April 8, 2012

Yes, it's difficult to show ALL the foreseen benefits in a pilot.

The recently published 'National Evaluation of the Department of Health’s Integrated Care Pilots', performed by RAND Europe and Ernst and Young, is an interesting read. Besides pointing out several benefits in the business process and quality field, it also notes that several benefits (mainly in the consumer/patient domain) could not be demonstrated. This could easily lead to less scholarly interpretations, suggesting these pilots were a turn in the wrong direction. Given the experience (from our team back at the University of Primorska) with similar pilots I can confirm that it's very difficult to demonstrate all the foreseen benefits of a novel intervention in a pilot. Especially as  these interventions often do not replace the existing interventions or services but merely complement them (thus it's sometimes difficult to demonstrate reductions of patient visits or to show the cost efficiency).
I am happy to see that the majority of media publications and related forum posts were supportive of this.


And I hope we will soon be able to discard the following interpretation: '...the most likely improvements following integrated care activities are in healthcare processes. They are less likely to be apparent in patient experience or in reduced costs.' Obviously further improvements in the field of patient engagement and empowerment - likely including certain levels of gamification and possibly socially (family) driven motivation - will be needed.


What is your take on this?

Some further references:
http://www.gponline.com/Medeconomics/article/1080910/Promoting-integrated-care---does-mean/
http://www.ehi.co.uk/news/primary-care/7659/integrated-care-pilots-show-few-benefits

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