Optimity Advisors was at ICIC19 last week to talk about evaluation of integrated care. We’ve presented the integrated care performance assessment framework and tool we have developed for the European Commission and showed how its use can help to prove that integrated care works.
Funded by the EU Health Programme, Optimity carried out a study published last November that presented the state of play in integrated care in the European Union’s 28 Member States, Norway and Iceland. As part of the study, we mapped 546 integrated care initiatives (compiled in a repository) across all 30 countries. What we learned from the extensive mapping exercise was that integrated care is being implemented in many different ways across Europe: initiatives vary in size, coverage, funding, but also in terms of their type of integration (functional, organisational, professional, or clinical), level of integration (vertical and/or horizontal) and the degree to which different elements of the initiative are connected (linkage, coordination, or full integration).
The study also required for us to propose a framework of indicators for assessing integrated care. It was therefore important to propose a framework that was adaptable to the different contexts but also allowed for meaningful comparison. To make sure that what we proposed was practical and functional for its future users, we carried out an iterative stakeholder engagement programme across the continent. The co-design journey we took involved:
- Review of existing frameworks: we reviewed existing performance assessment frameworks.
- Iterative approach to developing the framework: we carried out 5 rounds of stakeholder engagement with 6 expert advisors to the study, 4 peer-reviewers, and representatives from 18 integrated care initiatives in Europe, through interviews, questionnaire, webinars and workshops.
- Validation with frontline staff: we carried out a final consultation round with doctors, nurses and allied health professionals to test the proposed framework of indicators.
As a result, 18 core indicators were selected classified across the following domains advancement of integration; use of care services; health outcomes; experiences of care; financial performance.
The framework and tool co-produced and validated by stakeholders across Europe is now available to use by anyone who is implementing integrated care. It can be accessed here. The tool is still a prototype that will need to be further developed and refined, but this will only be possible by using it and testing it further. We at Optimity will be pleased to support the use of the framework and tool and feed back to the European Commission on how it can be improved. We know integrated care works, makes sense and has many benefits. Now we need to prove it.
By Mariana Dates, Principal Consultant