Integrated health systems are considered part of the solution to the challenge of sustaining Oman healthcare system. This systematic literature review was undertaken to guide decision-makers and others to plan for and implement integrated health systems.
This review identified 10 universal principles of successfully integrated healthcare systems which may be used by decision-makers to assist with integration efforts. These principles define key areas for restructuring and allow organizational flexibility and adaptation to local context. The literature does not contain a one-size-fits-all model or process for successful integration, nor is there a firm empirical foundation for specific integration strategies and processes.
Ten key principles for integration
|I. Comprehensive services across the care continuum Cooperation between health and social care organizations Access to care continuum with multiple points of access Emphasis on wellness, health promotion and primary care|
|II. Patient focus Patient-centred philosophy; focusing on patients’ needs Patient engagement and participation Population-based needs assessment; focus on defined population|
|III. Geographic coverage and rostering Maximize patient accessibility and minimize duplication of services Roster: responsibility for identified population; right of patient to choose and exit|
|IV. Standardized care delivery through interprofessional teams Interprofessional teams across the continuum of care Provider-developed, evidence-based care guidelines and protocols to enforce one standard of care regardless of where patients are treated|
|V. Performance management Committed to quality of services, evaluation and continuous care improvement Diagnosis, treatment and care interventions linked to clinical outcomes|
|VI. Information systems State of the art information systems to collect, track and report activities Efficient information systems that enhance communication and information flow across the continuum of care|
|VII. Organizational culture and leadership Organizational support with demonstration of commitment Leaders with vision who are able to instil a strong, cohesive culture|
|VIII. Physician integration Physicians are the gateway to integrated healthcare delivery systems Pivotal in the creation and maintenance of the single-point-of-entry or universal electronic patient record Engage physicians in leading role, participation on Board to promote buy-in|
|IX. Governance structure Strong, focused, diverse governance represented by a comprehensive membership from all stakeholder groups Organizational structure that promotes coordination across settings and levels of care|
|X. Financial management Aligning service funding to ensure equitable funding distribution for different services or levels of services Funding mechanisms must promote interprofessional teamwork and health promotion Sufficient funding to ensure adequate resources for sustainable change|