COLOUR CODE
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Theme 1. Promoting the health of children and families
Theme 2. Engaging and empowering people and communities
Theme 3. Re-orienting the model of care
Theme 4. Taking measures to improve quality
Theme 5. Funding and incentives that promote health outcomes
Cross-cutting Theme: Education & Training in association with the Integrated Care Academy©
Cross-cutting Theme: Implementation
International Journal of Integrated Care
* Denotes that paper or poster has been selected for Best Paper/Best Poster Award
** Nominated by two reviewers
Draft Programme – subject to change
1
Wednesday, 23 November 2016
07:30
Registration, refreshments, exhibition, posters and networking
9.00 – 10.30
1. Workshop: Developing
policies to support integration
of mental health services
PARALLEL SESSION 1
2. Workshop: Value-based
approaches to Integrated Care
Chaired by
Prof David Perkins, University
of Newcastle, Australia
Chaired by Valentijn, Pim Peter
Chaired by Prof Anne Hendry
Value-based integrated care:
Exploring strategies to enhance
the uptake of integrated care
(145)
A tale of two hemispheres introducing the Intermediate
Care Special Interest Group
(Anne Hendry, IFIC Scotland,
Lucy Fergus, Hawkes’s Bay DHB)
So much planning in Australian
mental health, so little change:
towards an implementation
toolkit (200)
(Roberts, Russell James et al)
A Whole of System Mental
Health and Addiction
Integration Transformation
Agenda in Counties Manukau
(226)
Tess Ahern, General Manager,
Mental Health and Addictions
and Wendy Brown, Service
Development Manager, Mental
Health and Addictions,
Counties Manukau Health
Mental Health Integration Past,
Present and Future: National
Draft Programme – subject to change
3. Workshop: Improving
transitional management,
introducing the Special Interest
Group on Intermediate Care
Identifying communities at high
risk of re-admission in
Singapore and understanding
their needs during transition of
care from hospital to home
(157)
(Chan, Darren Yak Leong et al)
Assessment tool for early
prediction of patients in an
acute hospital requiring long
term institutional placement
(151)
Melissa Chew, Principal Medical
Social Worker, Tan Tock Seng
Hospital
4. Workshop: Learning from
iCOACH: implementing
integrated care for older adults
with complex health needs
(209)
Chaired by Walter Wodchis
This session will review the
policy context and research
approach exposed through
policy, organizational and
provider level interview
approaches and key findings in
the iCoach project.
Presenters:
Walter Wodchis on policy
context and overall research
program goals and approach
Mylaine Breton on
organizational level approach
and findings to date
Tim Kenealy on understanding
the provider’s role and
outcomes from participating in
integrated care programs
Patient and carer perspective:
Frank and Rhene Hanson
5. Redefining the role of
pharmacists: the New Zealand
experience
Chaired by Karen Evison, Ministry
of Health NZ
Supporting Medicines Adherence
(165)
(Hannon, Robbie)
Better than an iPad app, a Clinical
Pharmacist in your practice (168)
(Duck, Brendan James et al)
178 Reshaping the Existing
Landscape: a collaborative
approach to managing diabetes in
General Practice
Sandy Bhawan,
Programme Development
Manager, Te Awakairangi Health
Network
38 A Service Evaluation of the
impact of a Pharmacist Prescriber
managing patients with diabetes in
primary care
2
Survey into Mental Health
Integration in England (212)
Emad Lilo, Integrated Care
Demonstrator Site Project
Manager, Social Care
Professional Lead, Quality
Innovation Centre, (QiC)
Towards Integration: Dispatches
from the Front Line (218)
(Pert, Harry et al)
Can we predict who we will see
in hospital next year? (192)
(Navin-Cristina, Tina)
Discussion and Q&A
Kerry Anne Muller, Pharmacist
Prescriber in primary care, Te
Awakairangi Health Network,
Lower Hutt, NZ
42 Nurse practitioners and
pharmacist prescribers in primary
health care: A realist evaluation of
the New Zealand experience
Tara Officer, PhD Candidate,
Health Services Research Centre,
School of Government, Victoria
University of Wellington *
6. Crosscutting Education Integrated Care Academy ©
Part 1
Chaired by Viktoria Stein, Robin
Miller and Jacquie Cummings
- What is Integrated Care?
