When considering the concept of Integrated Care, it is always useful to start off with a simple ‘why'?
Why should we pursue Integrated Care? The answer is - Integrated Care improves clinical outcomes, and quality of life for individuals, particularly for those patients with long-term and chronic health conditions, by orienting the health system around them.
Improving an individual’s health has the flow-on effect of improving the health of the population at large. Which can lead to reductions in the financial costs associated with running the healthcare system.
But while the concept of Integrated Care is simple (and generally accepted), what isn’t so simple is the ‘how’. Let’s take a look at that now.
Healthcare IT has a significant role to play in the seamless integration of our healthcare systems. This requires a common data platform to enable a shared, dynamic view of the person’s health record, supported by a workflow which enables teams to work together across care settings.
Being able to view a secure shared care record allows for timely, safe and informed decision–making, for and with the patient. This ‘person-centric’ health system transcends boundaries between primary, community and hospital-based care.
How can the healthcare IT system enable this?
The IT system and interoperability is a pain point for most healthcare organisations - the ability to provide clinicians with timely, accurate access to information which helps to improve the decision-making process is a necessity. However, many components in the healthcare system aren’t necessarily connected effectively, or indeed at all, thus hampering the ability to deliver connected healthcare.
Historically in Australia, general practice has been the main access point for healthcare services. But as specialised care has expanded, there has been increased fragmentation of healthcare services – particularly for patients with multiple and/or complex chronic conditions.
Furthermore, the Australian healthcare system is a complex mix of federal and state government funding and responsibility. Services are delivered through both the public and private sectors, which is confusing for patients to navigate. This complexity presents challenges in providing integrated pathways for the ongoing care of people with long-term chronic conditions who require coordinated access to services across primary, community and acute care settings.
However, the Australian government is recognising that there are multiple health, social and economic implications to fragmented healthcare, and that an integrated healthcare system is an integral part of healthcare reform. Evidence suggests that integrated primary health care is an effective way to optimise the efficient delivery of services and improve patients’ outcomes and experiences. It is this that Integrated Care sets out to address.
Gathering healthcare information
The many systems that are designed to improve the delivery of healthcare data can themselves become an obstacle. This is because legacy systems and new technologies in some instances cannot communicate with each other, hampering the ability to freely exchange data and make information available to those who need it. Seamless integration of these clinical and health systems is, therefore, required for connected healthcare.
One way to provide interoperability is through a healthcare-focused integration engine. These engines act as a universal translator for the multiple systems running within organisations. Integration engines that are designed for rapid interoperability between systems of varied maturity, and standards, work as a hub, and spoke model. They connect multiple systems together centrally, and manipulate data in the process, so that each destination system can understand it.
An integration engine that is scalable, powerful, and easy-to-use, is crucial. One that can adapt as new technologies and standards like HL7 FHIR emerge, and evolves with the needs of patients, care providers, and healthcare organisations.
Storing healthcare information
Data can be stored and shared in many different ways across organisations. To get the complete picture of an individual’s health, an IT system needs to provide secure data acquisition, and integration engine capabilities, across a wide array of systems.
Secure exchange of personal health information is a basic requirement for clinical IT systems, and with an increasing focus on open APIs (Application Programming Interfaces, which provide managed access to applications and their data) this can be a challenge.
Robust privacy and security levels are necessary, given the sensitive nature of the data created, exchanged and stored in these systems. Healthcare organisations need to ensure they are aware of potential risks, and do everything they can to protect valuable personal health information. Security measures such as SMART (Substitutable Medical Applications and Reusable Technologies) should be applied to standards in healthcare data integration. SMART adds a layer of security in front of FHIR interfaces to support safe access to data held within an EHR – or any other healthcare information repository.
In addition to the confidentiality of clinical information, we should be concerned with its integrity and availability. Fast, reliable connectivity and data sharing between legacy and next-generation health systems through the use of a robust integration engine ensures all information relating to a patient can be fed into a central repository and shared across the chain of care in real time.
The result? Accurate and reliable interoperability, which is the basis of Integrated Care.
Now is the time to accelerate systems that empower people, keeping them well for longer, and preventing the onset of preventable chronic disease.
This is the ‘why and the how’ of providing healthcare IT systems that gather and store accurate and comprehensive data, while delivering rapid interoperability between healthcare systems.
This is the second part of our blog series on Integrated Care where we will discuss the critical elements that support the journey to integrated care.
Read the white paper on the 6 essential steps to support a coordinated model of care delivery.