What Is Integrated Care
What is integrated care? Integrated care is when different healthcare teams and administrative staff work together at the same time, rather than one by one. Cooperation across departments can be difficult, so staff work from an integrated care model to ensure the best care possible.
The goal of integrated care is to improve the care provided and patient satisfaction. By working in greater harmony with other departments, a person’s health can be properly assessed at a quicker rate, rather than expecting them to go back and forth from department to department to get answers as part of their diagnosis and treatment.
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Written by Liam Sheasby
What integrated care means?
It also means healthcare professionals can see the full picture of a person’s medical history. They know what has been diagnosed before and what medications have or have not worked. This is less stressful for a patient, but it also uses resources more effectively as clinicians can pre-emptively tackle health conditions and illnesses before they require more acute treatment.
Cooperation is one of the principles of integrated care. It might sound like common sense but with how busy healthcare workers are, there is typically limited opportunity do more for a person’s care than just coordinate their treatment from one department to the next until they are discharged.
The integrated care model, or integrated care framework, plans out the administration, organisation and funding, but also the delivery of service to clients and the clinical help on offer. From there, healthcare providers implement an integrated care system to put these plans into action.
What is an integrated care system?
An integrated care system (ICS) is the partnership of organisations that provide care such as NHS trusts and local authorities.
These organisations team up to provide joined-up care, speeding up patient diagnosis and treatment, reducing costs, and reducing administration work.
The Health and Care Act 2022 officially formalised integrated care systems within England.
An integrated care framework structures how the integrated care system is built.
Technology and integrated care
Joined-up care or integrated care is about working together for better care outcomes. Technology is making this happen through software, and it’s on healthcare organisations to move with the times and modernise to ensure they are providing the best care they are capable of.
Integrated care roughly splits into four organisational areas:
- NHS
- Local Authorities
- Care providers
- 3rd party suppliers (charities, volunteer groups, private organisations)
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Integrated Care Tools
Software tools offer a wide range of improvements that all four of these sectors can benefit from, including:
- Better communication
- Greater coordination
- Simpler data sharing
- Easier to send referrals, or equipment requests
- More transparency for the patient re: treatment or care plans
Software like Access Rio electronic patient records (EPR) and Access Mosaic allow for a centralised collection of records across health and social care. This avoids any needless duplication of notes and helps keep records both accurate and up to date.
Access Patient Flow Management allows a bed manager to monitor and control patient movements through a hospital. This avoids bottlenecking in certain wards and better priority usage of beds and clinicians. It also supports virtual wards, giving teams a clear picture of those receiving care in the community.
Perhaps the most comprehensive scope comes from Access Adam Care Commissioning. This is a cloud-based management tool; designed for the public sector when commissioning health or social care. It handles onboarding, compliance, contracting, provider management, brokerage, invoicing and payments, and reporting. The company using it can manage workflow, support staff teams, and it allows managers to set targets and provide direct guidance to employees.
Beyond this there are tools for local authorities such as PAMMS (Provider Assessment and Market Management Solution), to help them choose the right partner organisations from tender, as well as Access Elemental – a social prescribing tool designed to help GPs coordinate with link workers in the community to provide holistic, personal care away from a clinical setting.
Why is integrated care important?
Integrated care is important because the best way to help people is by providing effective care. With integrated care, care agencies can easily share information and data, but the coordination means continuous patient care. Nobody falls through the gaps.
The UK Government website states that:
good integrated care can reduce: confusion, repetition, delay, duplication and gaps in service delivery, people getting lost in the system.
The patient experience is paramount to healthcare. Those in need of help are the highest of priorities, and with integrated care you can provide more help to more people, all at a quicker rate, and save money in the process by being proactive with care. There’s less repetition, and more confidence that you’re being treated by people who are alert to your needs and concerns.
Care workers do an essential job, and their work is often challenging, but it can be difficult being a patient too. Not knowing what the problem is with your health can be scary and emotionally draining. It’s important that healthcare accounts for these concerns and reassures people that their wellbeing is a priority. Integrated care can achieve all of this by allowing for overlapping treatment. Clinical teams can work together much faster, all the data and clinical notes needed are readily available, and transferring a patient from one department to another is simple to organise. It saves staff time and patients from worrying – two very big wins.
Barriers to integrated care
Integrated care is a challenge. This style of care is not a natural development, because each department or service has a role to perform. They exist to be specialists. The challenge then is uniting these specialists to collaborate.
One of the biggest barriers to integrated care is limited understanding within smaller organisations. Integrated care as official government policy is new. Smaller care providers may not know what their place is within an integrated care system, or what their role is exactly.
Larger organisations, not used to collaborating with other care groups, may also be complacent about committing to the new integrated care system given the additional work required in establishing such partnerships.
All organisations have their own targets too. For NHS trusts, they rely on the integrated care board. Their goals for the local area come from the board, so negotiation and cooperation depend on the instructions from the board.
For local authorities, they are part of the integrated care system via an integrated care partnership (ICP). The ICP is a committee, made up of the integrated care board and the local authorities. The ICP is a locally-elected democratic group that produces the integrated care strategy for the area, but this is then relies on partner organisations doing as requested. An organisation may not have the experience or skills to achieve what has been asked of it, or they may have insufficient resources to even offer the services. Smaller organisations can’t be assumed to have the required infrastructure to provide integrated care.
These problems take time to overcome, but there are so many upsides to the initial outlay of time, effort, and funding.
Benefits of integrated care
The benefits of integrated care are potentially industry-changing. The World Health Organisation reports that there are now more people over 60 years old than there are under five years of age. By 2050 the world’s population will see 22% of people over 60 years old. This is a challenge for healthcare resources, both human and financial, and will see a necessity for integrated care going forward. Through proactive care, illness can be prevented, and by saving time there is a greater capacity to treat a growing, ageing population.
The benefits of integrated care systems are that these new integrated care opportunities can be properly introduced. The systems are what tie the organisations together. The organisations cooperate effectively with their care provision for the wider population. Patients get excellent care with improved access, due to greater efficiency, and public health improves.
The biggest of these organisations will be NHS Trusts. The benefits of integrated care for the NHS involve the sharing of medical information. Data and notes passing between departments in a hospital is commonplace, but sharing data between hospitals or with external healthcare providers gets more difficult. Different patient software can mean difficulty transferring notes. A file type might not be supported. The data might be there, but it attaches itself to the wrong boxes for the information required. Whatever the technical issue, time lost waiting on information to be provided is time that a patient is not being treated.
Integrated care sees experts and specialists come together to solve these problems. Data can be shared quickly, communication is easy, funding can be allocated with ease. All of these eliminate hurdles to continuous patient care, giving a better care experience and improving healthcare overall.
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