Best Practices for Integrated Health and Social Care in Scotland

How Michael Porter's Value Agenda best practices can help the Scottish Government achieve their vision of an integrated Health and Social Care system

CivTech Challenge

The types of real-world challenge and “Digital Health” realities they face in achieving this program were explicitly defined in one of the latest CivTech challenges : Number 7 – How can we make the NHS waiting time system more efficient and effective?

Matching available health service capacity to demand is a long-recognised challenge that affects health boards in Scotland. The management of these processes is manual, remaining unchanged for many years.

Solving this challenge is not simply about replacing current processes. We want to engage a company that can modernise, automate and optimise demand management for hospital services. We need a team that can bring a completely new point of view to the problem and bring a product or technologies that have the potential to scale across Scotland.

The Value Agenda

The latest management practices combined with the latest technology advances offer the ideal framework for addressing these challenges.

The most notable of these approaches is the ‘Value Agenda‘ from legendary management guru Michael Porter.

Michael describes the practice as a whole systems approach that identifies interconnecting impacts and causes, and addresses them at a global level.

In this presentation from Harvard, and this one for the OECD, Michael explains that the traditional departmental or single policy goal approach only constitute “local optimizations”, ie they might improve the patient throughput for one section not the total journey.

This may sound obvious however Michael describes situations where management programs may be designed in a piecemeal fashion, emphasizing one goal that is too narrow, such as ‘Increasing Access to Care’ or just cost-cutting without appreciation of the impact upon the ability to achieve the desired goals.

Without a holistic design perspective these can be interpreted in such a way as to be counter-productive to the overall system goals, and so the Value Agenda provides a means for regulating this aspect and instead building all activities around a core goal of patient-centric measures for management that produces the best outcomes for the least cost.

Integrated Practice Units

The ideal focal point are what Porter describes as ‘IPUs’ – Integrated Practice Units, discussed in detail in this presentation.

These are virtual teams that span multiple organizations and departments, and define specific ‘process pathways’, project teams drawn from multiple disciplines dictated by the needs of the patient treatment. Porter highlights that most healthcare delivery is organized around the traditional hierarchical approach, with costs and resources tied to departmental units.

In contrast IPUs are aligned around patient journeys and cut across all the organizations needed to deliver them, and can be achieved by a variety of virtualized Cloud services, in particular video and team social collaboration tools. We’ll be showcasing a variety of these as part of this ongoing series.

This Scottish Government update on ‘The Modern Outpatient‘ explores these types of dynamics in action.

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