Overview of concepts,
models and tools. (Viktoria)
- What is the international
evidence about impact and
key success factors including
culture and values (Robin)
- Implementing integrated
care in the NZ context:
policy, data, impact and
challenges (Jackie)
Group discussions throughout
Draft Programme – subject to change
3
10.30 – 11.00
Refreshments, exhibition, posters and networking
11.00 – 12.30
1. Promoting a healthy life
through education and
activation
Chaired by Nick Chamberlain
PARALLEL SESSIONS 2
2. Workshop: Case studies
highlighting integrated mental
health services
Chaired by
Prof David Perkins, University of
Newcastle, Australia
224 No single intervention will
solve the obesity epidemic –
RACP physicians and
paediatricians exploring points
in the life cycle to prevent and
manage obesity for children
and families
Professor Chris Bullen, The
Royal College of Physicians,
New Zealand
177 Health 4 Life. Improving
Maternal Physical Activity and
Nutrition
Tanya Radford, Health
Promotion Team Leader, Te
Awakairangi Health Network
and Tricia Keelan, General
Manager | Māori and
Population Health, Compass
Health
134 Supporting Weight
Management in Primary Care ABO Programme – Brief
Opportunistic Intervention &
3. Workshop: Whanau Ora and
Te Tiriti
4. Risk prediction tools and
strategies
Chaired by Keelan, Tricia,
Compass Health
Chaired by Tracy Johnson,
Denver Health
Searching for Te Tiriti in Primary
Care (203)
Optimising Resource Use in
General Practice with Predictive
Risk Modelling (180)
Damien Hannah, Product
Manager, Clinical & Change
Management, ProCARE
Population base integrated care in
Poland- policy process (221)
(Koziel, Anna et al)
The decentralization and
integration of Norwegian
psychiatric services and possible
implications for coercive
practices (115 + 149)
(Wynn, Rolf and Myklebust, Lars
Henrik)
Stratification of patients by risk
of acute hospitalisation –
algorithm development and
implementation (163)
John Grant, Director of Business
Intelligence and Martin Hefford,
CEO, Compass Health
Evolving Integrated Care: Moving
Towards a Population Health
Approach (129)
G. Ross Baker, Professor, Institute
of Health Policy, Management and
Evaluation, University of Toronto
CDHB/ Police Watch-house
Nurse Initiative (95)
(Howie, Stephen James)
137 Identifying and Selecting
Patients for Integrated Care
Interventions in NSW:
Unpacking Risk Stratification
Erin Lilley, Integrated Care
Program Manager, NSW
Ministry of Health
Clinical Video Telehealth for
Mental Health Care: Operations,
Engagement and Outcomes
(160)
(Naseem, Ahsan)
Implementing new models of
integrated mental health care:
what impacts effective
performance? (126 + 130)
(Ehrlich, Carolyn)
Draft Programme – subject to change
5. Workshop: Policy design and
implementation for a new
paradigm
Chaired by Chai Chuah and Prof
Anne Hendry
The Five Eyes of Innovation (198)
(Yap, Jason)
Transformation lab – to
sustainability and beyond
Chai Chuah and Prof Anne Hendry
A Real-time Frequent Hospital
Admitter Risk Stratification
4
Ongoing Management (Jones,
Philippa Mary)
Call To Action Through Sport
(Sweeney, Dave) (91+92)*
Model (FAM-FACE-SG score) to
predict “Familiar Faces in
Singapore” (11)
Dr. Low Lian Leng, Singapore
Health Services
Integrated Care for Emergency
Medical Patients - Irish Acute
Medicine Programme (93)
Dr Orlaith O Reilly, National
Clinical Advisor and Programme
Lead, Health & Wellbeing,
Health Service Executive –
South (SE), Ireland
Draft Programme – subject to change
5
6. Crosscutting Education Integrated Care Academy ©
Part 2
Chaired by Viktoria Stein, Robin
Miller and Jacquie Cummings
- Introduction of the Project
Integrate Evaluation
Framework (Viktoria)
- Discussion and reflection in
small groups on where we
stand with implementation:
in our organisation,
profession, local context
- 'And now what?' - how can
academics, practice and
policy work together:
discussion and sharing of
examples
- Wrap-up: building a
learning environment
12.30 – 14.00
Buffet Lunch, exhibition, posters and networking
13.00 – 14.00
Lunchtime Workshops
1. Oral Poster Session:
Engaging children, families
and communities
2. Workshop: Whanau Tahi
3. Workshop: Quality
Expeditions for GP Federations
(13)
4. Workshop: IBM Watson Health
- Cognitive care management
improves integrated care in
Harrow (119)
Chaired by Dr Andrew Wilson
Draft Programme – subject to change
6
Perceptions about Perinatal
Deaths in the Mountainous
