International Foundation for Integrated Care (IFIC)’s North American Conference on Integrated Care in Calgary, NACIC24 which was co-hosted with our Canada country hub partner, The University of Toronto was a great opportunity to hear about what is happening in the practice of integrated care across Canada.
Whilst the diversity of maturity and implementation priorities as well as policy initiatives was evident across the different provinces in Canada, the conference provide me with an opportunity for me to reflect against a wider international background.
My reflections on the 3 days were:
- The mechanisms or things we do to implement integrated care are the same the world over. Hospital-at-home, inter-professional collaboration, digitally-enabled continuity and coordination, mobilizing caring communities, these are evident on all continents now.
- Sustainability remains an issue. So many presenter, when asked about the future of their initiative shared that it had received short term funding and there was currently no plan for long term funding. We are accumulating yet more “proof of concept” evidence without planning for sustainability. My hope is that recent CIHR Transforming Health with Integrated Care (THINC) research initiative will address this directly by sharing knowledge on implementation, evaluation, adaptation, spread and scale of existing evidence-informed integrated care policies and interventions.
- People and communities actively involved in the design, monitoring and evaluation of care changes the conversation. The power of this was in evidence at NACIC24 itself. We had over 40 people with lived experience and family carers in the room for the 3 days. Plenary discussion included these partners. The sub-plenary session on Wednesday on family care givers as care integrators provided a hopeful counterpoint to the morning plenary focused on the collapse of the health system. Family caregivers do what they do from love, but autonomy and choice in where and how support to them is provided is a step that needs to be taken now.
- As I have said before in other contexts, the shift to integrated and people centred care is a political and social one. The evidence we are collecting on the impact of integrated care is not just numbers related to health outcomes and economic value, as important as those are, but also relates to changing norms that reflect the value of people’s experience of providing and receiving care and support, in other words the value of relational care. This is a contested area and one that means advocates of integrated care will need to be more comfortable with conflict and develop sharper elbows!
I left Calgary tremendously hopeful that there is a core group of people across the provinces more than ready to take on these challenges in Canada and we at the International Foundation for Integrated Care (IFIC) will be there to support them.
Dr Niamh Lennox-Chhugani
International Foundation for Integrated Care (IFIC)