In the first of a new career panel Q&A series, Nuria Toro, from the World Health Organisation, based in Geneva, talks about the multiple roads she travelled in her career and offers advice to the next generation of researchers and practitioners in integrated care.
What led to your current role in integrated care research/practice?
Before I became technical officer at WHO where I coordinate efforts around the Framework on integrated people-centred health services, I spent 10 years working for the Basque Institute for Healthcare Innovation. Prior to that, I worked for KPMG Consulting in the field of strategy and management.
The Basque Institute for Healthcare Innovation is an advisory body to the Ministry of Health in the Basque Country tasked with identifying health trends and developing innovative organisational service delivery models. As part of this mandate, I attended my first course on integrated care delivered by Nick Goodwin and Dennis Kodner (may he rest in peace), and I have to confess I was fascinated about its underlying concepts and values, that was really the kind of health service delivery I believed in. That course was a milestone in my career on integrated care.
Several years after, the Basque Country engaged in a broad health system transformation process which aimed at putting the patient at the centre. I was part of that transformation team focused on designing, implementing and evaluating the ‘Integrated Care Plan in the Basque Country’. Then, four years ago, I joined the World Health Organization.
What helped get you there?
Being able to see the health system as a set of interrelated and interconnected relationships (holistic approach), which can be partially attributed to the theories of complexity I learned during my first years at the Innovation Institute.
I believe an ability to generate and convey enthusiasm for change, involving key stakeholders in all stages of the process is critical as well as connections with international initiatives and implementation experience.
How do you continue to advance policy and research on integrated care in your current role?
In WHO we have an extensive network of collaborating centres and partners with whom we collaborate on regular basis to advance policy and research.
In your scope of work, what do jobs in integrated care research/policy look like and where should a young professional or junior researcher interested in integrated care look for such jobs? E.g. Industry, hospitals, government, research institutes?
In addition to traditional settings, such as hospitals, research institutes, etc., the scope of application of integrated care is increasingly broadening. For example, the Bill and Melinda Gates Foundation, who have traditionally invested in vertical health programmes (HIV, malaria, TB, etc), have appointed a Director for Integrated Delivery. The rationale for this appointment is to put the focus on improvement of health systems as a whole, putting the person at the centre of care with a focus on people, not diseases. Another example is the Pharma industry, in an attempt to strengthen partnerships with governments and increase the value proposition, is embracing patient-centric principles and solutions as an alternative business model to the traditional product focus.
How do you stay relevant/up to date in integrated care research/practice? What types of techniques do you recommend for staying relevant?
• Scientific articles
Is there something you know now that you wish you knew when you were starting out in the field of integrated care?
Leadership is one of the most significant factors to facilitate and develop sustainable health system transformation
What take home messages would you give to the new generation of researchers and practitioners in integrated care?
• Small, or very small causes might have huge effects in your career – think butterfly effect, unfortunately we cannot predict these effects but must be hoping for being influenced by even small causes
• Become a good and active listener, and act less as a speaker! Don’t take anything for granted!
• Be an advocate for change
• No matter how tough the journey to integrated care is… keep smiling!
Nuria Toro is a technical officer with the World Health Organisation (WHO), based in Geneva