20 de febr. 2016

Could an Integrated Delivery System be a cure for fragmentation in Catalonia?

An Integrated Delivery System (IDS) defined by Alain C. Enthoven  is an organized, coordinated, and collaborative network that:

(1) links various healthcare providers, via common ownership or contract, across 3 domains of integration—economic, noneconomic, and clinical—to provide a coordinated, vertical continuum of services to a particular patient population or community

(2) is accountable, both clinically and fiscally, for the clinical outcomes and health status of the population or community served, and has systems in place to manage and improve them.

With all of the following  characteristics:
  1. Shared values and goals; 
  2. Aligned incentives; 
  3. Physicians leadership; 
  4. Comprehensive records; 
  5. Shared practice guidelines; 
  6. A culture of teamwork; 
  7. Integration across care settings; 
  8. And a focus on populations as well as individuals.
Here there is the article explaining what is an IDS. A. Enthoven (2009) Integrated Delivery Systems: The Cure for Fragmentation*
*acces to pdf on the last page

Alain C. Enthoven said in 2007 in a Nuffield Trust (UK) seminar:
"Integration is about relationships between people. These relationships are not informal friendships. They have to be worked on and built professionally if clinical integration is to be meaningful and sustained through good and bad times. Effective integration takes years to develop, and is not a quick fix".

We should explore more this idea in Catalonia.

photo: (*) Photosolde