Integrated care has been touted as a panacea for managing spiralling healthcare costs, meeting the needs of patients with long-term conditions, and of an ageing population. However, difficult questions are sometimes raised about integrated care and its implications. What is meant by integrated care? What are its potential benefits? How will it affect the healthcare industry?
To debate these issues, Integrated Healthcare Group brought together a number of prominent speakers to discuss the opportunities and challenges of Integrated Healthcare at an event organized by the INSEAD Alumni Association in London on February 13. “Everyone agrees that integrated care can improve patient outcomes and stem healthcare costs inflation,” says Abhishek Agrawal, co-founder of psHEALTH. “However there is no universal model. Successful Integrated Healthcare initiatives come in all shapes and sizes,” he adds.
At the event, Chris Ham, Chief Executive of The King’s Fund, set out a number of factors proven to impact on integrated care delivery in a negative way. Key obstacles identified by The King’s Fund, he explained, include: focusing on a specific disease area – which tends to mean that the impact of co-morbidities on patients with chronic conditions are ignored; provision for small groups of patients, which lacks scale benefits; and use of monopoly providers, which undermines patient choices and inhibits competition to improve care standards.
Tim Johnson, Bupa’s Corporate Strategy Director, explained his belief that successful integrated care delivery requires significant investments which can only be recovered over a long period. This requires contractual arrangements that align interests of both funder and providers for the long term. The delivery of integrated care in Valencia, Spain, where Bupa is managing a fully integrated health system, for a population in excess of 200,000, was highlighted as an example of success. According to Mr Johnson, the contract length, in excess of 10 years, has enabled Bupa to invest in costly operational changes and in disease-prevention initiatives, which will pay off over contract length.
Ruth Pool, of Healthcare at Home, discussed the importance of putting the patient in the centre of care delivery. She is hopeful that CCG commissioners over time will begin to commission for actual patient outcomes. According to Ms Pool, the use of case managers, to co-ordinate care and access to electronic patient records, is a key ingredient for success.
What role will pharmaceuticals play in the future? Janssen Healthcare Innovation, part of the Johnson & Johnson group, is working on a number of new service-led models independent of drug brands. Marco Mohwinckel, a partner in the innovation team, discussed Janssen’s success in Germany managing a specific cohort of patients with mental health issues and indicated that Janssen is developing similar services world-wide.
Lastly, Dr Mohammad Al-Ubaydli, the CEO of PatientsKnowBest, made passionate arguments for the need for patients to be in control and the need for patient-centric health records. According to Dr Al-Ubaydli, no one can take the patient and his/her carers’ place as the chief co-ordinator of care.
“It’s clear that successful Integrated Healthcare initiatives require a lot of ingredients, says Abhishek Agrawal, summing up the day. Strong local oversight, long-term financial incentives, difficult organisational changes and co-ordination across multiple stakeholders. However it’s difficult to achieve this without an underlying robust, flexible and secure case management system that integrates with a number of legacy systems. In our view, the future will involve a lot of experimentation. With our secure, cloud-based solutions we are helping providers reduce the time and cost to market as they innovate and create effective new services.”
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