Integrated Care: Operationalizing it!

“I’ve been asked to build integrated-based services in my agency. Where do I even start?” Doris, the clinical director of the Hope Clinic asked the agency consultant, Rodis. “Congratulations.” He responded “You are being asked to do something challenging, noble, and required. You also are not alone feeling this way, and I am glad you are here. Let’s take some time, and think through the fundamentals so you get a framework to address the ins and outs of this much needed endeavor.”

Let’s start with operationalizing Integrated Care:

The word “integrated” means “various parts of aspects linked or coordinated.” The Latin word for it is “integer” which means “whole.” In this vein, simply looking at the Latin word integrated care would mean providing care that looks at the individual as a whole. There is a physical, intellectual, mental, and financial, aspect for each person, among others. And according the World Health Organization (WHO), the definition of health, as also found as one of the principles of its constitution, is phrased as, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” While this phrase was not constructed with integrated care in mind, it, along with the definition of the word “Integrated” can be seen as pivotal components to operationalize the concept of “integrated care.”

Now, let’s see what is currently or mostly commonly known about Integrated Care:

Currently, when talking about the term “integrated care” there are many different interpretations or beliefs about what it means.

1. Some are unaware of what that means;

2. Some see it as the integration of physical health and mental health;

3. Some believe it refers to “co-occurring disorders” and their treatment; and

4. Others regard integrated care as “holistic treatment,” in such case, advocating for better integration of spirituality in healthcare.

Each of these ways of viewing Integrated Care is incomplete, and so, the conversations, and information shared about Integrated-Care are lacking. As Rodis said to Doris, the best way to get this right from the start, which includes what we really mean by integrated care and its fundamentals, as proposed below:

Integrated Care means providing care to our patient and clients in the most in the most holistic and least fragmented way possible. It may be unwise, at times, to operationalize a concept, using its antonym. However, at other times, information is in the difference, knowing what we don’t want may be our first step to knowing what we do want, and in this vein, contrasting Integrated Care with fragmented care may be a concrete and practical way for us to define, or operationalize or understand what Integrated Care is.

In summary, and in other words, what is integrated care?:

Integrated care is the type of care that is provided to our patients and clients, in the most holistic way possible, and the least fragmented way possible, taking into consideration each individual’s needs regarding all the spheres of hers or his lives, including (and not limited to) the physical part, the mental health component, the behavior sphere, lifestyle, among others.

With this definition, you may then be asking: “How does one even start providing this level of care? The system is not designed for that!” The subsequent article will provide the answer to this question.