The complexity of care, the increase in old age, growing risk of the complex chronic condition and an ever increasing cost and complexity in the medical technology as seen in the case of Geisinger Health System has put a lot of strain on the current care system, and there is an urgent need for a solution that can address this issues and also ensure that quality health is met so as to help in achieving the complex health issues as well as the social needs of the populace. Integrated care implementation in the hospital is such a solution as demonstrated by Geisinger Health System ( Tsutsui, 2014). The medical dictionary defines it as the concept which aims at bringing together inputs, care, rehabilitation, health promotion and also management to address the fragmentation of the patient services so that a better and able coordination and more continuous care is achieved. Integration within the hospital system is achieved through careful planning and financing coupled with a vision which units the whole hospital which is centered on the target patient population ( McCarthy, Mueller & Wrenn, 2009). It is very important to note that due to its impotence, there is a significant need for the hospitals to be integrated. It is important to note that with integrated care system; there is a reduction of fragmentation of care and thus ensures that barriers to access of care, waste of the resources and also a contradiction in the decision making are reduced within the hospital setting. It also “Improved coordination of housing, social care, and community services and thus, might also prevent unnecessary admissions to acute care." However, proper integration of care system faces barriers and issues which need to be dealt with before achievement of full care integration within the care institution. This article, therefore, presents these barriers and issues which need to be noted for the care institution which wishes to integrate its operation and some of the recommendation which it can use to ensure that the process is successful.
The benefits of healthcare integration are countless, however, the hospital or care institution need to have some issues noted and some barriers removed or cleared before dreaming of enjoying the benefits of integrated care. The first one is the financial as well as the economic side of integration. Having this critical process in an organization is not a walk on a red carpet. It has a financial burden that the institution management need to be aware of and careful plan for in order have it in place as seen in the case of Geisinger Health System. The hospital need to note that to achieve an integrated care system, it needs a very well calculated and well planned financial partnership and structure which will support the cost of the technology needed, the communication channels and many other cost which the hospital will accrue as they try to have the system in place. Further, the hospital has to be aware of the operational complexity which they will have to faces as they to adjust to the integrated care system. Integrated care system very complicated due to technology, partnership, financial structure and many other large numbers of people who are brought together under one goal and this make it very complicated, and thus may lead to its failure ( Paulus, Davis, & Steele, 2008) . Currently, many care systems have a preexisting system where they have a different division with regards to their financial department, management structure as well as care provision. This may preclude the implementation of the integrated system and thus need to be noted as an important issue with an organization which wishes to have an integrated system in place. There are also regulations which come with an integrated care system which such organization also need to be aware of before deciding to have an integrated system within its premise. “Regulation is exerted over specific providers such as hospitals, community health services, and insurers. In an integrated care model, however, regulation must shift to be exerted on services across a continuum of care or a care package.” It means that before dreaming of having an integrated care system in the organization, the hospital needs to be aware of regulations so that they are in line with any regulations which are needed so that they don't fall a victim of the laws. Lastly, the organization has a specific culture which they operate and which is also known within the hospital. However, the hospital management needs to be aware that upon the implementation of this system, they will have to undergo some culture shift. Managing the new culture is also a determinant of whether or not the organization may succeed with the culture of integrated system ( Blumenthal et al., 2016).
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However, there are specific issues which the hospital can put in place or can do differently and can make the integrated system successful in such organization. First, the care system management needs to ensure that they have a long-term plan which has adequate financial protection and partnership that are willing to support the hospital financially. "Financial incentives must be directed toward integrated pathways and designed to redistribute incentives to stakeholders." The hospital also needs to have well integrated electronic patient records which help in the provision of information to all stakeholders and thus reduce information conflict which may contribute to different attention within the hospital. Lastly, it needs a long-term strategic planning to ensure that every part of the project is brought together and is well financed a researched so that upon implementation, it becomes in line with the culture of the organization as well as a regulation which are required of it as asserted by Mccarthy, Mueller and Wrenn (2009).
References
Blumenthal, D., Chernof, B., Fulmer, T., Lumpkin, J., & Selberg, J. (2016). Caring for high-need, high-cost patients—an urgent priority. New England Journal of Medicine , 375 (10), 909-911.
Mccarthy, D., Mueller, K., & Wrenn, J. (2009). Achieving the potential of system integration through innovation, leadership, measurement, and incentives. The Commonwealth Fund, 1(9), 1-16.
Paulus, R. A., Davis, K., & Steele, G. D. (2008). Continuous innovation in health care: implications of the Geisinger experience. Health Affairs , 27 (5), 1235-1245.
Tsutsui, T. (2014). Implementation process and challenges for the community-based integrated care system in Japan. International Journal of Integrated Care , 14 (1).
