Struggling with Disjointed
Healthcare? What Are
The Solutions?

Over the past few decades, healthcare systems have been undergoing rapid digitalization. Although there have been years of progress, the adoption and use of digital technology remain inconsistent due to disjointed care systems. Today, these problems are more apparent than ever.

Fragmented care exposes patients to unintended harm and causes significant waste in healthcare. In fact, a 2019 JAMA article estimated that the cost of waste due to uncoordinated care ranges from $30 billion to $80 billion per year in the U.S. healthcare system ⁽¹⁾.

Integrated Care Systems (ICSs) present a viable solution to these challenges ⁽²⁾. However, for a truly integrated healthcare system, we need a non-siloed data environment that allows unrestricted access with strong privacy and security measures. This is possible only if ICSs are supported by an innovative infostructure, a health information architecture that enables sharing insights through data at scale.

ICS: The Shift from Fragmentation to Integration

ICSs are a major step toward more connected and collaborative healthcare systems. The aim of these systems is to provide equitable and coordinated care based on a person’s health and social needs. In practice, ICSs join up the many threads of health, social, local, and community services, bringing together partners and providers from various sectors ⁽³⁾,⁽⁴⁾.

Key Aspects of ICSs:

• Collaboration: ICSs are coordinated and collaborative ecosystems where different stakeholders work together to achieve better patient outcomes. The vision of ICSs is to provide better care in smarter ways.
• Value-Based Care: ICSs move away from sickness-based to wellness-oriented healthcare, focusing on population health. They represent a shift in healthcare philosophy and models from fragmented care toward integrated care.
• Population Health Management: ICSs prioritize wellness and prevention over reactive care.

Place-Based Integration: ICSs involve multiagency partnerships and are built on local integration and collaboration.

The Role of Innovative Infostructure in ICSs

A robust infostructure is a digital backbone of ICSs. This includes integration of digital technologies, creation of unified medical records, health information exchanges, collaborative ecosystems, and interoperable systems.

In the context of integrated care, innovative infostructure refers to a health information architecture that allows for innovation and data fluidity. The design of these architectures should deliver speed-to-value, allowing continual development and rapid deployment of innovative products and services ⁽³⁾,⁽⁴⁾.

According to McBride and Vermeulen, a true ICS should have an open platform architecture. It should allow gathering and linking all relevant data, no matter where it is created or stored. Hence, the infrastructure needs to be decentralized and networked so that it can collect data from many sources and make sense of it ⁽⁵⁾.

How Infostructure Transforms Integrated Care

Unleashed True Power of ICSs

Successful implementation of an innovative infostructure can unlock the true potential of ICSs as coordinated and interconnected ecosystems. By ensuring a semantic standard, the framework can not only adopt advanced digital technologies like cloud computing, AI, and IoT but also support seamless data sharing and connectivity, real-time communication, and collaborative care delivery ⁽⁵⁾,⁽⁶⁾.

Unified Patient Records

Innovative info-structures are interoperable and portable ⁽³⁾. They enable the creation of unified patient records that are accessible to all healthcare providers involved in a patient’s care. This ensures that every provider has up-to-date information, reducing the risk of errors and improving the quality of care ⁽⁷⁾.

Improved Communication and Collaboration

A key benefit of ICSs is enhanced communication and collaboration between different healthcare providers and local authorities. Utilizing these systems, providers can access patient information in real-time. Innovative infostructures facilitate this by providing platforms for real-time messaging, video conferencing, and collaborative decision-making {2, 3}.

The COVID-19 pandemic acted as a catalyst for the wider adoption of ICSs, which pushed stakeholders toward rapid innovation in joint working practices. In fact, a 2022 survey by the NHS Confederation reported that 90% of ICS leaders were effectively collaborating among system partners ⁽⁴⁾. This has been crucial in adapting to pandemic challenges and responding to increasing healthcare demands.

Streamlined Workflows

ICSs streamline workflows by adopting electronic health records, enabling seamless data exchange, and providing clinical decision-making tools. This reduces the administrative burden on healthcare providers by automating routine tasks and addressing workforce shortages.

ICSs make system leaders more poised to cope with financial constraints, minimizing healthcare spending. This allows them to focus more on patient care and make informed decisions ⁽⁴⁾.

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References

1. Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US health care system: estimated costs and potential for savings. JAMA, 322(15), 1501-1509. doi:10.1001/jama.2019.13978

2. Blockley, D., Stirrat, G., Alexander, K., & Phillips, S. (2022). Integrating health and social care services. Global Advances in Health and Medicine, 11, 2164957X221117112. doi:10.1177/2164957X221117112

3. Ernst & Young LLP. (2022). How innovative infostructure can power the purpose of integrated care systems: Designing health information architecture to reach a common ground of shared purpose Ernst & Young LLP.

4. Pett, W., & Bliss, A. (2022). The state of integrated care systems 2021/22. NHS Confederation.

5. McBride, A., & Vermeulen, E. (2022). How innovative infostructure can power the purpose of integrated care systems Ernst & Young LLP.

6. Melchiorre, M. G., Papa, R., Quattrini, S., Lamura, G., Barbabella, F., & ICARE4EU Consortium. (2020). Integrated care programs for people with multimorbidity in European countries: eHealth adoption in health systems. BioMed research international, 2020(1), 9025326. doi:10.1155/2020/9025326

7. Lalani, M., Wytrykowski, S., & Hogan, H. (2023). Approaches to improving patient safety in integrated care: a scoping review. BMJ open, 13(4), e067441. doi:10.1136/bmjopen-2022-067441