Dr. Michelle Davis, DBH, Assistant Director of the DBH Program

From April 1-3, 2019 I had the honor of attending the International Conference on Integrated Care (ICIC) in San Sebastian, Spain. The conference was attended by an estimated 1400 people representing countries from around the world. During the conference attendees shared their experiences, thoughts, and suggestions for best practices of integrated care. There were learning opportunities through panel discussions, research findings presentations, and a plethora of poster topics.

There were several themes one could pursue, including integrated health and social care in the home; engaging patients and communities to be part of care; building stronger integrated primary care; models of care; measuring outcomes; digital health; education of integrated care professionals; and creating shared work cultures, norms, and values across organizations, professionals, and people. Obviously, there was a lot to learn! Many of the sessions ran simultaneously and as such, one had to miss some excellent presentations.

It was truly a pleasure seeing Dr. English launch the first day with a presentation and panel entitled, A Global Review of Current and Emerging Education and Training to Advance Integrated Systems of Care. Dr. English presented and paneled with colleagues such as Dr. Anne Wojtak from the University of Toronto, Frances Barraclough from the University Centre for Rural Health in Australia, Lynne Sinclair of the University of Toronto, Canada, and Dana Newcombe from Children’s Health Queensland Hospital and Health Service, Australia.

The panel shared information about existing and emerging education and training programs for integrated care across different jurisdictions. The panelists shared their knowledge about best pedagogical best practices and discussed the benefit of developing global partnerships among institutions and programs to support education and research in integrated care.

The second day also launched with Dr. English serving as a panelist on the topic of Multiple Roads Traveled: A Career Panel for Emerging Researchers in Integrated Care. This panel provided an opportunity to hear and learn from the experiences of four global integrated health leaders in academics and learn how these professionals have navigated the field of integrated care.

The important take-aways from the panelists were…

Robin Miller: IFIC Co-Editor-in-Chief & Advisor to the European Forum for Primary Care

  • Know yourself and how you like to work
  • Good opportunities don’t always come at a good time
  • Be true to yourself

Lynne Sinclair: Assistant Professor and Innovative Program and External Development Lead at the Centre for Interprofessional Education, University of Toronto

  • Expose yourself to other professions and points of view
  • Look for your mentors (find individuals who you look up to)
  • Tune into your “gut” – lead with not only your head, but with your heart

Mandy Andrews: RN, Senior Programme Manager for the European Joint Action on Frailty (ADVANTAGE JA) and an Associate Director with the Health and Social Care Alliance Scotland (The Alliance)

  • Be inquisitive -Use an inquiry approach; Constantly ask what others’ stories are.
  • When faced with challenges—take a broader view, breathe, consider the other person

Cara English: CEO & Director of DBH Program, Cummings Graduate Institute.

  • It can be difficult to see the world from integrated perspective
  • Follow what you’re passionate about

I will highlight a couple more engaging presentations that stood out to me. I went into a presentation on the topic of Co-Production. Co-production is the idea that we should utilize patient input to inform how we structure and delivery health care. Sadly, I missed the beginning introduction of the researcher for this project, but I did catch that it focused on a teaching model for medical students and physicians, with the concept that this type of change requires changing decision making from the bottom up versus the top down. This is something I would like to learn more about in the future, and definitely plan to revisit.

The final presentation I will share occurred at the close of the conference and was titled, C3-Cloud Management of Personalized Guideline-Driven Care Plans supported via Clinical Decision, presented by Dr. Mustafa Yuksel. This presentation was about a “Federated Collaborative Care and Cure Cloud Architecture for addressing the Needs of Multi-morbidity and managing Poly-pharmacy.” This presentation demonstrated how this program managed patients and their care team in an integrated dashboard that works with existing electronic health records. The program has several useful features, such as goal setting and push messages that were available for the patient.

Among several informative and high-quality posters, there were two that stuck out to me; one from University of Toronto entitled, A Roadmap to Assess Patient Experience with Person-Centered Integrated Care: When, What, and How? This poster was a summary of a literature review that was conducted to include seminal works, theoretical papers, and tools used in looking at the patient experience with Person-Centered Integrated Care (PC-IC). The literature was then synthesized to consider the patient experience. The results indicate that patient experience depends upon two factors; the first being patient social, demographic, and disease related factors, which seem to impact patient goals and expectations. The second was the organization providing the care and its culture, resources, type, and number of partnering organizations. These factors shaped the process of care.

This study points out that most of the current tools for assessing the patient experience seem to focus on the experience of the health visit and not on overall care, tend to focus on the attainment of the organization’s goals over the patient’s goals, and may not fully capture the mechanism of the patient experience.

The other poster was titled Measuring Triple Aim through Claims Data, this research was from Belgium, and looked at the Triple Aim as an evaluation framework for 12 integrated care projects since 2018. They included all care reimbursed by statutory health insurance that is recorded in database of sickness funds. Findings indicated that some elements, such as population health and direct costs, can be partially measured through claims data. This study indicated that the quality of care dimension is more difficult to determine. There was a suggestion to repeat the research for other countries.

This summary of the conference is a very small snippet of the amazing work and research being conducted around the world that I was exposed to. I am so grateful for the opportunity CGI has provided for me to have such an educational and eye-opening adventure. I am also so proud to represent CGI and see, once again, how high quality and on-target our program is for the marketplace.