Villages of Nepal: Fatalism and
Acceptance Contributing to
Poor Perinatal Survival (171)
(Paudel, Mohan)
An integrated model of care for
children at risk of developing
chronic respiratory disease (64)
(Aish, Harley et al)
56 Where Youth Health and
Youth Justice Intersect
Robyn Sharp, MN, Team
Leader Health Services,
Rotovegas Youth Health @ Te
Maioha O Parekarangi Youth
Justice Residence and Christine
Betchetti, Team Leader Clinical
Practice, Te Maioha O
Parekarangi, Youth Justice
Residence, Child, Youth and
Family
Chair, NHS South Cheshire CCG
& AQuA Fellow in Leadership for
Quality 2016
Social care accounts for as much as
40% of a typical London Borough’s
budget and could soon exceed all
other council spending. IBM
Watson Health and the London
Borough of Harrow are taking an
integrated approach to health and
social care programmes and to
improve individual choice in UK
health and social services through
the facilitation of personal health
budgets, the use of cognitive
technology, and care management
best practices.
Councillor Anne Whitehead,
Harrow Council
Martin Duggan, Director of
Strategy and Market Development,
Social Programs, IBM Watson
Health
Professionals mastering
identity ambiguity to improve
participation in a small-scale
nursing home (161)
(Koster, Luz Angela)
engAGE – Local Integrated
Multidisciplinary Teams for
Older People (197)
Dr Lucy Fergus, Geriatrician
Draft Programme – subject to change
7
Older Persons Health,
Rehabilitation and Allied
Health Sevices, Hawkes Bay
Hospital
3 Tweets are not always
supportive of patients with
mental disorders (Wynn, Rolf
et al.) *
14.00 – 16:00
PARALLEL SESSIONS 3
1. Co-designing care –
empowering people
2. Improving patient journeys
through integrated care
pathways
3. Creating networks to provide
holistic care for vulnerable
populations
155 Integrated management
pathways for alcohol and drug
clients into treatment (impact)
service reduces emergency
department visits
(Demirkol, Apo et al)
The Inner Sydney Urban
Partnership for Health and
Wellbeing (146 + 190)
(McGeorge, Peter et al)
Chaired by Vince Barry,
22 Respiratory Patients
Breathing Life into the
Canterbury Integrated
Respiratory Service
Louise Weatherall, Community
Respiratory Nurse, Canterbury
Clinical Network
223 Using co-design process to
develop care options for
people with chronic and
complex care needs across four
community health services in
the Southern Melbourne
Primary Care Partnership,
Debra Starr, Central Bayside
Community Health Services
Parkdale, Victoria Australia
217 A randomized controlled
trial measuring the effectiveness
of a biopsychosocial integrated
care model, care pathway and
enhanced patient navigation for
the management of patients
with Chronic Obstruction
Pulmonary Disease (COPD) in the
community
(Kannusamy, Premarani)
Draft Programme – subject to change
Equally Well: together we are
making a difference (85)
(Lockett, Helen) *
Re-orienting models of care: the
creation of integrated physical
and mental services (143)
James Baker, Simon Besley and
Allison White, North Sydney
Local Health District Mental
Health & Drug and Alcohol *
Assessment and Management
of Self Harm in Emergency
4. Measuring integrated care to
improve quality
5. Implementation: Using data to
improve service design
Chaired by Les Toop
Chaired by Gregor Coster
36 GPVu: Your Practice Insight
(Allen, Gary)
81 Transforming child health
through the delivery of an
integrated health information
programme
Bronwen Warren, Service Manager
Child and Youth Health, Pinnacle
Midlands Health Network **
127 Integrated care for
participants attending general
practice: a record linkage study
based on the 45 and Up
population cohort study
Julie McDonald, SEaRCH
South Eastern Sydney Research
Collaboration Hub, University of
New South Wales
75 Patient Reported Measures:
Delivering Outcomes and
Experiences that matter to
patients in NSW (Tinsley,
Melissa)
54 Precision Driven Health: A New
Zealand Research Partnership
(Dobbie, Gillian)
187 The development story of
creating a whole of system cloudbased platform for supporting
quality improvement for
integrated care
(Carswell, Peter)
8
Linda Betts, Linda Betts &
Associates, Essendon, Victoria
Australia
158 Empowering CommunityDriven Change: Leadership in
Southcentral Foundation’s
Nuka System of Care
(Gottlieb, Katherine)
Developing an improvement
leaders fellowship programme
and the evaluation of the
integration of patient fellows
(114)
(Myron, Rowan Rachel et al.)
