Healthcare transformation - leveraging integrated care systems for better patient & clinical outcome

Maiden Edition Maiden Edition Healthcare Transformation Leveraging Integrated Care Systems for Better Patient and Clinical Outcome

By Fiyinfoluwa Adeoti

GNS/22/02/000001 GNS/22/02/000001 There is a prevalent level of deteriorated provision and access to healthcare services for the neediest population across Nigeria. Hence, they are subjected to the risk of combating serious medical issues. How far spread is this problem? The organizational structure of the Nigerian health care system today suffers decentralization in terms of operations, management of the patient records, and patient safety. And now more than ever, there is a need to push for a shift in the healthcare system leveraging integrated care systems.

Although change usually comes slowly, the Covid-19 pandemic has demonstrated that it is possible to rapidly reorient our systems if there is a strong enough stimulus. The healthcare system has been described as “deeply fragmented, with only a small fraction of the healthcare coming from a unified and organized center. ” According to the World Health Organization 2017, Integrated Care Systems are ‘’the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results, and provide value for money.’ Provider-centered models of care and to reorient many based on principles of integration to ensure everybody has access to a continuum of care that is responsive, coordinated, and in line with people’s needs throughout their life. Successful integration also ensures that health care services throughout this continuum of care are of acceptable quality, i.e. effective, safe and people-centered. Integrated care contributes to improved access to services, fewer unnecessary hospitalizations and readmissions, better adherence to treatment, increased patient satisfaction, health literacy and self-care, greater job satisfaction for health workers, and overall improved health outcomes.

Integrated healthcare systems are built on three layers: infrastructure, intelligence, and engagement. The infrastructure layer is foundational, composed of effective data capture, curation, management, storage, and interoperability to create a common data set

upon which the ecosystem can operate. Built on top of the infrastructure layer is the intelligence layer, which converts data elements to consumable and actionable insights. Finally, bringing an ecosystem to life also requires a robust engagement layer, enabled by the infrastructure and intelligence layers, to effectively curate an end-to-end experience for suppliers who provide services and offerings to patients. Components of these layers can be built, bought, partnered, or vended by ecosystem curators and participants.

Data liquidity—the ability to access, ingest, and manipulate standardized data sets—is required for the infrastructure layer to serve as the foundation for all insights and decisions made in the ecosystem. This data liquidity enables the ecosystem to create value and removes silos by allowing stakeholders to operate off the same data sets with increased coordination.

In this article, the emphasis would be laid on how the engagement layer of ensuring integrated healthcare systems can improve patient and clinical outcomes. The engagement layer of the ecosystem is where end-users interact with services that are in turn supported by underlying data sets from the infrastructure layer and insights from the intelligence layer. The engagement layer requires a shared digital platform where end users can access, through one principal channel, the curated set of services and offerings. In healthcare, these engagement offerings might include appointment scheduling, transportation assistance, daily health monitoring, and financial assistance. In this layer, data liquidity and infrastructure will support advanced digital therapeutics and coordinated care across traditional and innovative care models that rely on up-to-date and comprehensive patient information. So, to fully take advantage of this model in healthcare, industry behaviors will need to change. For example, provider practice changes include using the layer of intelligence to inform care decisions, leveraging innovative care delivery models and working across a care team at distributed sites, and capturing data from all relevant healthcare-related encounters. These changes will require payment model innovation to align provider and healthcare stakeholder incentives to change provider, payer, and patient behaviors.

In conclusion, how can healthcare stakeholders prepare for and act within healthcare ecosystems? Strategically, stakeholders need to decide whether they will act as curators or participants across the ecosystems that they touch. Stakeholders who wish to curate an ecosystem will need to ensure meaningful improvement in outcomes for a specific set of patients. This approach will require being clear on which industry-agnostic services they leverage and how they augment those services with healthcare-specific capabilities to create a differentiated ecosystem. Other stakeholders who want to provide point solutions will need to ensure their value proposition is both competitively distinctive and compatible with a variety of ecosystems.