How Does Health Systems Integration Work? Overview and FAQ
Health systems integration occurs when separate healthcare platforms and organizations align clinical practices, operational processes, and data sharing to deliver more coordinated and efficient care. By reducing fragmentation across separate clinical settings, integration improves the overall value of care while enhancing the patient experience.
Although it’s connected to the concepts of care coordination and patient flow, integration at the systemic level extends well beyond individual clinical encounters. It encompasses the infrastructure, technology, and governance that make those encounters possible.
We’ll clarify this broad defragmentation effort by providing an overview of health systems alignment, including answers to frequently asked questions. With a clearer understanding of this increasingly important topic, you can help strengthen and build the intersystem connections that support a more seamless care continuum, spanning healthcare services.
Defragmenting Health Systems
A health system includes the institutions, processes, and resources that contribute to promoting, maintaining, and restoring better health. This encompasses healthcare personnel, technology, policies, and the physical infrastructure that support care delivery. Yet, while these systems work to improve patient’s lives every day, they often operate in silos. This leaves patients largely responsible for charting their own healthcare journeys (like arranging a primary care follow-up after a hospital stay).
Integrating the systems that support care delivery can reduce this fragmentation and systemic isolation. For example, instead of relying on patients to independently coordinate their own follow-up care, an integrated acute care system would proactively communicate, scheduling the subsequent care with the outpatient system as part of a coordinated workflow. These organizational and intersystem connections can act as guardrails for continuity, consistency, and smoother transitions in support of comprehensive patient care.
Real-World Integrated Healthcare System Examples
If you’re asking, What is an integrated health system example that’s operational today? you’re not alone. Here are some current, real-world examples of healthcare systems integration.
1. Clinically Fueled Integration
Interfacility transfer agreements are an excellent example, shared by many of the largest integrated health systems. Within these agreements, two distinct services reach a mutual decision on how to best share responsibility for patients across the continuum of their potential service requirements. These shared policies and protocols help make facilities readily available to patients as their care needs shift.
2. Regulation-Fueled Integration
The Centers for Medicare and Medicaid Services (CMS) implemented the TEAM model to foster intersystem collaboration by holding acute care providers responsible for certain surgical patients even after they’ve been discharged. This mandatory episode accountability incentivizes hospitals to collaborate with primary care services, creating intersystem communication and handoff measures that ensure optimal patient care across the distinct settings.
3. Technologically Fueled Integration
The Healthcare Corporation of America (HCA) is home to some of the industry’s top integrated healthcare systems. To strengthen their intersystem collaboration and communication, HCA contracted an expansive electronic health record (EHR) system that utilizes cloud technology. This system makes patient medical charts accessible to clinicians across more than 2,300 sites of care.
Healthcare Systems Integration: FAQ
Healthcare theories and models guide enhancement efforts that span the range of care deliverables, from bedside interventions to systemwide practice updates. Health systems theory offers a framework for approaching all aspects of care delivery as interconnected. To help you with your systemic integration efforts, we’ll expand on the theory by answering some questions below.
Why are healthcare systems often fragmented?
Fragmented healthcare is multifactorial and driven by a number of culminating issues. A few contributing factors include the following:
|
|
|
|---|---|
|
False Assumptions |
Fragmentation occurs when patients are unintentionally led to believe (or assume) that care coordination is happening on their behalf. |
|
Time and Productivity Pressures |
Providers are often pressed to accommodate as many patients as possible in little time. This often limits their ability to collaborate with other clinicians or communicate effectively. |
|
Patient Privacy Concerns |
Due to strict regulations around patient information and confidentiality, many clinicians worry about sharing data outside of their specific facility or department. |
|
Failure to Utilize Available Resources |
EHR interoperability and case management (or utilization review) team analytics could be leveraged to identify gaps in care and insufficient intersystem collaboration. By not using these resources, the status quo of healthcare service siloing is allowed to persist. |
Which frameworks support health system integration?
Many worldwide and national level organizations have developed structural approaches to guide the integration of health systems. Some of these frameworks include:
- Comprehensive Health Integration (CHI).
- Integrated Community Care (ICC) framework.
- Integrated People-Centered Health Services (IPCHS).
How does integrating health systems affect patient care?