213 The Unmet Needs of
Patients and Carers within
Community Based Primary
Health Care
Kerry Kuluski, Scientist, Sinai
Health System and Assistant
Professor, Institute of Health
Policy, Management and
Evaluation, University of
Toronto
179 Better Journeys for People
with Dementia in Northern
Sydney
(Olivetti, Lyn et al.) *
Departments in Ireland: The
National Clinical Programme
(204)
(Wrigley, Margo)
193 Integrating care planning for
cancer patients: A scoping
review
(Khan, Anum Irfan; et al)
Relationships count – person
centered wellbeing support in
general practice (80)
Dr Sue Copas, Community
Participation Manager,
Auckland District Health Board
Standardising care for heart
attack (STEMI) patients, Ireland
(199)
Dr. Siobhan Jennings, Consultant
Public Health Medicine,
Department of Public Health, Dr.
Steevens's Hospital
19 Developing a culture of health
through a prevention pathway in
a French Mediterranean region
(Reuzeau, Jean-Claude et al)
Draft Programme – subject to change
188 Development and testing of
the Provider and Staff
Perceptions of Integrated Care
(PSPIC) Survey: Provisional
results
Sarah Derrett, Associate
Professor in Public Health
(Health Systems & Public Policy)
and Director – Injury Prevention
Research Unit, Department of
Preventive and Social Medicine,
University of Otago*
Using Front Line Networks to
Develop and Implement Data
Driven Policy (67)
Richard Lewanczuk, Alberta Health
Services, Canada
Preliminary report of unmet needs
in persons living with physical
deficiencies in Quebec, Canada: a
target for service integration (154)
Michel Raîche, PhD Associate
Researcher, Research Centre on
Aging, CIUSSS-Estrie CHUS
28 A marketing approach to
innovation in chronic care: new
value for patients in Lombardia
region
Dr. Elena Bellio, Department of
Marketing and CERMES Centre
for Research on Marketing and
Services, Bocconi University,
Italy
62 A Systematic Review of
Indicators to Measure
Population Health
Professor Julian Thumboo,
Director, Health Services
Research & Evaluation,
SingHealth Regional Health
System, Singapore Health
Services*
9
6. Workshop: The Pegasus
Health Small Group Education
Programme (12)
Led by
Dr Caroline Christie, Pegasus
Health
16:00 – 16.30
Refreshments, exhibition, posters and networking
16.30 – 18.00
PLENARY 1 – Taking measures to improve quality
Chaired by
Dr Janice Wilson, Chief Executive, Health Quality & Safety Commission (HQSC)
Using frameworks to measure and promote quality and integrated care: lessons from USA
Dr Richard Antonelli, Medical Director of Integrated Care, Medical Director of Physician Relations and Outreach, Boston Children’s Hospital/
Harvard Medical School
Getting the measure of integration: lessons from New Zealand (185)
Richard Hamblin, Director, Measurement and Evaluation, Health Quality & Safety Commission
Real-life data analysis and evaluation at the Clalit Research Institute: Data-driven policy in action for improving quality
Dr Maya Leventer-Roberts, Director Translational Policy, Clait Research
Questions and discussion
18.00
Welcome Drinks
19.30 (TBC)
Stakeholder Dinner (Invitation only)
Draft Programme – subject to change
10
Thursday, 24 November 2016
8.30 – 9.15
Main Theatre
Powhiri
9.15 – 9.30
Official Opening
Hon Dr Jonathan Coleman, Minister of Health and Minister for Sport and Recreation, Ministry of Health
9.30 – 11.00
PLENARY 2 – Promoting the health of children and families/whanau
Chaired by
Professor Alan Merry, Chair, Health Quality & Safety Commission (HQSC)
