Shaping the Future of Social Work Practice in Healthcare: Addressing COVID-19 Needs through Integrated Primary Care.

COVID-19 has illustrated the urgency of promoting integrated healthcare as the model of the future, with social workers not only supporting the physical and mental health of providers and patients, but also leading efforts to transform systems, policies, and social work education. Primary care, where the role of social workers is continuing to grow, is a central location for integrating the treatment of medical, social, and behavioral problems. In these settings, social workers can take the lead to meet community needs, assist in public health efforts, and bolster the frontline medical workforce. The following article reflects upon what we as social workers have learned a year into the global pandemic and how we can apply this knowledge to shaping the future of social work in primary care. Authors consider how the multiple medical and psychosocial needs of patients affected by COVID-19 are addressed in primary care through three core functions of social work: providing behavioral healthcare, coordinating care, and undertaking population health-based interventions. Article ends with a discussion about how social work can respond to the urgent task of transforming health within the context of social work practice, policy, and education for the next generation of healthcare social workers.

Proactive Outreach for At-risk Health Plan Members During COVID-19 Pandemic in New Mexico.

OBJECTIVE: -Explore the impact of proactive outreach to a health plan population during COVID-19 pandemic in New Mexico. BACKGROUND: -By March 2020, the 2019 novel coronavirus (COVID-19) was a global pandemic, circulating in more than 114 countries. As more information about virus transmission, symptoms, and comorbidities were reported over time, recommendations for reducing the spread of the virus within communities was provided by leading health organizations like the Centers for Disease Control and Prevention (CDC). METHODS: -Criteria were developed to identify health plan members most at risk for virus complications. Once members were identified, a health plan representative contacted each member to inquire about member needs, questions, and provide them with resources. Members were then tracked for COVID-19 testing results and vaccination status. RESULTS: -Overall, 50,000+ members received an outreach call (during 8-month timeframe), and 26,000 calls were tracked for member outcomes. Over 50% of the outreach calls were answered by the health plan member. Of the members who were called, 1186 (4.4%) tested positive for COVID-19. Health plan members that could not be reached represented 55% of the positive cases. A chi-square test of the two populations (reached vs unable to reach) showed a significant difference in COVID-19 positive test results (N = 26,663, X2(1) = 16.33, P<0.01). CONCLUSIONS: -Community outreach was related to lower rates of COVID-19. Community connection is important, especially in tumultuous times, and proactive outreach to the community provides an opportunity for information sharing and community bonding.

Integrated care with digital health innovation: pressing challenges: Managing Community Care

Purpose>Digital health care has emerged as one of the most important means to deliver integrated care by care providers in recent years. As the use of digital health increases, there are some pressing issues such as interoperability of data across different healthcare information systems, regulatory environment and security and privacy of patient’s information which need to be discussed and addressed in order to reduce information silos and to ensure efficient and seamless use of digital health technologies. The purpose of this paper is to address these issues.Design/methodology/approach>In this paper the authors outline the key concepts of interoperability, key challenges pertaining in achieving interoperability and concepts of security and privacy in context of digital health models of integrated care.Findings>The study suggests that standardization of digital health information systems and connecting existing systems to health network, addressing privacy and security related issues through a comprehensive but supportive regulatory environment and educating citizens and healthcare providers are some of the ways to achieve effective use of digital health in models of integrated care.Originality/value>Although the concepts of privacy and interoperability are not new, however, as per best of the authors’ knowledge, this is the first attempt to discuss the challenges and possible actions to meet the objective of achieving integrated care through digital innovation.

An allocation model for emergency medical services based on integrated healthcare during an epidemic

Enhanced virus control and patient treatment outcomes during an epidemic requires flexible and efficient medical services. This research explores an epidemic medical service allocation model from an integrated healthcare perspective, aiming to enhance the overall regional emergency medical service capability based on collaborative medical treatment. The study is based on COVID-19 medical services and its main treatment stages, and resource allocation models are constructed for the allocation of multiple medical services. The model addresses the dispersed medical service resources and demands in a certain region, and realizes the division of labor and resource sharing among medical institutions from the perspectives of distance, cost, and fairness with the advantage of integrated healthcare. We design examples in the context of COVID-19 epidemic and verify the validity and applicability of the model under different phases. This paper provides reference to the research and practice of achieving collaborative medical treatment between multiple medical institutions.

A delicate balance: how physicians manage change towards collaborative care within their institutions

Purpose In response to the COVID-19 pandemic, in 2020-2022, the immutable and fragmented character of our healthcare system changed. Healthcare professionals and their institutional leads proved remarkably agile and managed to change toward collaborative care. The purpose of this paper is to examine experiences with collaborative practice in healthcare during the COVID-19 pandemic in two regions in the Netherlands, to explore and understand the relationship between policy and practice and the potential development of new collaborative care routines. Design/methodology/approach Using a methodology informed by theories that have a focus on professional working practice (so called "activity theory") or the institutional decision-makers (discursive institutionalism), respectively, the perspective of physicians on the relationship between policy and practice was explored. Transcripts of meetings with physicians from different institutions and medical specialities about their collaborative COVID-19 care were qualitatively analysed. Findings The findings show how change during COVID-19 was primarily initiated from the bottom-up. Cultural-cognitive and normative forces in professional, collaborative working practice triggered the creation of new relationships and sharing of resources and capacity. The importance of top-down regulatory forces from institutional leads was less evident. Yet, both (bottom-up) professional legitimacy and (top-down) institutional support are mentioned as necessary by healthcare professionals to develop and sustain new collaborative routines. Practical implications The COVID-19 crisis provided opportunity to build better healthcare infrastructure by learning from the responses to this pandemic. Now is the time to find ways to integrate new ways of working initiated from the bottom-up with those longstanding ones initiated from top-down. Originality This paper presents a combination of theories for understanding collaboration in healthcare, which can inform future research into collaborative care initiatives.

