Conclusion

Abstract

Health systems worldwide are in the midst of major transitions. In this book we explained that a move towards greater integration of care at the ecosystem level is needed in order to contribute to achieving the quadruple aim: to boost the quality of healthcare, to increase cost efficiency, to promote public health, and to improve the quality of working life of all those contributing to the co-production of care. We showed that much is known already about ways to improve care integration within single organizations, and a growing body of knowledge is being developed on care integration through organizational networks, but that far less is known on how to move the larger and much less formal, often competitive and even difficult to know, constellation of ecosystem actors towards a more integrated care delivery, across organizational and network boundaries. We have sought to increase our practical understanding in this area while also addressing explicitly the intentional design of integrated care at the ecosystem level. Based on emerging theory and practice in the realm of complex human systems design (including but not limited to Socio-Technical Systems Design), and drawing on multiple cases from around the world, a practical action framework for collaboratively designing integrated care ecosystems was developed.