Prof. Nick Goodwin visit’s Taiwan to sign a new knowledge partnership agreement with the IAIC

Prof.Goodwin reflects on his visit to Taiwan between 22nd and 26th October 2018 to sign a new knowledge partnership agreement with the International Academy of Integrated Care (IAIC).

The International Foundation for Integrated Care has developed global reach in the last few years and now boasts a network of approximately 19,000 individuals and organisations across more than 50 countries worldwide. This growth has been particularly strong in the Asia-Pacific region where IFIC has been undertaking conferences, research and educational activities for several years – especially through its growing IFIC Australia collaborative centre partnership with the Centre for Rural and Remote Mental Health at the University of Newcastle, NSW.

A highlight of my most recent visit to the region was in Taiwan where we encountered the generous hospitality and participation of the International Academy of Integrated Care (IAIC) during the various meetings, forums, workshops and conference sessions that were organised. The central focus of the visit was the realisation of three workshops on Community-based Integrated Care organised by IAIC in conjunction with the Ministry of Health and Welfare held consecutively in Taipei, Taichung and Kaohsiung between 23-25th October. Attended by some 300 people, the level of interest in the topic of integrated care and the range of national and local innovations that were presented was impressive suggesting that much can be learned and shared from Taiwanese experiences.

Central to thinking in Taiwan is how to deal with the existing and future challenges of its ageing population. As with many countries in the region, a history of hospital-centric investments has meant that the care system now needs to think differently on how to recalibrate activities towards more community-oriented innovations to meet long-term care needs. Taiwan was able to introduce national health insurance in 1995 leading to improved accessibility, universal health coverage, shorter waiting times and relatively lower system costs. Nonetheless, the system has its challenges in relation to the need for better gatekeeping and care coordination in the community. The ambition to introduce long-term care program 2.0 has prompted the need to develop new models of community-based integrated care in order to find sustainable solutions that might avert the lived experiences of countries like Japan where the demands for health and long-term care have been highly challenging.

During the workshops to explore innovative solutions to the long-term care needs of older people, many interesting case studies of new innovations were presented. These included a community-led model supporting older people through an alliance of local services focused around care management co-locate at community health canters in the North Coast of New Taipei City; and the positive effects related to good discharge planning and care transitions from hospitals into long-term care based in the community. Indeed, it was clear that there is both commitment and passion from all sides to find effective solutions. These ranged from hospital-led approaches to outreach into the communities in which they are placed, to the need for investing more resources in the community to promote good care coordination and care management practices from the bottom-up. The presence of a local community village structure together with a high propensity for local people to volunteer in care support (encouraged by time banking) gives hope that innovative solutions in integrated community care may be found that bring together the institutional strength and resources of hospitals with care in the community and at home.

The purpose of the IAIC is to take forward the adoption of the WHO Global Framework on Integrated People-Centred Health Services that IFIC had a role in shaping before its adoption by the World Health Assembly in 2016. With a similar mission to IFIC in promoting integrated care across policy and practice, as well as to promote sustainable and innovative system development, it was a pleasure to sign an ongoing knowledge partnership with IAIC and to begin to scope out future activities that will involve developing a platform to share knowledge to advance integrated care thinking, but also to share and promote integrated care innovations on the global stage.

My gratitude goes out to everyone involved in this first meeting, but especially to Professor Ye-Fan Wang, Principal Advisor, IAIC and to Dr. Meng-Chih Lee, President of the Board, IAIC. IFIC looks forward to our future collaboration with great enthusiasm.

Dr Nick Goodwin is the CEO and co-Found of the International Foundation for Integrated Care (IFIC)