Treating the whole person: Moving from fragmented to integrated care

The concept of integrated care varies from one jurisdiction to another. The WHO states that integrated care places the patient at the center of care with a global strategy of “universal health coverage, primary health care as well as action on noncommunicable diseases and addressing the social determinants of health, but also on more recent calls to strengthen national health emergency and disaster management and the resilience of health systems”.

Core principles of integrated care

There are core principles to integrated care to name a few: coordination, whole-systems thinking, holistic, sustainable, preventive, continuous and empowering. Some of these necessary elements can be a challenge in terms of change management. Healthcare is not equitable due to cost and access and social need determinants lead to a lack of continuity. The main tool patients lack is a unique identifier that creates a closed loop of coordination. A unique identifier creates a move in change management to a whole-systems thinking that empowers the patient and brings continuity. Then one should focus on the social, economic and environmental causes of patient decline in health and any unforeseen barriers to self-care. A long-term management of disasters and care towards displaced acute conditions as well as patients with chronic diseases need to be identified and addressed before events occur.

WHO recommendations

A globally integrated care model is not “one size fits all” because of access and cost variance. There are 5 strategies the WHO recommends despite a country’s economic level from empowerment and engagement of patients, good governance, reorienting the model of care, and an enabling environment.

UK perspective

In the UK, Professor Chris Ham defines integrated care and the challenges and opportunities faced by the nation, cost and success stories. YouTube → Integrated Care | In conversation with Professor Chris Ham.

The Estonian perspective

In Estonia, at the eHealth Tallinn event, the country’s healthcare innovators will demonstrate why they are one of the best in Europe. YouTube — The best place for health innovation.

Local integrated care encompasses a focus on building a cooperation between nursing and social workers with consensus between different care sectors, and legislative support from the state thanks to professor Kai Saks, an Assoc. prof. of the University of Tartu.

eHealth Tallinn is an opportunity to learn best practices for integrated care from the national viewpoint that can be shared with clinicians from North America and beyond.

This article was originally published on the HIMSS Europe Blog.

Research, thoughts, and opinions are my own. Further references can be found on my personal sites innonurse.info and ammende.info.