Abstract
The complex or heterogeneous nature of multimorbidity implies the need to provide integrated care for multimorbid patients. However, Implementing and Managing integrated care for Multimorbid patients (IMM) faces several challenges, which have led to several best practices in healthcare and Information Technology (IT). Thus, care programmes need to mutually and holistically adopt multiple best practices for providing integrated care to multimorbid patients. Yet this is not an easy/trivial task, due to the need to understand the contextual and holistic characteristics of specific best practices prior to adoption. Achieving this requires rational or systemic thinking about problems and solutions or best practices in providing integrated care for multimorbid patients. Thus, this paper answers the research question: How can challenges and best practices in IMM be rationally classified, and how can best practices be holistically aligned and prioritized for adoption? Answering this called for adoption of Soft Systems Methodology (SSM). Key research activities involved conducting a narrative review of literature on challenges and best practices in providing integrated care for multimorbid patients, and processing findings using SSM techniques. These yielded a model that specifies core strategic objectives and thematic actions, that can inform and guide the coherent alignment and implementation of healthcare and IT practices in providing integrated care for multimorbid patients. The strategic objectives and thematic actions can be perceived as requirements for a method that stakeholders can use to proactively assess the ‘value addition’ of specific healthcare and IT practices in a care programme for multimorbid patients.
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Acknowledgements
The authors hereby thank Mujeres por Africa Fundación and Bizkaia Koopera of Basque Country (Spain) for facilitating this research; and Kronikgune Institute for Health Services Research and Makerere University for providing enabling conditions and working environments in which the research was conducted.
Funding
The primary author (AN) was a visiting postdoctoral research fellow at Kronikgune Institute for Health Services Research (Bilbao, Spain). The research visit was funded by Mujeres por Africa Fundación (Spain) and Bizkaia Koopera of Basque Country (Spain), under the Programme for Women, Science, Technology and Innovation in Africa.
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AN and EMK were responsible for the conception, design and writing of the manuscript. AN conducted the literature review. AFZ, DVB, and JTS were responsible for reviewing and revising earlier versions of the problem and solution taxonomies and trees as well as SOTIMM model; and assisting with the writing of the manuscript. All authors critically reviewed the manuscript and approved the final version submitted for publication.
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Nakakawa, A., de Manuel Keenoy, E., Zabala, A.F. et al. Strategic Objectives for Aligning Healthcare and IT Practices in Providing Integrated Care for Multimorbid Patients: A Soft Systems Methodology Perspective. Syst Pract Action Res 37, 59–80 (2024). https://doi.org/10.1007/s11213-023-09643-1
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DOI: https://doi.org/10.1007/s11213-023-09643-1