Developing integrated care models for children and their families
Fionnagh Dougan, Health Service Chief Executive and Frank Tracey Executive Director, Community, Mental Health and Statewide Services,
Children’s Health Queensland
Caring for Country Kids: Improving the Health and Wellbeing of Children in Rural and Remote Areas
Lindsay Cane, CEO, Royal Far West ‘Caring for Country Kids’, Sydney, New South Wales, Australia
Next Generation Study
Dr Judith Sligo/Assoc Prof Bob Hancox, Otago University
11.00 – 11.30
Refreshments
Draft Programme – subject to change
11
11.30 – 13.00
PARALLEL SESSIONS 4
1. Healthy children: whanau
ora around the world
2. Technology-supported care
Chaired by Frank Tracey
Chaired by Fiona Thomson,
GPNZ
Ha ngawiri (Breathe Easy) (141)
Katie Inker, Nurse Practitioner
and Marlene Whaanga Dean,
Community Health worker,
WHAIORA (Maori Health
Organisation working to
promote health and wellness in
the Wairarapa)
Mana Tu Diabetes (201)
(Jansen, Rawiri)
Improving Integrated
Management of Newborn and
Childhood Illnesses in Northern
Uganda (58)
(Chitashvili, Tamar) **
Kids GPS Integrated Care Leaving the Ivory Tower (49)
(Altman, Lisa)
69 Paediatric Optometry
Alignment Project: towards
interprofessionality between
paediatric eye care providers
Dr Dana Newcomb, GP Liaison,
Children’s Health Queensland
106 Promoting Patient
Empowerment and Engagement
in Care: The U.S. Veterans
Health Administration (VHA)
Home Telehealth Program
Mary Walker, DNP (Doctor of
Nursing Practice), Veterans
Affairs (VA) Veterans Integrated
Service Network 23 Telehealth
Program Manager, Veterans
Health Administration
215 Chronic Heart Failure Care
Model for Home Monitoring of
Patients
Dr Rajiv Jayasena,
Business Relationship Manager
& Victorian Lead, eHealth
Research Program, CSIRO
Health & Biosecurity Business
Unit and Iain Edwards, Director
of Integrated Care & Dental,
Peninsula Health
2 Patient centred care - Green
Cross Health's approach to
managed disruption (Simon,
Jonathan Edward)
Draft Programme – subject to change
3. Towards health care homes
(medical homes) in local
neighbourhoods
Chaired by Jeff Lowe
4. What influences policies?
Analysing the past to influence
the future
5 Preliminary Experiences with
the Integration of a Patientcentered Medical Home into
Ambulatory Healthcare Services
Centers in Abu Dhabi (Baynouna
Al Ketbi, Latifa Mohammad et
al)
Critical Success Factors for
Regional Health Systems - An
International and Local
Comparison of What Makes
Regional Health Systems Tick (207)
(Yap, Jason)
100 Weaving many strands:
Northland Neighbourhood
Healthcare Home Development
Liane Penney and Jenni Moore,
Northland DHB
72 Integrated Healthcare
Homes & Neighbourhoods:
governance, clinical, managerial
& evaluation matters
Prof Siaw-Teng Liaw, UNSW
Medicine Australia**
26 The Western Sydney
Integrated Care Program:
Qualitative Evaluation
Dr Steven Trankle, Research
Fellow, School of Medicine,
Western Sydney University
5. Implementation: QI
frameworks to support change
Chaired by Ros Rowarth
Integrated Care: Better and
Cheaper (7)
Prof Guus Schrijvers, Chair,
International Foundation for
Integrated Care (IFIC)
Inter jurisdictional governance for
a health system – is it possible?
(111)
Nicholson, Caroline, Honorary
Senior Lecturer, Discipline of
General Practice, School of
Medicine, University of
Queensland
97 Reform but no change: The case
of aging at home policy in Ontario,
Canada (Peckham, Allie et al)
Predictive risk modeling: Policy
applications and considerations.
