Meredith B. Rosenthal, Eric C. Schneider, M.D., Sara J. Singer, M.B.A., Ph.D., Jako Burgers, M.D., Ph.D., Mark Friedberg, M.D., M.P.P., and Lucian Leape, M.D.
S. J. Singer, J. Burgers, M. Friedberg et al., "Defining and Measuring Integrated Patient Care: Promoting the Next Frontier in Health Care Delivery," Medical Care Research and Review, published online June 16, 2010.
In health care circles, the term "integration" can take on a number of meanings. Integration can apply to organizations—an integrated delivery system is one that provides a continuum of health care services or professionals. It can also refer to a formal collaboration among providers within or across institutions. However, "integrated patient care" is not merely the byproduct of such a delivery system or collaboration. The authors of this Commonwealth Fund–supported study in Medical Care Research and Review propose a definition of integrated patient care and develop a framework for measuring it.
According to the authors, integrated patient care is "patient care that is coordinated across professionals, facilities, and support systems; continuous over time and between visits; tailored to the patients' needs and preferences; and based on shared responsibility between patient and caregivers for optimizing health." The authors outline a framework for measuring integrated care that takes into account 1) the degree of coordination across professionals, facilities, and support systems and the continuity of care over time and between visits, and 2) the degree to which care is patient-centered—that is, tailored to patients' needs and preferences and based on shared responsibility between patients and caregivers. Measuring integrated patient care from the patient's perspective, the authors say, will require creating an instrument, including patient surveys, to assess each dimension.
Defining and measuring integrated patient care will provide opportunities for health care providers to observe the extent to which they improve the health of their patients through "well-orchestrated, considerate, and humane interventions."