Ten steps towards better integrated health care

Wednesday, November 26, 2014

When faced with structural or broad policy change most parts of Australia’s health system tend to focus on what it will mean for them, rather than taking a comprehensive view, according to findings released today by the Australian Healthcare and Hospitals Association (AHHA). 

The report, Integrated healthcare: policy pathways and pitfalls, discusses outcomes from an Integrated Care Simulation held on 23 October 2014 which tested three potential policy initiatives. 

Participants considered the likely impact on the health system of bundled care packages for chronic disease, a greater role for private health insurance in primary health and the introduction of Primary Health Networks. Ten key recommendations are outlined in the Simulation report:

  1. Health policy needs to have clear goals, be evidence-based and well-thought through, taking account of all potential consequences, and specific on details for all elements of the system, including providers and patients. 
  2. While financial sustainability of the health system is critical, policy makers must not lose sight of consumer interests – these must be central to health policy.
  3. People working within the health sector need to engage regularly with policy makers at all levels in government to highlight any perverse or unintended consequences of policies, as well as to offer alternative solutions.
  4. Healthcare cannot operate in isolation from social supports and care, and policy and planning should be undertaken together where possible.
  5. Integrated care strategies and models could work well for people with high health care needs, however more research is required to better support health promotion and illness prevention strategies, including for generally well people.
  6. The Australian healthcare system needs a greater focus on inter-professional leadership, requiring all areas of the health sector to actively collaborate and engage.
  7. Australia should invest in the foundations of health system integration enablers, including funding, data collection and sharing, coordination capability in primary care, shared systems such as electronic records, and addressing parts of the health system not funded by Medicare.
  8. There needs to be a stronger focus on ensuring informed decision making in health, especially among consumers—work must be undertaken to improve health literacy.
  9. Evaluation criteria for health policies and programs should focus on quality and outcomes.
  10. When developing policies, data strategies must be developed as an important first step to ensure any change can be measured and assessed to improve future implementation. Consideration must be given to data availability and consistency as well as data linkage and sharing. In particular, improved access to, and use of, granular MBS and PBS data must be supported by Government, in order to ensure a robust evidence base for health policy development.

“It was clear that no matter the background, experience or particular area of expertise, our 80 plus participants were united by the common interest in a high performing health system and taking a genuinely patient centred approach in developing and implementing health policy” said Alison Verhoeven, Chief Executive of the AHHA. “The Simulation provided a realistic, but controlled environment to test three different health policies and for participants to consider what they would mean for an integrated health system in Australia.”

“There is a clear need for broad consultation and communication on change.  By working together and collaborating with leaders across the health sector, health policy in Australia would be better informed with agreement on objectives and priorities. Shared objectives are essential for successful implementation of any new health policy, especially on major reforms.”

“The Simulation proved to be an excellent opportunity for a diverse group of health leaders to come together and to work through some important issues facing healthcare in Australia.”

“The commonality across all responses throughout the Simulation was that we all want a high-performing health system that looks after us all. The challenge lies in meeting that expectation,” said Ms Verhoeven.   

The Simulation report is available here.