Integrated Care: What Needs To Be Done

A conversation with Carol Yip, Chief Executive Officer of Aged Care Group, discussing why is integrated care important and what are the physical components and structure needed to establish an integrated care operation.

In our article ‘Integrated Care: Defining The Future Provision Of Care’, we spoke with To’ Puan Dr Safurah Jaafar and discussed what were the elements of integrated care. That it is the systematic coordination of general and behavioural healthcare that provides medical and social care services in as real-time as possible to individuals – at the point of care – encompassing physical, mental and social health needs.

These services are rendered through an efficiently orchestrated approached by all care providers within a country. This is to effectively reduce confusion, repetition, delay and gaps in service delivery of care.

We have also discussed the requirements of integrated care. Firstly, it keeps in view the care-receiver’s perspective as the central organising principle. Secondly, the people involved – those in planning, financing and providing services – shared a similar vision and employ a combination of processes & mechanisms to ensure that a human-centred approach remains the hub of the wheel.

Now that we’ve gone through a quick recap, the next questions are: what is its’ significance to us? How do we realise this concept? How does it look like as a tangible and physical structure?

In our interview with Carol Yip, CEO of Aged Care Group, we discuss the specifics of why developing integrated care is essential, how it functions, what are the physical structures that needs to be embedded, the current development we need to make towards integrated care to be provided seamlessly.

The Necessity of Integrated Care
“Everyone benefits from an integrated care framework, be it the young, middle-aged or seniors. When we have this system, everything becomes seamless and things work hand-in-hand to meet the demand while simultaneously creating supply for the need” says Carol Yip, CEO of Aged Care Group.

When integrated care is embedded in a community or neighbourhood, communication becomes easy. You won’t get ‘lost’ in the system as your medical history is collected, centrally stored and made assessible to your neighbourhood care providers. Thus, a person’s health condition can be easily assessed and solutions can be applied without delay. Care providers would also have greater insight to anticipate potential needs or events and be on stand-by to take action.

“Hospitals need to be integrated because everyone who checks in will have all their data on their health and circumstances stored in the hospital. The hospital will then share with the family members, as well as the people who will be caring for the care-receiver” says Carol Yip.

Resources are also managed better due to economies of scale. When more people are connected via the system, the more we save on costs for both people who need care and the facilities that provide the appropriate services. In terms of operations, the processes and mechanisms are also more effectual and well-organised. Ultimately, an integrated care system is better off financially as opposed to care providers working in isolation which makes the cost of services expensive.

Tackling New & Existing Townships
Townships that are decades-old need to be addressed. In Malaysia, matured townships in rural and urban areas contain people who have been living within them for 40 to 60 years. Some could be very old and in need of integrated care services. So how can we inject integrated care to an established township – built for demands of decades passed – now in need to keep up with current ageing trends?

“One of the easiest way is to build Day Care Centres, a locale catered specially for seniors. They can get simple care, do leisure activities and meet their peers. The Day Care can also be an avenue for care professionals – e.g. nurses, caregivers, physiotherapists, etc. – to congregate and apply their trade. From the data collected, we can slowly progress to setting up nursing homes and other essentials for integrated care.” says Carol.

On the other hand, new townships are easier to handle as a location to set up care facilities – such as nursing home, day care and step-down care units (similar to confinement houses for postnatal-care) – need to be identified at the beginning stages of master plan.

Get the Ball Rolling
According to Carol Yip, another component to kick start the establishment of integrate care is home care services. Currently, home care in Malaysia is not regulated, yet it is the most required service at present. Nursing homes in the form of bungalow houses – which for a time filled the vacuum for home care needs – are no longer sufficient.

“The reason we need to address this issue is because there are no proper monitoring of the quality of care delivered. The priority is to improve our current home care services. Many felt the Private Healthcare Act – which currently regulates private nursing homes – is difficult to comply with. However, if we are providing care we should adhere to this requirement. We need to acknowledge that compliance is crucial to provide good service” says Carol.

She also stated that trained manpower – e.g. nurses, care workers – who are mobile to move from the home to hospitals or care centres and vice versa are another essential component to the structure of integrated care.

At present, the Ministry of Health’s are also working on policies to shift the public’s perception and attitude towards ageing and aged care services. As Malaysia moves towards an ageing nation, in tandem with the evolving care needs, we need to be more progressive and do things better with a difference.

Public – Private Partnerships
Partnerships and collaborations have begun to take form in Malaysia in an effort to cope with the increasing healthcare demands and actualise the first steps of an integrated framework.

At a recent forum discussion between University of Malaya and Aged Care Group, Professor Dr Tan Maw Pin – an Associate Professor in Geriatric Medicine – stated that 26% of those who attended University of Malaya Medical Centre’s (UMMC) emergency department in 2014 were seniors, which is an alarming statistic.

During that period, the general senior population surrounding UMMC comprised 6.1% of the total population. The disproportionate figure suggests:

• a lack of or inadequate community services for the ageing community in Malaysia and
• a lack of confidence toward primary care physicians and general practitioners.

When such data are shared amongst those with similar vision to provide continuum care, the work to actualise integrated care into our communities can begin in earnest.

“The non-medical private sector need a lot of support from the medical parties and public sector to give feedback on what are the challenges their facing. Then we will be able to find solutions together.

To summarise, Carol stated we needed to develop trained manpower and the government to hasten the development of aged care facilities, in order to get the ball rolling. We also need to establish the proper incentivisation for those who wish to take part in the industry when they offer their services. Currently, Aged Care Group has already collaborated with various organisations in an effort to establishing integrated care.

“For the last two years, we have created products that are unique such as CareTRUSTTM together with Kenanga and Rockwills to help Malaysians have enough money to sustain their long-term care. We partnered with EcoWorld to create CareHub at Eco Sanctuary, where the care component is embedded into a new township. We intend and will continue to create products and services that meet the Malaysian culture, context and setting of ageing needs.”



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