David Oliver: A manifesto for multimorbidityBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1044 (Published 06 March 2018) Cite this as: BMJ 2018;360:k1044
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Models for integrated care have been increasing in prominence in healthcare organisations worldwide as they hold great opportunity for the delivery of seamless, efficient and effective “patient care” whilst at the same time controlling expenditure, enhancing communication and optimizing consumer participation. Integral and built into effective provision of integrated services is a robust and agile information technology platform, able to host numerous cycles of improvement innovation that helps to create learning health systems.
As Oliver correctly points out, it is no longer best practice to continue on the current path of reflexive and incident initiated patient care provided in silos – for reasons of increasing healthcare expenditure, health care wastage, patient outcome and patient experience. In addition, opportunities for converting data to knowledge and research abound within integrated service models of care.
Strategies for the future in many organisations should include provision of truly integrated care. With an ageing population with significant comorbidities, health needs are no longer related to single organ systems and require complex solutions. These must incorporate strategies of prevention and healthy lifestyle promotion, consideration of the social determinants of health, care delivery within the patient’s home and community and outside the walls of large hospitals as well as smoothing the road at the end of life. By using predictive analytics and incorporating best practice and a process of constant improvement, healthcare needs to evolve to being sustainable yet better, safer and smarter care for all.
Competing interests: No competing interests