Tracy Johnson, Denver Health
107 South Island Well Child
Tamariki Ora Quality
Improvement Project
Anna Foaese, South Island Well
Child and Tamariki Ora, Quality
Improvement Project Manager,
South Island Alliance
Programme Office and
Michael McIlhone, Director of
Nursing, Pegasus Health
142 Sharing coordination of
Health Services on Flinders
Island using an applied
continuous quality
improvement approach
Dr Sarah Ahmed, Clinical
Epidemiologist, Primary Health
Tasmania and Angela Smith,
Nurse Unit Manager, Flinders
Island Multipurpose Centre
*
169 Planned Proactive Care – a
quality improvement framework
for Primary Care
Dr Tim Hou, GP Clinical Lead
Planned Proactive Care and
12
and GP, Mater Refugee
Complex Care Clinic
Hannah Johnson, Project
Officer, Queensland Children’s
Eye Health Strategy, Children’s
Health Queensland
174 Owning My Gout –
Engaging people with Gout in a
Pharmacist-Led Collaborative
Gout Management Service
(Rolland, Ta-Mera Cherina)
Lucy Hall, Programme Manager
- Integrated Care Team,
Counties Manukau Health
6. Implementation: Engaging
the workforce to lead change
1 Relationship Centred Practise
(Phillips, Andrew John)
176 Integration between
general practitioners and other
health care providers in New
Zealand in 2015
(Townsend, Frances et al)
39 Engaging Clinicians to lead
improvement of care
integration
Sharyn White, Director of
System and Service Integration
– Northern NSW, North Coast
Primary Health Network
128 Implementing peer support
workers in clinically oriented
sub-acute mental healthcare
teams: New approaches - new
challenges (Ehrlich, Carolyn et
al)
Draft Programme – subject to change
13
13.00 – 14.30
Buffet lunch, exhibition, posters, networking and lunchtime workshops
13.30 – 14.30
Lunchtime Workshops
1. Workshop: Curricula
Development for Integrated
Care
2. Oral Poster Session: Using
technologies to improve
services
Chaired by Christopher Kewley
Chaired by Albert Alonso
Confronting the paradigm of
discipline specific expert
knowledge: Is professional
integration the Holy Grail for
sustainable and authentic
models of co-production and
integrated care? (125)
(Kewley, Christopher)
66 Electronic alert on
diagnosing an HIV indicator
condition in Primary Care
(Cayuelas, Laia et al)
Integrating Our Knowledge of
Integrated Care – A Framework
for Knowing, Understanding,
Improving and Sharing What
We Know (208)
(Yap, Jason CH)
136 The usability, usefulness
and use of a national
collaborative IT platform for the
purpose of continuity of care
Chelsea Ah, Senior Manager,
Clinical Transformation Services
Information Services Division,
MOH Holdings Pte Ltd
3. Workshop: Implementation
– the experience with medical
homes in Australia and North
America
Chaired by Rahbar, Safa Majidi
et al
4. IJIC: Meet the Editors
205 Discussion on the
Implementation of the Patient
Centred Medical Home model Experiences from Australia
182 Health Care Home - what is
it? (Parker, Helen)
+ Prof Claire Jackson and Dr
Richard Antonelli
71 eHealth and Integrated
Primary Health Care Centres
(Liaw, Siaw-Teng et al)
59 Seeking to Understand the
Patient Experience & Co-Design
a Self-Management App
(Charles, Jocelyn Elizabeth)
Draft Programme – subject to change
14
21 Retrospective Analysis of
Telemonitoring (RATE)
Veronica Gonzalez-Arce
Research & Evaluation Officer |
Integrated Health Care, South
Western Sydney Local Health
District
18 Admission 2 Discharge
Together (A2D) – improving the
hospital journey for people with
intellectual disability
Lif O’Connor, Clinical Nurse
Consultant, The MetroRegional-Intellectual-Disability
Network, South Eastern Sydney
Local Health District
184 Practice Population
Profiling – Using PMS data for
patient and practice benefit Dr
Hwell Lloyd, Director of Health
Informatics and Chris Churcher,
General Manager, Health
Informatics, BPAC Clinical
Solutions LP
Diane Taylor, Team Leader,
Planning and Performance and
Paul Abernethy, General
Manager, Programmes and
Practice Development, Te
Awakairangi Health Network
Draft Programme – subject to change
15
Main Theatre
14.30 – 16.00
PLENARY 3 – Reorienting the model of care
Chair
