To what extent are digital tools used today to support the implementation of integrated care systems?
The deployment of digital technologies in all areas of healthcare is a new strategic imperative to make the best use of all patient data available to systems and improve both the access and quality of care for populations. The European Union, and many countries across the world have therefore recently committed to Digital First approaches in healthcare. Strategies and policies have envisioned and outlined how healthcare systems across Europe should develop in the next decade: health and care will be digitally-enabled, person-centred and provided in an integrated way.
But, if we know where are going, where are we today? What is Europe’s starting point?
We attempted to set the baseline by leveraging the data from a study that Optimity Advisors conducted for the European Commission last year, that aimed, as part of its objectives, to understand the current state of play of care integration in Europe. Optimity did this by (i) analysing the readiness of health systems to successfully implement integrated care models, using the SCIROCCO Maturity Model; and (ii) analysing the level of prevalence of integrated care initiatives across Europe, by mapping initiatives, organisations, policies and strategies in the EU28 Member States, Norway and Iceland.
Based on the findings from the maturity assessment and mapping exercises, we were able to scope the extent of the use of digital elements in integrated care initiatives across Europe. Key findings show that:
- Many healthcare systems across Europe need to further develop their information and eHealth services supporting their integrated care systems. Using the SCIROCCO Maturity Model to assess the readiness of Integrated Care systems implementation we were able to identify that maturity for the eHealth services domain varies widely between the healthcare system assessed in the study. Overall the score for this domain was only 2.5 on average, lower to most other domains, and 1/3 of the Integrated Care systems reviewed had this domain as the least developed in their initiatives.
- Currently, less than 15% of the Integrated Care Initiative (n=80) that Optimity has mapped through the review of initiatives include a digital component. As a result of mapping and review of Integrated Care initiatives implemented across Europe, Optimity, in collaboration with experts and researchers from the 30 countries reviewed, developed an extensive repository of 546 integrated care initiatives implemented across Europe (including small projects, larger programmes, organisation, strategies and policies). Of these 546 initiatives, only 80 included in their description an ICT element included in their initiatives.
- Of these 80 initiatives, 42% focused on the initial setting up of eHealth services and infrastructures, through the establishment of ICT infrastructures and shared records. In order to identify which initiatives, of the 546 collected, were digitally-enabled, we reviewed them one-by-one and assessed whether they described their initiative as having a digital component at their core or being support by ICT systems. As a result, eight types of digital technologies and solutions were found: (i) Establishment of ICT infrastructures; (ii) Shared Care Records; (iii) e-Prescriptions; (iv) Risk stratification and population-wide screenings; (v) mobile health; (vi) Artificial Intelligence and Robotics; (vii) Wearable devices for monitoring and prevention; (viii) Homecare management.
What is clear from this work is that up until now, Digital was not a defining and central element of integrated care systems and initiatives. Data from the repository has allowed us to set the baseline to understand where we are today, and where the transformation to digitally-enabled integrated care systems will bring health and care systems to in the next years. What we will be interested to research in the next couple of years will include to understand whether a Digital First approach in healthcare will lead to practical changes and more digitally-enabled integrated care initiatives, as well as whether the use of digital technologies will translate to better health and wellbeing outcomes.
By Micol Tedeschi, Senior Consultant