In the realm of care transformation, there is a crucial shift underway in Saudi Arabia, one that embraces a holistic approach to care and well-being. This transformation, often referred to as integrated care, represents a promising evolution in the delivery of health and social protection services.
Exploring integrated care in Saudi Arabia
Coordinated health and social outcomes is a concept often referred to as integrated care in Saudi Arabia. Dr. Upegui, Worldwide Market Development Executive and Chief Health Officer at Cúram by Merative, describes this concept as a person-centric service delivery model where health and social outcomes are pursued in a coordinated way.
“In today's healthcare landscape, complexity is increasing. Hospitals and general practitioners worldwide are endeavouring to shift patient care outside traditional facilities. This involves embracing telemedicine, establishing care centres within communities, and even exploring in-home care options,” he said.
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The reason behind this shift is the growing number of chronic diseases, which necessitates referral to more specialised care. Many hospitals are globally facing overcrowding, largely due to people seeking treatment for chronic conditions rather than acute episodes, while primary health care centres are also impacted with this increasing complexity as resolution capacities are being challenged
It is gradually becoming more apparent in certain cases that traditional approaches might not be the most effective for addressing chronic diseases. Consequently, healthcare is moving towards involving the community, families, and individuals in self-support, and self-activation, supported by technology. This transition places demands on society to adapt and respond to evolving needs. Community assets need to be activated effectively, ensuring better transportation, companionship, and health and wellbeing literacy.
Simultaneously, many people with chronic diseases are also dealing with social issues, for example they may require disability benefits. Often there can be extensive complexity in navigating both healthcare needs and social protection requirements. Here's where the concept of Coordinated Health and Social Outcomes comes into play. Instead of requiring individuals and their families to navigate the intricacies of healthcare systems and social protection systems, this approach places the individual at the centre. The goal is to have the entire healthcare and social ecosystem revolve around the person. Achieving this entails combining health and social data, not just healthcare data, but also data on available community assets.
This amalgamation of health and social data necessitates both know-how and technology, constituting the Coordinated Health and Social Outcomes model. It's a person-centric service delivery model, focused on addressing health and social outcomes in a coordinated manner. It's essential to emphasise that this model isn't solely a policy-level concept; it's equally about execution on the ground. This approach ensures that outcomes, not just processes, are coordinated. The ongoing work in Riyadh Cluster One is Saudi Arabia is testament to this. It involves the collaborative efforts of social workers, case managers, and the existing structure within Cluster One hospitals in Saudi Arabia. This approach underscores the shift towards prioritising the outcomes achieved by coordinated care, ensuring better support for individuals.
Riyadh First Health Cluster’s transformational SHIFA project
Zaid Abdulaziz Alrafi, Executive Director of Client Experience at Riyadh First Health Cluster in Saudi Arabia, believes that the journey to integrated care begins with a strategic viewpoint.
“The Ministry of Health in Saudi Arabia has been unwavering in its focus on integrated care as part of the healthcare transformational strategy, aligning it with Vision 2030. A key part of it is The Patient-Centred Care Model forming the bedrock of holistic patient care. This model encompasses all facets of a person’s health, including physical, mental, and social well-being. Its primary objective is to facilitate seamless coordination among healthcare providers and community services, ensuring the individual receives comprehensive and cohesive care,” he explains.
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Another pivotal component is the strengthening of Primary Care Centres, positioning them as central hubs for patient care. The focus is to make sure these centres are equipped to deliver continuous and comprehensive care to patients, ensuring that they receive the right care, at the right place, and at the right time. This approach emphasises the importance of coordination among healthcare providers, resulting in a more efficient and effective healthcare delivery system.
Chronic Disease Management stands as a critical piece of the integrated care puzzle. Managing chronic diseases necessitates continuous and coordinated activities. “To address this, we've focused on community health programs with an emphasis on preventive care, health promotion, and community engagement. The objective is to seamlessly integrate health services with community resources to enhance patient care,” says the Executive Director of Client Experience at Riyadh First Health Cluster.
Riyadh First Health Cluster demonstrates Saudi Arabia's commitment to healthcare transformation through the robust implementation of the Integrated Care Framework in the SHIFA area. This effort, which is strategically aligned with Vision 2030, emphasises a comprehensive approach to chronic disease management, integrating health, social, and mental components to save costs and strengthen patient-centred healthcare.
“Our journey in implementing integrated care began with a project in SHIFA, encompassing 11 residential neighbourhoods, served by a community hospital, 11 primary healthcare centres, and a community centre. Future plans include expanding to 168 primary healthcare centres by the end of 2024, gradually building on the initial implementation. Our approach involves managing chronic diseases comprehensively by addressing health, social, and mental aspects. The goal is to optimise costs, fortify person-centred care, and enhance the overall patient experience. An integral part of our strategy involves the integration of case management, social care, and mental health services to identify and holistically manage high-risk patients. Our overarching aim is to reduce hospital visits and readmissions by providing comprehensive care, thereby improving outcomes and optimising resource utilisation,” he concludes.
Watch the webinar
Key experts Zaid Abdulaziz Alrafi, Executive Director of Client Experience at Riyadh First Health Cluster in Saudi Arabia, Dr. Héctor Upegui, Worldwide Market Development Executive and Chief Health Officer at Cúram by Merative, and Dr. Ahmed Balkhair, Chief Digital Health Officer at OIG, shared observations in a recent webinar hosted by Omnia Health Insights, Learnings from applying a real integrated care outcomes approach in Saudi Arabia.
In discussion were topics such as how to build a roadmap for transformation towards a person-centred service model for integrated care outcomes, referring to a specific case study in Saudi Arabia. The panellists guided the audience on a journey to explore how integrated care is building a roadmap towards a person-centred service model, ultimately reshaping the landscape of health and social outcomes.
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