Implementing integrated Care for Older Adults with Complex Health needs: iCOACH. An international network discussion

Abstract

Background: iCOACH began in 2012 as research study funded by the Canadian Institute for Health Research and the New Zealand Health Research Council. The intention of iCOACH was to understand the steps to implementing Integrated Community-Based Primary Health Care (ICBPHC). The iCOACH team approached the challenge of successful implementation of ICBPHC including 1) policy, 2) organization, 3) provider, and 4) patient and (unpaid) carer perspectives. Through approximately 450 interviews of policy makers, managers and leaders, provider and patients and their carers across three health systems (Ontario, Quebec, New Zealand), we have developed a rich understanding of essential mechanisms used to design and implement integrated care. Recently Danish researchers, also looking to study integrated care have adopted the iCOACH protocols in order to study new programs of integrated care being implemented in Denmark. Aims and Objectives: In this workshop we will discuss an emerging international network of patients, clinicians and managers, researchers and policy decision-makers interested in understanding, implementing and evaluating integrated care. We will describe the approach undertaken in iCOACH across the 4 perspectives and the advantages of involving multiple jurisdictions. The objective of the discussion is to highlight knowledge emerging from iCOACH and discuss the creation of an international network of researchers applying this approach to studying and evaluating integrated care. Format: Dr. Walter Wodchis, (iCOACH co-principal investigator from Ontario, Canada) will provide a high level overview of the iCOACH study to date. Dr. Tim Tenbensel (New Zealand) will review key findings regarding how policy contexts affect the implementation of integrated care. Dr. Mylaine Breton (Quebec, Canada) will explore key conceptual frameworks including the expanded Chronic Care Model and the Rainbow Framework for integrated care. Dr. Viola Burau (Denmark) will describe how Denmark is adapting the iCOACH study design in an emerging program of research. Finally Jodeme Goldhar (Ontario, Canada and IFIC) will lead a discussion of how this emerging network can spread to other jurisdictions to accelerate learning, implementation, scale and spread of integrated care programs internationally. Target audience: The target audience for this workshop includes policy makers, organizational leaders and managers, clinicians and other professionals and health care workers, patients and unpaid carers as well as researchers with an interest in studying and learning from integrated care. Learnings/Take away: In the iCOACH program so far we have learned about the relative opportunities and challenges under 3 policy environments of implementing ICBPHC. We have developed a common outcome framework based on patient and carer values, goals and needs. We have uncovered a number of key mechanisms required for the successful implementation of sustained integrated care models. We are now testing these outcomes and mechanisms under three extending research programs in Ontario and New Zealand as well as an emerging program of research in Denmark. Participants will engage in discussion of how this approach to studying emerging integrated care programs can be spread to other countries.