Two visions of clinical integration: perspectives from health system leaders

Abstract

Objective: Clinical Integration has been implicated as the key to achieving higher quality of care at a lower cost. However,ambiguity regarding the meaning of clinical integration poses challenges as health care professionals strive to adapt to the rapidlyevolving health care environment. This study aims to solicit insights from health system executives about what it means to beclinically integrated.

Methods: The authors interviewed 13 health system executives from 11 different institutions in Pennsylvania ranging fromsmall community hospitals to large academic medical centers.

Results: Two major viewpoints of clinical integration were identified from the interviews: patient-centric, which emphasized theimportance of the patient’s experience and strengthening patient involvement in their own healthcare, and provider-centric, whichfocused on leadership roles, organizational structure, and physician alignment. Participants with provider-centric viewpointswere associated with larger medical centers and were more likely to describe their health systems as highly clinically integrated.Conversely, patient-centric perspectives were affiliated with smaller health systems/hospitals and were more likely to describetheir health systems as less integrated. Participants also identified five key success factors of clinical integration: physicianalignment, shared data and analytics, culture, patient engagement, and an emphasis on primary care.

Conclusions: Despite the central role of clinical integration in emerging health systems, there is not a shared understanding ofits definition. A better understanding of the varied perspectives regarding clinical integration can help current and future healthcare professionals to better communicate with one another about clinical integration and the practical steps necessary to achieveit.