INTRODUCTION:Demographic ageing is one of the major challenges for governments in developed countries because older people are the main users of health and social care services. More joined-up, partnership approaches supported by information and communications technologies (ICTs) have become key to managing these demands. This article discusses recent developments towards integrated care in the context of one of the arenas in which integration is being attempted, the Single Assessment Process (SAP) to support the care for older people in England. It draws upon accounts of local SAP implementations in order to assess and reflect upon some of the successes and limitations of service integration enabled by ICTs. DESCRIPTION OF CARE PRACTICE:At the Department of Health in England, policy and strategy are directed at the integration of services through a 'whole systems' approach, with services that are interdependent upon one another and organised around the person that uses them. The Single Assessment Processes (SAP) is an instance of inter-organisational and cross-sectoral sharing of information intended to improve communication and coordination amongst professions and agencies and so support more integrated care. The aim of SAP is to ensure that older people receive appropriate, effective and timely responses to their health and social care needs and that professionals do not duplicate each others efforts. This article examines examples from two programmes of work within the context of SAP in England: one with the direction coming from local government social services, the other where the momentum is coming from the National Health Service (NHS). CONCLUSION AND DISCUSSION:Both examples show that the policy and practice of ICT-supported integration continues to represent a significant challenge. Although the notion of integrated care underpinned by ICT-enabled information sharing is persuasive, it has limitations in practice. The notion of an 'open systems' approach is proposed as an alternative way of improving communication and coordination across the domains of health and social care.

译文

简介:人口老龄化是发达国家政府面临的主要挑战之一,因为老年人是卫生和社会护理服务的主要使用者。在信息和通信技术(ICT)的支持下,更多的联合伙伴关系方法已成为管理这些需求的关键。本文讨论了尝试整合的领域之一,即单一评估流程(SAP)以支持英格兰老年人护理的最新发展。它利用本地SAP实施的帐户来评估和反思ICT带来的服务集成的一些成功和局限性。
护理实践说明:在英格兰卫生部,政策和策略旨在通过“整体系统”方法来整合服务,服务相互依赖并围绕使用它们的人进行组织。单一评估流程(SAP)是组织间和跨部门共享信息的一个实例,旨在改善专业和机构之间的沟通和协调,从而支持更全面的护理。 SAP的目的是确保老年人能够对其健康和社会护理需求做出适当,有效和及时的回应,并且确保专业人员之间不会相互重复。本文研究了SAP在英格兰范围内的两个工作计划的示例:一个计划的方向来自地方政府的社会服务,另一个计划的动力来自国家卫生服务(NHS)。
结论和讨论:两个例子都表明,信息通信技术支持的一体化的政策和做法继续构成重大挑战。尽管以信息通信技术促成的信息共享为基础的综合保健的概念具有说服力,但在实践中仍存在局限性。提出了“开放系统”方法的概念,作为改善跨卫生和社会护理领域沟通与协调的另一种方法。

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