Change Management Issues for Primary Health Care A Business Model for Service Coordination

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Change Management Issues for Primary Health
CareA Business Model for Service Coordination
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Aim

• To highlight the change management issues
  associated with implementing CDSM programs
• To identify an alternative business model for
  coordinating care teams

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What makes CDSM different?

• Patients more active in their own care program
• A multi-disciplinary care team approach

• Requires more than an incremental change in the
  primary health care sector

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Traditional General Practice Business Model
Allied Health Service Provider
Allied Health Service Provider
General Practice
Patients
Divisions of General Practice
DOHA
Legend
Allies
Service or product flow
Information flow
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Impact of CDSM on the General Practice

• Professional skills and other human resource
  requirements
• Patient communication and interpersonal skills.
• Team leadership, communication and coordination.
• Data management and information sharing.
• Staff supervision, quality assurance skills.
• Web based patient service delivery.

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Impact of CDSM on the General Practice

• Resources
• ICT infrastructure
• Physical assets
• Organisational Practices
• Patient scheduling and reminder system
• Out-of-hours consultations and education

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Impact of CDSM on the General Practice

• Strategy
• Driven by the revenue model
• therefore the revenue model must support
• Practice nurse service delivery
• Compensation for the team coordinator role
• Web based consultation

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What are the necessary characteristics of the
care-team coordinator?

• Equivalent to the Value Net Integrator in
  electronic commerce terms.
• Value net integrators add value by improving the
  effectiveness of the value chain by coordinating
  information. (Weill and Vitale, 2001, p221)

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Value Net Integrator Business Model
Allied Health Service Provider
Patients
VNI
General Practice
Divisions of General Practice
DOHA
Allies
Information Flow
Primary Relationship
Service flow
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The Care-Team Coordinator must

• have the trust of all team members.
• be aware of the services available in the wider
  primary care sector.
• understand the requirements and capabilities of
  all other care-team members.
• be able to gather, synthesise and distribute
  information to all care-team members.
• be able to coordinate the flow of services to the
  patient

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The Care-Team Coordinator

• Should be in a position to know more about the
  patient than any other care-team member.

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Other Issues to be dealt with

• Who should be providing the ICT infrastructure
  and management?
• Information management problems such as
• Security
• Privacy
• Costs
• Computer skills of users
• Patient acceptance
• Legal issues

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The prerequisites for successful change
management include

• A vision of the future and a clear mission for
  the organisation
• An organisation culture that is receptive to
  change
• Strong leadership and trust
• Good communication and
• Participation.
• (Mabin, Forgeson Green,2001).

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Closing thoughts.
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