"Carried me with you": the objectives of integrated care are a matter of more than one

Mònica Almiñana
 

This song from the Onward soundtrack, one of Disney's latest animated productions, bring about a good mood because, in addition to having a country touch, I have always liked lyrics that speak of how important it's that they accompany you, guide you and help you achieve your goals.

As I have highlighted on other occasions, one of the keys to transforming health care is to listen, prioritize and solve the needs of patients - in many cases complex - and let them participate in the solutions that affect their health.

Person-centred integrated care often clashes with the way our healthcare systems are organized. Health services were organized more than a century ago around diseases, devices and professionals specialized in these devices and systems, without focusing the model on people, their needs, their circumstances and the specific impact of their diseases.

For this shift to occur, many levers of change are needed, one of which would be goal-oriented care. In the article "Goal-oriented care: a catalyst form person-centred system integration, by Steele Gray et al", published by the International Journal of Integrated Care, the authors explain, regarding three international cases, models of primary care based on this philosophy in different communities in Ottawa (Canada), Vermont (United States) and Flanders (Belgium), in which goal-oriented care (GOC) was adopted to stimulate clinical, professional, organizational and systems integration. The "Goal-oriented care" (GOC) model, or goal-oriented care, was conceived as a way of approaching the comprehensive care of patients with complex health problems and important social needs.

The article, of which I recommend an in-depth reading, exposes how through the GOC we can integrate patient-centred processes. It says that one of the important components of goal-oriented care is the co-production and co-design of the care plan between the patients and their health and social providers. That is their active participation.

The article teaches us that by establishing a common vision and philosophy to drive shared processes, goal-oriented care can be a powerful tool to facilitate the delivery of integrated care. We should be encouraged to start it given the results, perhaps we would end up humming without realizing it:

…Yeah, it's true

You carried me with you

Oh, we'll be sittin' on the world together (Ooh-ooh)

Watchin' as the days turn into night (Ooh-ooh)

We know how to brave the stormy weather (Ooh-ooh)

And we're never givin' up without a fight

If you should ever bear a heavy load

I'll be your wheels, I'll be the road

I'll see us through the thick and thin

For love and loss until the end

Cause you carried me with you…