Guiding Principles of Integrated Cancer Care Delivery Within a Regional Health System.

introductionUS hospital consolidation has been driven primarily by economic advantages, rather than by efforts to improve regional clinical care delivery. Health systems are secondarily redesigning delivery models but have little guidance on how to integrate care across an expanded footprint. We sought to understand how hospital leaders at a quaternary academic health system approach care delivery integration.

methodsWe conducted 12 semistructured interviews with hospital-level quality, operations, strategy, and patient engagement leaders in a Midwestern regional health system. Interviews explored perceptions of current integration strategy and the key features of an integrated health system to inform future organizational structure. Interviews focused on colorectal cancer, as it is multidisciplinary, longitudinal, and a common cancer with a range of complexities and well-defined care guidelines. A hybrid inductive and deductive thematic approach was used to analyze interview data.

resultsHealth system leaders described aspects of ideal regional cancer care, which were categorized into four primary themes and associated subthemes: (1) ensuring consistent, high-quality, evidence-based care across all entities within the system; (2) optimizing site of care delivery for effective regional triage; (3) leveraging technology for care coordination; and (4) fostering provider engagement and cultural unity.

conclusionsThe four themes identified in this study form a proposed framework that may guide colorectal cancer care integration across a regional health system and enable improvements in clinical care coordination. Beyond a clinical, operational, and financial focus, these principles highlight the importance of developing cultural unity as a key component of successful integration.