Transforming primary care: scoping review of research and practice

Miller, Robin; Weir, Catherine; Gulati, Steve

doi:10.1108/jica-03-2018-0023

Cited by 28 publications

(38 citation statements)

References 41 publications

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“…Furthermore, a greater adoption of eHealth seems to emerge where a NHS model are provided, that is with a tax-based financing system and with healthcare incentives which seem more favorable to eHealth implementation. Finally, also PC seems to have a key role, given that it can strengthen healthcare systems and can provide a more flexible access to services and integration across settings through technology [91,128]. A strong PC system can facilitate for instance a comprehensive care coordination [129,130], and this context influences the adoption of eHealth applications.…”

Section: Discussionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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Introduction. eHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics. Materials and Methods. In 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country). Results. 85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development. Conclusions. Although in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.

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Section: Discussionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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“…At a basic level, "integration" simply means a holistic and joined up system from previously distinct entities. This agenda includes the reorganisation of primary care services (Miller et al, 2018), as well as the appropriate involvement of private and third sector services (Tester, 2013;Bull et al, 2016;.…”

Section: Discussionmentioning

confidence: 99%

Partnership working across sectors: a multi-professional perspective

El-Farargy

2019

JICA

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Purpose The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now required to work in partnership and interdependently to deliver shared outcomes for the people they serve. The purpose of this paper is to explore any features, practices and behaviours that could influence effective partnership working across sectors. Design/methodology/approach A questionnaire was designed and distributed to a range of stakeholders working in health, social care and the third sector. With reference to the changing health and social care reform agenda, the aims of the survey were to gather views, experiences and perceptions of working across sectors, and any workforce development needs. Findings The majority of respondents were from the NHS (80.3 per cent, 118/147), and experiences were largely drawn from those working with the third sector. The utility of working with the third sector was positively highlighted; however, there were limited opportunities to fully engage. Whilst formal education and training was welcomed, workforce development needs were mostly related to fostering relationships and building mutual trust. Originality/value This paper highlights views, perceptions, enablers and barriers to integrated care in Scotland. Whilst the Scottish integration landscape is currently not fully fledged, insights into prevailing attitudes towards integrated care, by a cohort of the Scottish health and care workforce, are offered. In particular, reflections by the NHS workforce to working with third sector services are discussed.

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“…Our study provides some answers by showing that solid planning and overall management are important in this context. Other investigations have outlined the significance of suitable contextual conditions and sufficient resources, as well as ensuring involvement of stakeholders and the use of continuous system feedback to make intended system changes happen [48, 49].…”

Section: Discussionmentioning

confidence: 99%

What happened and why? A programme theory-based qualitative evaluation of a healthcare-academia partnership reform in primary care

Uvhagen

Hasson

Hansson

et al. 2019

BMC Health Serv Res

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BackgroundThere is increasing interest in and demands for partnerships between academia and healthcare practices. Few empirical studies have described the influence of such partnerships from a practice perspective. The purpose of this study was to evaluate the impact of a reform launched to increase integration between primary care and academia and to identify potential reasons for why the observed impact occurred in three areas targeted by the reform: research, student education, and continued professional development.MethodsThe study was conducted in Stockholm County, the largest healthcare region in Sweden, at the introduction of a partnership between primary care and academia, including eight coordinating centres and approximately 500 surrounding primary care units. A programme theory-based qualitative approach to evaluation was used, building on document analysis, and in-depth interviews with the centre managers (n = 6) and coordinators (n = 8) conducted 42–66 months after the initiation of the reform.ResultsThe analysis showed that the reform had some impact on all three areas targeted by the reform: research, student education, and continued professional development. The input that contributed most extensively to the impact was the establishment of facilitating roles. Most changes occurred at the coordinating centres and primarily in the area of student education. The effect on student education was primarily due to having prior experience in this area and perceptions of timely benefits of students to care practice.ConclusionsPartnerships between primary care and academia hold the potential of practice impact. To increase integration between primary care and academia, the components of the integration must be understandable and relevant for primary care practitioners, and importantly, compliant with delivery of primary care.

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Transforming primary care: scoping review of research and practice

Cited by 28 publications

References 41 publications

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Partnership working across sectors: a multi-professional perspective

What happened and why? A programme theory-based qualitative evaluation of a healthcare-academia partnership reform in primary care

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