Integrated Care is a well-established knowledge domain in healthcare systems but with a multiplicity of definitions and conceptualisations. Kodner and Spreeuwenberg summarised Integrated Care expansively as “... a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors ... [to] ... enhance quality of care and quality of life, consumer satisfaction and system efficiency for patients with complex problems cutting across multiple services, providers and settings”.
The World Health Organization calls Integrated Care "a concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve services in relation to access, quality, user satisfaction and efficiency.” The Nuffield Trust and the National Health Service in the United Kingdom provide somewhat similar definitions that focus more on the goals of Integrated Care rather than the means of achieving said goals. In 2009, Armitage et al counted some 175 definitions and concepts in Integrated Care, which Kodner in the same year described as “an imprecise hodgepodge”. Since then, there have been many more definitions, models and frameworks (collectively “models”), not least of which is the popular Rainbow Model by Valentijn.
All models are attempts at succinctly capturing the essence of complex realities, differently and differentially experienced by participants, with a view to providing a common language for engagement and communication. Models represent the underlying reality and thus mediate across minds and contexts.
The benefit of a model depends on how closely it represents the underlying reality for useful decision-making. Current models inevitably perceive the world through their own lenses and are, in themselves, not the reality, so the choice of model may significantly influence conversations on Integrated Care. The sheer number of models make a complex knowledge domain even more challenging.
A "Unified Theory of Integrated Care" that brings together disparate models onto a common architecture could go a long way to improving our common understanding and communications in Integrated Care.
The Business Model Canvas (Osterwalder, Pigneur, Smith et al) is a design tool that helps entrepreneurs conceptualise, develop, test and enhance their businesses, especially novel startups attempting to disrupt current value delivery processes. In brief, each canvas captures how products and services meet value propositions for their clientele through defined relationships and channels, and how resources and partners are sustainably and profitably engaged to create these products and services.
This presentation collates common definitions, frameworks and models of Integrated Care and maps them onto a common business model canvas, demonstrating their different perspectives and emphases, illustrating their parallels and differences, and enabling a more transparent display of the systems and processes that underlay Integrated Care. If the past models are each separate windows into the house of Integrated Care, this exercise breaks down the intervening walls to open the interior of the home for hopefully greater understanding and insight.
How to Cite:
Yap J. Understanding Integrated Care with the Business Model Canvas. International Journal of Integrated Care. 2021;20(S1):122. DOI: http://doi.org/10.5334/ijic.s4122