TY - JOUR
AU - A. Elizondo
AU - R. Williams
AU - S. Anderson
AU - K. Cresswell
A1 - 
AB - BACKGROUND: New models of care that integrate health and social care provision around the patient require a supportive infrastructure, including interorganizational arrangements and information systems. While public policies have been designed to facilitate visions of integrated care, these often neglect the implementation of effective and efficient delivery mechanisms. METHOD: This study examines a decade of attempts to move from fragmented health and care delivery to integrated care at scale in NHS England by developing and implementing a support infrastructure. We undertook a longitudinal qualitative investigation -encompassing interviews and documentary analysis- of the implementation of interorganizational and digital interoperability infrastructures intended to support integrated care policies. FINDINGS: Our findings underscore the long-term symbiotic relationship between institutional interorganizational frameworks and the construction of interoperability infrastructures, emphasizing how they mutually reinforce each other to support their ongoing evolution. Iterative, flexible, and experimental approaches to implementation provide opportunities to adapt to local realities while learning in the making. CONCLUSION: This study underlines the importance of adaptable, locally-informed implementation strategies in supporting the vision of integrated care, and the need to understand such development as a long-term, ongoing process of construction and learning.
AD - School of Informatics, The University of Edinburgh, United Kingdom. Electronic address: Andrey.elizondo@ed.ac.uk.; Institute for the Study of Science, Technology and Innovation, The University of Edinburgh, United Kingdom.; School of Informatics, The University of Edinburgh, United Kingdom.; The Usher Institute, The University of Edinburgh, United Kingdom.
AN - 39706716
BT - Health Policy
C5 - Healthcare Policy; HIT & Telehealth
DA - Oct
DO - 10.1016/j.healthpol.2024.105237
DP - NLM
ET - 20241213
JF - Health Policy
LA - eng
N2 - BACKGROUND: New models of care that integrate health and social care provision around the patient require a supportive infrastructure, including interorganizational arrangements and information systems. While public policies have been designed to facilitate visions of integrated care, these often neglect the implementation of effective and efficient delivery mechanisms. METHOD: This study examines a decade of attempts to move from fragmented health and care delivery to integrated care at scale in NHS England by developing and implementing a support infrastructure. We undertook a longitudinal qualitative investigation -encompassing interviews and documentary analysis- of the implementation of interorganizational and digital interoperability infrastructures intended to support integrated care policies. FINDINGS: Our findings underscore the long-term symbiotic relationship between institutional interorganizational frameworks and the construction of interoperability infrastructures, emphasizing how they mutually reinforce each other to support their ongoing evolution. Iterative, flexible, and experimental approaches to implementation provide opportunities to adapt to local realities while learning in the making. CONCLUSION: This study underlines the importance of adaptable, locally-informed implementation strategies in supporting the vision of integrated care, and the need to understand such development as a long-term, ongoing process of construction and learning.
PY - 2025
SN - 0168-8510
SP - 105237
ST - Implementing integrated care infrastructure: A longitudinal study on the interplay of policies, interorganizational arrangements and interoperability in NHS England
T1 - Implementing integrated care infrastructure: A longitudinal study on the interplay of policies, interorganizational arrangements and interoperability in NHS England
T2 - Health Policy
TI - Implementing integrated care infrastructure: A longitudinal study on the interplay of policies, interorganizational arrangements and interoperability in NHS England
U1 - Healthcare Policy; HIT & Telehealth
U3 - 10.1016/j.healthpol.2024.105237
VL - 160
VO - 0168-8510
Y1 - 2025
ER -