objective of the workshop: To identify the different and sometimes conflicting interests of the major stakeholders – the Payer(s) (State, Region, Municipality, social insurer), the providers ( clinicians, provider organizations), the patient and his caregivers  

To set up consensus groups with "representatives" of all stakeholders

To challenge the participants in the consensus groups to negotiate a workable integrated care model that takes into account the interests of all stakeholders

To share learnings among the groups

To briefly share 4 patient- centered innovative integrated care solutions that have been implemented in Ashdod with preliminary results


Introduction to the workshop (10 minutes)

a. Setting the Scene – Dr Rachelle Kaye (4 minutes)

b. Barriers to Integration – Hospital Perspective – Dr. Ofer Chen (3 minutes)

c. Barriers to integration – Payer/Community Services Perspective –Keren Schecter Azoulay ( 3 minutes)

Divide participants into small groups – their task to negotiate an integrated care model that takes into account the needs and interests of each stakeholder group (20 minutes)

Presentation of small group findings and discussion - Dr. Rachelle Kaye, moderator (10 minutes)

Presentation of integrated care solutions in Ashdod (15 minutes)

a. Home Hospitalization and Home Rehabilitation – Dr Ofer Chen (5minutes)

b. Community integrated care units in the hospital – Keren SchechterAzulay (5 minutes)                  c. CONNECARE – patient empowerment through digitally supported coordinated care – Reut Ron (5 minutes)

Summary of learnings and comments from participants (5 minutes)

Target audience: Health care managers, Clinicians, Researchers

Learnings/Take away: Analysis of practical challenges and barriers in Implementing Integrated Care

Building New models for implementing integrated care in practice that overcome the barriers

Implications of Learnings for other environments

How to Cite: Kaye R, Chen O, Scheter Azulay K, Ron R. Integrated Care – how to negotiate the Challenges among different Stakeholders. International Journal of Integrated Care. 2019;19(4):117. DOI:
Published on 08 Aug 2019.


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