Author:

Abstract

Title: Use of the new paradigm of healthcare ecosystem research in mental health planning

Luis Salvador Carulla, Carlos Garcia-alonso, Jose albero Salinas, Nerea Almeda and Mary Anne Furst.

CMHR, ANU, Loyola University

INTRODUCTION: Health Ecosystems Research (HER) is a new discipline in implementation sciences that incorporates systems dynamics, context analysis, health economics and knowledge discovery from data. HER is particularly relevant for the analysis of integrated care.

METHOD: A collaborative strategy based on systems research has been implemented to regional mental health planning based on context analysis. The organisational learning strategy included: i) the development of the conceptual model, ii) atlases of regional Mental Health Care, iii) integrated resource utilisation analysis applying  new units following the recommendations made by the PECUNIA group(*), v) geospatial analysis of administrative prevalence, vi) financing of mental health care, vii) cost of illness of sentinel conditions, viii) modelling of efficiency and organisational improvement.

RESULTS: All the blocks of this strategy have been used for policy including the regional mental health strategic plans in Catalonia and the Basque Country (Spain). From a summative perspective the main factors related to the success of the strategy have been 1) the agreement on the framework and drivers included a common taxonomy, 2) policy of full transparency by the public agency,3) the continuity of the planning team, 4) the multidisciplinary  and flexibility of the reference network, 5) the development of a general framework for the collaboration, 6) the use of bidirectional multiple sources of funding, 7) the trust building process for effective knowledge transfer and bridging, 8) use of policy opportunities to increase the general knowledge base. Major challenges for implementation have been: 1) the need to accommodate the global strategy to specific short-time policy demands, 2) the lack of continuity of research funding and research teams, 3) the difficulty of information generated for practical use by decision makers and stakeholders without expert guidance, 4) the political cycles, 5) structural and administrative constraints in the Spanish public and research systems. This experience is being applied to local planning and expert-guided evidence informed policy in Australia

DISCUSSION: The healthcare ecosystems and context analysis framework is key for evidence-informed regional planning. The Spanish case highlights the importance of an integrated health ecosystems approach for use of health economics data in the real world. 

(*) The PECUNIA project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 779292.