Patients largely benefit from health systems integration. Some of the primary advantages (beyond increased accessibility and health system investment) are explored below.
|
|
|
|---|---|
|
Improved Care Outcomes |
Care fragmentation drives increased mortality risk for patients. By connecting care services, treatment plans, and goals, patients benefit from better continuity and are given improved odds of success. |
|
Increased Patient Safety |
Communication boosts patient safety. By improving intersystem information flow, patients (and critical care services) are less likely to fall through the cracks. |
|
Decreased Burden on Patients |
Intersystem collaboration reduces the burden on patients and their families to communicate and promote their treatment plans among providers (and specialty services). |
|
Higher Patient Satisfaction |
Creating a single care journey that’s cohesive (vs. juggling separate and sometimes conflicting treatment plans) offers patients a holistic approach that’s easier to engage with and often promotes higher satisfaction. |
|
Healthcare Cost Savings |
Intersystem connections can offset the financial toll related to duplicative services, increased length of patient stays, and negative health outcomes. It’s been shown to stabilize finances, particularly among smaller, rural health systems. |
Are there any cons associated with health systems integration?
All healthcare innovation requires careful change management and risk assessment. Some of the potential disadvantages associated with systemic integration are considered below.
|
|
|
|---|---|
|
Confused Care Ownership |
When multiple providers (or services) are caring for a patient, accountability may become less clear. This confused leadership can lead to treatment plan stalls and delayed care. |
|
Higher Breach Risk |
More data sharing increases the complexity of keeping patient information confidential and safe. With high transmission of protected health information, the risk for breaches also increases. |
|
Less Clinical Autonomy |
Specialty providers may become more limited in their treatment options due to shared, connected treatment plans. This restricts their professional autonomy, risking clinician dissatisfaction and, worse, ineffectiveness. |
|
Reduced Healthcare Competition |
By combining health systems, integration risks monopolies that can demand higher price points from payers, inflating healthcare costs. This also jeopardizes patient choice and autonomy when choosing among providers and specialty service offers. |
|
Inflated Healthcare Bureaucracy |
Creating more administrative control over the progression of care can contribute to expensive, overlarge bureaucratic systems. This increased administrative authority constrains clinical care, potentially damaging the decision-making capacity of those on healthcare’s front lines. |
Does defragmentation help align systems with value-based initiatives?
Integrating health systems can help providers achieve better value-based care results because it also champions the payment model’s primary goal of supporting the whole person through better overall care. The frameworks share common objectives including:
- Increased collaboration.
- Higher quality and efficiency of care.
- Improved health outcomes and care continuity.
- Lower healthcare costs.
Who is responsible for integration among health systems?
While regulatory bodies (like CMS) may influence the rollout of health system integration efforts, the ultimate responsibility lies with system leadership, typically at the C-Suite level. To ensure that planning and implementation align with compliance and clinical measures, these leaders (such as a healthcare chief executive officer or chief operating officer) may seek support from other services like legal, financial, and clinical departments.
What are some best practices for healthcare systems integration?
Whether you’re in the planning or review stages of an integration initiative, here are some best practices for strengthening your intersystem collaborative approach and strategies.
|
|
|
|---|---|
|
Secure Organization-Wide Buy In |
The success of the program depends on engagement that spans the facility hierarchy. From C-suite executives to clinical personnel, everyone (across each organization) needs to be engaged with the integration. |
|
Align Cultures and Facility Values |
Integration needs to build on commonality and shared systemic values. These cultural considerations can be harnessed to drive better engagement and inform achievable objectives that resonate with all participating parties. |
|
Use a Multidisciplinary Integration Team |
By incorporating perspectives that span participating teams, intersystem collaboration will be accountable to the many elements that drive success. This inclusive approach protects the quality of patient care while supporting regulatory compliance and institutional viability. |
|
Maintain Transparent Communication |
Building trust among systems and each organization’s personnel is essential. Good communication and transparency can help manage (or avoid) disruptions related to systemic change while optimizing the program’s credibility among staff. |
|
Commit to Prioritizing Patient Care |
The motivation from day one should be higher quality patient care. This priority needs to remain the primary focus, informing the program’s implementation and refinement going forward. |
Want Intersystem Cooperation Without Disruptive Change?
Health systems integration isn’t an overnight process. For help making the most of all its advantages — and managing its possible disadvantages — use our wide range of facility guides and healthcare insights to improve your roll out strategy while protecting staff and patients alike.