Health systems face significant challenges in moving towards integrated care. Despite long time policy pressures and the existence of best practice models at international level, integrated care frequently remains limited to pilot projects.
There are multiple reasons why pilot projects are not scaled up. First, the internal validity of the findings may be questioned: can we be sure the project really reached its results? Secondly, assuming internal validity it is sometimes unclear how results were achieved: are the causal pathways from integrated care structures over processes to outcomes sufficiently understood to capture the active ingredient of the intervention package? Third, ambiguity may exist regarding the external validity of a pilot project: which context factors determine project success and how can the intervention be scaled up beyond the initial reach? Fourth, how can the boundaries of the complex intervention - which integrated care projects are by definition – be set and how do we address system context, cultures and circumstances. Fifth, how do we monitor implementation and performance in widespread roll out of the integrated care project to support quality improvement and accountability?
We want to address these questions and related methodological challenges in an interactive workshop. We will initially present two case studies of comprehensive evaluations of integrated care pilot projects, followed by a moderated discussion of the methodological issues outlined above. The audience will be engaged through a series of interactive panel questions (using Mentimeter) and group discussions. Following the conference, and in collaboration with others SIGs (Measuring Integrated Care, Realist Evaluation, Regulation and Inspection) we aim to prepare an evaluation framework to be published as a position paper for IFIC.
Oliver Groene, Vice Chairman of the Board, OptiMedis AG, and convenor of the Special Interest Group on Population Health Management
Eva-Maria Oppel, Assistant Professor, Hamburg Center for Health Economics, currently leading the evaluation of the integrated care pilot INVEST in Hamburg, Germany
Mary Alison Durand, Associate Professor, London School of Hygiene and Tropical Medicine, currently co-ordinating the Department of Health funded longer-term Evaluation of the Integrated Care and Support Pioneers in England (2015-2020).