A Large-Scale Screening Responding Sporadic Epidemic of COVID-19 in China by an Integrated Health-Care System.

Introduction: In the post-pandemic period of COVID-19, the majority of cities in China try to balance the normalization of epidemic prevention and social-economic development. However, the appearance of asymptomatic infected patients poses threats to public health, which might be infectious without clinical symptoms and only be detected by testing approaches. Methods: Along with the appearance of one symptomatic case, a regional large-scale screening program was carried out in Shenzhen City charged by a regionally integrated healthcare system. After describing the screening program, a retrospective cross-sectional study for the screening outcome and efficacy was conducted. Discussion: According to the screening results, the asymptomatic case was infectious and their close contacts should be quarantined cautiously as the close contacts of symptomatic cases. Besides, after integrating medical resources in Luohu district of Shenzhen, the medical capability of Luohu district improved greatly which could be demonstrated in inspection and organization abilities in this screening program. Conclusion: The large-scale screening contributed to preventing epidemic transmission. In the post-pandemic period, regular surveillance of asymptomatic cases and rapid response capability for emergent screening program are both crucial for the prevention and control of COVID-19 epidemic. The integrated healthcare system coordinating regional medical institutions and optimizing regional medical recourse has advantages to address public health emergencies.

The Impact of Health Care Funding on Interprofessional Collaboration and Integrated Service Delivery in Primary and Allied Care: Protocol for a Scoping Review.

BACKGROUND: Improving funding models and implementing policies that facilitate greater interprofessional collaboration and integration at the primary and allied health level could improve the ongoing quality and safety and future sustainability of the wider health care system by reducing inefficiencies and inequalities. Defining these key health care funding-related models, policies, and concepts, identifying research gaps, and systematically mapping the associated literature will inform future research on this topic. OBJECTIVE: The aim of this scoping review is to provide a descriptive overview of contemporary health care funding models and the key policies involved in the delivery of primary and allied health care. Further, it will investigate the impact these models and policies have on interprofessional collaboration and integrated service delivery at the primary and allied health care levels. METHODS: A search of published and grey literature will be conducted using the following databases: the Allied and Complementary Medicine Database, CINAHL, Embase, Emcare, MEDLINE, PsycINFO, Scopus, Open Access Theses and Dissertations, and Web of Science. The search will be limited to resources available in the English language and published since 2011. Following the search, an independent screening of titles and abstracts will be undertaken by 2 independent reviewers, with a third reviewer available to resolve any potential disagreements. Full-text resources will then be assessed against the inclusion criteria following the same process. Extracted data will be presented using a convergent narrative approach, accompanied by tables and figures. RESULTS: Electronic database searches have retrieved 8013 articles. The results of this scoping review are expected in May 2022. CONCLUSIONS: The findings from this review will be used to inform future research projects investigating the role of primary health care funding, interprofessional collaboration, and service integration in improving health care access, efficiency, effectiveness, and sustainability. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36448.

Models of Integration of Specialized Palliative Care with Oncology.

OPINION STATEMENT: Evidence from randomized controlled trials and meta-analyses has shown that early integration of specialized palliative care improves symptoms and quality of life for patients with advanced cancer. There are various models of early integration, which may be classified based on setting of care and method of palliative care referral. Most successful randomized controlled trials of early palliative care have used a model of specialized teams providing in-person palliative care in free-standing or embedded outpatient clinics. During the COVID-19 pandemic, telehealth has become a prominent model for palliative care delivery. This model of care has been well received by patients and palliative care providers, although evidence to date is limited. Despite evidence from trials that routine early integration of palliative care into oncology care improves patient outcomes, referral to palliative care still occurs mostly according to the judgment of individual oncologists. This hinders equitable access to palliative care and to its known benefits for patients and their caregivers. Automated referral based on triggering criteria is being actively explored as an alternative. In particular, routine technology-assisted symptom screening, combined with targeted needs-based automatic referral to outpatient palliative care, may improve integration and ultimately increase quality of life.

Integrated Healthcare Systems Response Strategies Based on the Luohu Model During the COVID-19 Epidemic in Shenzhen, China.

COVID-19 has affected primary health-care delivery in metropolitan areas. An integrated health-care system offers advantages in response to the community outbreak and transmission of highly infectious diseases. On the basis of practitioner experience with a pioneering integrated health-care system in Shenzhen, China, this article presents the following effective strategies in response to the epidemic: (1) enhance the public workforce in primary health care; (2) integrate resources to allow regional sharing and efficient use; (3) employ teams centered on general practitioners for community containment; and (4) adopt e-health and telemedicine for health-care delivery. An integrated health-care system is usually very specific to a particular regional context; however, the core strategies and mechanisms based on the Luohu model can contribute to improving the public health capacity in emergency responses; they can transform health-care delivery in the COVID-19 epidemic. The experience in Shenzhen may help other cities in enhancing and coordinating the preparedness of their health-care systems in dealing with future public health emergencies.