Technology should be considered from the outset and not as an “add-on” when developing an integrated care system, a Nuffield Trust researcher has said.

Sarah Scobie, deputy director of research at the trust, said technology on its own is not a solution to integrated care problems but “underpins” the success of many health systems.

“There is good evidence that when it comes to developing integrated care systems, technology needs to be considered from the outset and not as an add on,” she told Digital Health News.

“A recent NAO report showed that the systems not taking technology infrastructure requirements into consideration made it difficult to deliver some of the plans.”

She advised integrated care system (ICS) leaders to focus on getting basic infrastructure in place in order to successfully adopt new technology in the future.

“In a rapidly changing environment there are always lots of exciting opportunities but it’s important to focus on the most pressing issues that need to be addressed first,” she added.

Getting the basic infrastructure right is essential in order to adopt any new technology in the future. Staff also need to have the time, capacity and skills to implement and embed technology if it’s going to be sustainable.

“Technology is not a solution to integrated care problems on its own, but if you look at other health systems that have shifted their focus towards integrated care then they have technology as one of the underpinning enablers to success.”

Her comments come as the Nuffield Trust released a briefing on evaluating integrated care, focusing on why assessments aren’t producing the expected results of reduced hospital admissions.

“Within our own work and elsewhere we have found a number of curious cases in which the data suggests that people receiving integrated care services were using some hospital services more than a carefully selected group of matched controls,” the briefing read.

It highlighted problems with the design models, implementation and expectations as the key reasons results are not as expected.

Back to basics

Planning should focus on what prevents integration locally rather than “shiny new initiatives”, the briefing advised service model designers.

“For example, sort out the known barriers associated with data sharing, information technology, and management and administration that can hinder communication between providers and coordination of services,” it read.

“Carefully define your local problems and health and social care needs that can be addressed through incremental changes or investments. Then think about whether integrated care is the solution, and which known enablers you will need to put in place.”

Scobie emphasised that effective development of an ICS needed to come from the involvement of senior leaders, not just the IT teams responsible for putting the technology in place.

“For ICSs to make the best use of technology, organisations need to work together to plan and invest in digital developments. This should reduce duplication in the long run and improve interoperability and data sharing across the ICS,” she said.

“Doing this effectively will need involvement of the senior leaders in the ICS, not just IT teams.”