As a scientist, I am always seeking more theories, frameworks, evidence, and guidance for shaping effective interventions. I brought my PhD project, the I-CONNECT project, as a case study. My work centers around developing a complex intervention for older adults with mood disorders and physical multimorbidity. It’s a project that aims to coordinate care between primary and secondary healthcare settings, ensuring that the care delivered is person-centered. I had come to Oxford seeking new knowledge to help shape and improve the work we're doing. I expected to leave with more theories, frameworks, and guidelines. What I didn’t expect was the realization that integrated care is far more than established frameworks or concepts.
One of the most striking lessons from the course was how integrated care isn’t about processes or protocols—it’s about complex relationships at its core. We aren’t designing systems for machines or training models, as it might seem while writing a protocol where everything is so controlled. We’re creating care for people, with all the complexities that human connections bring. I’ll never forget a conversation we had in Gloucestershire with Dame Gill Morgan, where she emphasized that integrated care is about forming long-lasting, meaningful relationships. She explained that we, as actors in integrated care, are not the guests at the dinner party. We are the table—the structure that holds everything together—while our partners, patients, and healthcare professionals are the guests. This analogy hit home for me and changed the way I think about my role in this field.
Relationships take time. They need to be nurtured, and they don’t happen overnight. That is why we constantly hear about the integrated care revolution, and we are still working on that day after day. As much as frameworks, co-designs, and person-centered care sound like trendy topics, they are fundamentally about one thing: people caring for people. And caring for people takes energy, dedication, and trust.
Towards the end of the course, we were asked to reflect on our own projects—mine being the I-CONNECT project—and how they fit into the lives of the people we aim to serve. This was a powerful exercise because it reminded me that, in research and healthcare programming, it's easy to get distracted by deadlines, publications, and metrics. But when you remember that at the heart of it all are real people—patients and healthcare providers with their own stories, goals, and needs—it shifts your perspective entirely. You start to see beyond the data points and frameworks and focus on the human connections that truly make care integrated.
The course gave me the tools I was looking for—the theories, the frameworks, the strategies—but it also gave me something more valuable: a deeper understanding of why this work matters. As I continue developing the I-CONNECT project, I am more committed than ever to ensuring that our research is not just theoretically sound but grounded in real, human relationships. We are caring for people with people, and that is the heart of integrated care.
Curious about I-CONNECT?
I-CONNECT is a research project at KU Leuven in Leuven, Belgium, under the supervision of Professors Geert Goderis, Mieke Deschodt, and Bert Vaes from the Public Health Department at the Academic Center of General Practice (ACHG). This project is driven by the urgent need for coordinated, integrated care for aging populations facing mental health disorders and physical multimorbidity. Older adults with these conditions often require complex care, yet they experience fragmented and poorly coordinated services, which increases health risks, diminishes quality of life, and leads to higher mortality rates. Recognizing that mood disorders and multimorbidity significantly impact the well-being of aging populations, we're addressing the challenges of fragmented care and lack of coordination.
Using a co-design approach, we’ve developed an integrated, holistic care intervention aimed at improving the overall health and quality of life for older adults (65 and older) suffering from mood disorders and physical multimorbidity. Our intervention is built upon principles of patient-centered care, enhanced coordination, self-management support, multidisciplinary collaboration, regular medication reviews, and proactive, tailored follow-ups. These guiding principles help create personalized care plans, streamline communication between primary and secondary healthcare providers, engage patients through shared decision-making, foster collaboration among healthcare professionals, optimize treatment through pharmacist-led assessments, and ensure ongoing support with adaptable care plans.
We're preparing for an upcoming hybrid effectiveness-implementation study in Leuven, which will evaluate the impact of the intervention on physical functioning, mental well-being, and care experience. If successful, the model could be expanded to other regions, offering a scalable solution to the challenges of integrated care for older adults.
For more updates on I-CONNECT and how we're striving to make integrated care a reality for those who need it most look at I-CONNECT - Integrated care model for home-dwelling older patients with depression and physical multimorbidity — The Academic Centre for General Practice (kuleuven.be).
