Background:Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care.Methods:We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools.Findings:From 7,133 abstracts, we retrieved 114 unique tools. We found many quality tools to measure care coordination, patient engagement and team effectiveness/performance. In contrast, there were few tools in the domains of performance measurement and information systems, alignment of organizational goals and resource allocation. The search yielded 12 tools that measure overall integration or three or more indicator domains.Discussion:Our findings highlight a continued gap in tools to measure foundational components that support integrated care. In the absence of such targeted tools, “overall integration” tools may be useful for a broad assessment of the overall state of a system.Conclusions:Continued progress towards integrated care depends on our ability to evaluate the success of strategies across different levels and context. This study has identified 114 tools that measure integrated care across 16 domains, supporting efforts towards a unified measurement framework.

More studies are needed to further validate and refine these algorithms. However, the ability of a small number of easily assessed variables to predict MDE risk indicates that algorithms are a promising strategy for identifying individuals in need of enhanced monitoring and preventive interventions. Ultimately, application of algorithms may lead to increased personalization of treatment, and better clinical outcomes.

The developed prediction algorithm has good discrimination and calibration capacity. It can be used by clinicians, mental health policy-makers and service planners and the general public to predict future risk of having major depression. The application of the algorithm may lead to increased personalisation of treatment, better clinical decisions and more optimal mental health service planning.

Strategies to improve staff education and mitigate against IT security and privacy risks are discussed. Future research should focus on integrating health IT competencies into the educational programs for health care professionals.

IntroductionThis case study was part of a larger programme of research in Alberta that aims to develop an evidence-based model to optimize centralized intake province-wide to improve access to care. A centralized intake model places all referred patients on waiting lists based on severity and then directs them to the most appropriate provider or service. Our research focused on an in-depth assessment of two well-established models currently in place in Alberta to 1) enhance our understanding of the roles and responsibilities of staff in current intake processes, 2) identify workforce issues and opportunities within the current models, and 3) inform the potential use of alternative providers in the proposed centralized intake model.Case descriptionOur case study included two centralized intake models in Alberta associated with three clinics. One model involved one clinic that focuses on rheumatoid disease. The other model involved two clinics that focus on osteoarthritis. We completed a document review and interviews with managers and staff from both models. Finally, we reviewed the scope of practice regulations for a range of health-care providers to examine their suitability to contribute to the centralized intake process of osteoarthritis and rheumatoid disease.Discussion and evaluationInterview findings from both models suggested a need for an electronic medical record and eReferral system to improve the efficiency of the current process and reduce staff workload. Staff interviewed also spoke of the need to have a permanent musculoskeletal screener available to streamline the intake process for osteoarthritis patients. Both models relied on registered nurses, medical office assistants, and physicians throughout their intake process. Our scope of practice review revealed that several providers have the competencies to screen, assess, and provide case management at different junctures in the centralized intake of patients with osteoarthritis and rheumatoid disease.ConclusionsUsing a broader range of providers in the centralized intake of osteoarthritis and rheumatoid disease has the potential to improve access and care specifically related to the assessment and management of patients. This may enhance the patient care experience and address current access issues.