Study: Integration of health and social services lacks comprehensiveness
A comprehensive integration of services and information systems in healthcare and social welfare is the most important objective of the health and social services reform. Achieving the reform objectives requires that, in addition to structural reforms, integration is advanced especially from the perspectives of clients and employees.
These are the conclusions of a study published today on 10 January. Its main objective was to examine national and international effects of the integration of services and client information systems in healthcare and social welfare. Integration of services means uniform service packages formed, on one hand, by basic-level and specialised services and, on the other hand, by services provided by more than one profession or organisation in healthcare and social welfare. A key element in information system integration is the transmission of information between information systems in a way that enables a reasonable implementation of service packages.
The integration of services and information systems appear fragmented when reviewed nationally and internationally. There is no conceptually unambiguous entity called service integration or information system integration. Instead there are a number of integration experiments which have local and sporadic effects.
There is globally little research evidence on comprehensive restructuring of health and social services at the system level. The Finnish health and social services reform is unique internationally in terms of its extent and tight schedule. The integration of services and information systems that forms a part of the health and social services reform will run into opposition and pitfalls if the reform is regarded merely a swift structural system-level reform. It would be more practical to approach the changes and measures associated with the integration also from the perspectives of employees and clients.
There is a call for a client-oriented environment favourable to change
It is important to commit to client orientation in both services and information systems to achieve a change-friendly environment as well as progress in the reform implementation. Client orientation must be seen as something that combines operations and information systems into one package. It should not, however, mean that clients alone have the responsibility to make choices. Instead, client involvement in services both encourages clients to take more responsibility for their wellbeing and speeds up the renewal of services.
Middle management and immediate supervisors play key roles for the implementation of the reform. They must promote client-oriented integration in workplace practices and working culture and understand its significance. For this purpose it is important to create a positive and inclusive environment where experiments are encouraged. It is also important to make use of expert knowledge when decisions are made regarding the restructuring of services. Personnel must be rewarded for promoting integration across barriers and for reinforcing a client-oriented service culture.
A key condition for the integration of services in the new counties is that both the political leadership and the senior officials have a consistent understanding of the needs, objectives and means regarding service integration. For this purpose it is necessary to link strategic operations management knowledge with service management.
The researchers point out that it is difficult to advance integration systematically when the political will is fluctuating. The grand targets of the health and social services reform regarding operations and cost savings will not materialise if the collaboration necessary for integration is not established in the organising and provision of services.
The report is part of the implementation of the 2016 Government plan for analysis, assessment and research. Its authors are Petri Virtanen, Jari Smedberg, Pirkko Nykänen and Jari Stenvall from the School of Management at the University of Tampere.
Further information about the Government’s analysis, assessment and research is available at tietokayttoon.fi.
Inquiries: Professor Jari Stenvall, University of Tampere, tel. +358 40 828 4350, [email protected] and Leading Specialist Petri Virtanen, Sitra, tel. +358 50 318 7068 [email protected] as well as Researcher Jari Smedberg, jari.smedberg (at) pp.inet.fi, tel. +358 400 608 824