Integrated healthcare – buzzword or reality?
The concept of integrated healthcare is much talked about and rarely (if ever) delivered. Why?
Perhaps the best place to start is with complex patients, those with co-morbidities. For patients 65 and older, 90% of costs are associated with those with three or more chronic conditions. As our population ages, the numbers of such patients are increasing massively. And they are failed by most health care systems, the world over.
Our publicly available interview with Dr. Jonathan Darer, Medical Director, Siemens Healthineers and former chief innovation officer at Geisinger Siemens Healthineers highlights three big problem areas:
- Most clinical guidelines are still written for single diseases. That leads to confusion and conflict.
- The lack of adequate information systems. Healthcare records are often more about billing, than the impeccable data that patients, doctors and families needs
- Patients and their families often get little information or access to records. He argues that they need to be included and so made members of the care team. Even something as simple as an online calendar showing all appointments makes an enormous difference.
Ultimately, Darer thinks that healthcare systems need to be able to improve the value of the care they deliver year-on-year through systems designed to learn. This sounds like a very obvious point, but he says that, in practice, very few organisations systematically assess the clinical outcomes they deliver or the cost it takes to deliver those outcomes.
Often integrated care is defined as something much broader than Darer’s focus on patients with co-morbidities. Evangelists see it covering the silos between social care and health care and between care delivered at home and care delivered in an acute setting. So it is sobering to consider the headaches that most hospitals have in delivering integrated care just within their own walls.
We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.