Abstract
BackgroundA guiding principle of a successful integrated health and social care delivery network is to establish a governance approach based on learning, grounded in a data and knowledge infrastructure. The ‘Krijtmolen Alliantie’ is a network of health and social care providers with the ambition to realize such a performance intelligence driven governance model in line with the Triple Aim. This study seeks to identify what performance intelligence is available and how it can be improved.MethodsThis case study was conducted in the district of Amsterdam Noord, the Netherlands, and employed 23 semi-structured interviews with stakeholders in health and social care, a feasibility analysis of available administrative data, and a reflection meeting with board members of the ‘Krijtmolen Alliantie’. Information needs for performance intelligence by the stakeholders were mapped and a data landscape of the district covered by the network was drafted. Finally, in the reflection meeting with board members of the ‘Krijtmolen Alliantie’ the information needs and data landscape were aligned with governing needs, resulting in priority domains around which to strengthen the data infrastructure for governance of the integrated health and social care delivery network.ResultsThe ‘Krijtmolen Alliantie’ encompasses a network of providers with a diverse range of catchment areas. There are indicators on population health and welfare, however they have limited actionability for providers due to a misalignment with their respective catchment areas. There is a barrier in data exchange between health and social care providers. It is difficult to construct one indicator for per capita cost in the Dutch health data infrastructure as health and social care are subdivided in financing siloes. Priority domains for improvement of performance intelligence for the ‘Krijtmolen Alliantie’ are: 1) Per capita and per patient cost data integration that would allow combined accountability through aligning financial incentives to facilitate integrated care, and 2) combined patient experience and outcome measures to reflect network quality of care and patient experience performance.ConclusionAvailable performance intelligence lacks actionability for the governance of integrated care networks. Our recommendation is to align performance intelligence with the regional governance responsibilities of stakeholders for health and social care delivery.
Highlights
A guiding principle of a successful integrated health and social care delivery network is to establish a governance approach based on learning, grounded in a data and knowledge infrastructure
The ‘Krijtmolen Alliantie’ (KMA) is a network of health and social care providers in the Amsterdam Noord district in the Netherlands who have been cooperating for about 10 years with the goal to realize a better experience of care for patients, improved health outcomes for the population, and lower per capita costs in line with the Triple Aim proposed by the Institute for Healthcare Improvement [2]
To do so we address the following questions: 1) Who are the members of the KMA and their stakeholders in the health and social care district Amsterdam Noord, and what are their roles and information needs? 2) What data is currently collected by health and social care providers and their stakeholders in the district covered by the network, which exchanges of information already take place and what performance intelligence is available to support the Triple Aim goals? And, 3) What priority domains to improve performance intelligence can be identified in Amsterdam Noord?
Summary
A guiding principle of a successful integrated health and social care delivery network is to establish a governance approach based on learning, grounded in a data and knowledge infrastructure. The ‘Krijtmolen Alliantie’ is a network of health and social care providers with the ambition to realize such a performance intelligence driven governance model in line with the Triple Aim. This study seeks to identify what performance intelligence is available and how it can be improved. Performance intelligence is an essential tool to govern integrated delivery systems, to redefine value of health and social care provision, and monitor outcomes [4,5,6,7,8]. The ‘Krijtmolen Alliantie’ (KMA) is a network of health and social care providers in the Amsterdam Noord district in the Netherlands who have been cooperating for about 10 years with the goal to realize a better experience of care for patients, improved health outcomes for the population, and lower per capita costs in line with the Triple Aim proposed by the Institute for Healthcare Improvement [2]. The KMA has decided to strengthen their cooperation through enhancing their shared performance intelligence
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