Dr Jeff Lowe, Chair, General Practice New Zealand (GPNZ)
Integrated Care in Action: The Counties Manukau Experience (105)
Benedict Hefford, Director of Primary Health and Community Services, Counties Manukau Health
Moving towards Integrated Care Organisations (ICOs): Lessons from the Basque
Representative from O+berri / Basque Foundation for Health Innovation
A vision for general practice and a sustainable health care system: lessons from Australia
Dr Steve Hambleton, Chair, Queensland Clinical Senate
Questions and discussion
16.00 – 16.30
Refreshments, exhibition, posters and networking
16.30 – 18.15
PARALLEL SESSION 5
1. Improving access to services
and information for hard to
reach populations
Chaired by Ron Durham
2. Empowerment through selfmanagement
30 Dilly Wanderer initiatives –
Wollondilly Health Alliance
Paige Brown, Project Manager,
Wollondilly Health Alliance, Ally
Dench, Executive Director
4. Integrated care measurement
frameworks
Chaired by Campbell Brebner
3. Key enablers for multidisciplinary and inter-sectoral
collaboration in primary care
Chaired by Larry Jordan
51 Introduction of the
DESMOND Programme for Type
Two Diabetes to WellSouth
Primary Health Network
Rebecca Grant, Long Term
210 Co-location of multidisciplinary professionals within
Primary Care Centres in Italy:
how do they collaborate? An
insight on three cases studies
144 Validating the Rainbow Model
of Integrated Care Measurement
Tool: results from three pilot
studies in The Netherlands,
Singapore and Australia
Draft Programme – subject to change
5. Better value for money
Chaired by Michael Howard
24 Integrated categories for
integrated care - the importance
of patient centred categories
(Hoyle, Philip)
16
Community Services &
Corporate Support
Wollondilly Shire Council
20 A community cultural
literacy programme becomes
the trojan horse. (Te Karu,
Leanne)
110 A model connecting
practice, research and policy to
improve refugee health
outcomes (Combined with 109)
Caroline Nicholson, Director,
Mater UQ Centre for Integrated
Care & Innovation
98 Caring for Caregivers:
Establishing Resilience through
Social Capital
Allie Peckham, Postdoctoral
Fellow, University of Toronto,
Institute of Health Policy,
Management and Evaluation*
118 Transfer of the idea of the
Managed Clinical Network into
less advanced settings
Tarry Asoka, Consultant in
Health Policy, Planning and
Management, Care-Net Ltd
(Nigeria)
Conditions Community Nurse,
WellSouth
164 Manawanui whai ora
kaitiaki: empowering selfmanagement through a
partnership approach (Webber,
Lindsey Ann)
from Tuscany Region through
Social Network Analysis
Manila Bonciani, PhD Research
Fellow, Sant'Anna School of
Advanced Studies, Pisa (Italy)
Institute of Management,
Laboratory of Management and
Health
27 Transforming patient
engagement to take charge of
their health and wellbeing
Diana Dowdle, Delivery
Manager, Ko Awatea
68 "To be followed up in
general practice" - developing
and implementing a shared care
model for prostate cancer. (Bro,
Flemming et al)
186 Creating self-management
teamlets in a primary care clinic;
the successes of a clinical-peer
team
Leona Didsbury, Health
Psychologist, Self-management
Trainer and Gary Sutcliffe,
Starcare Centre *
83 How are co-located primary
health care centres integrating
care for people with chronic
conditions?
Julie McDonald, SEaRCH
South Eastern Sydney Research
Collaboration Hub, University of
New South Wales
113 Are patient and carer
experiences mirrored in the
Practice Reviews of SelfManagement Support (PRISMS)
provider taxonomy?
Dr Nicolette Sheridan, Associate
Dean Equity, Faculty of Medical
& Health Sciences, Associate
Professor, School of Nursing,
University of Auckland
25 GPs- You Can Make Time in
Your Day - You can regain
Control (Edwards, Jan et al) *
Draft Programme – subject to change
(Valentijn, Pim Peter et al)
90 Whole of system measurement
for integrated care: The Counties
Manukau experience and creation
of aspirational goals (Gauld, Robin
et al)
183 We know what to do, but how
do we do it? A metanarrative
review of implementation
frameworks to guide the iCOACH
project (McKillop, Ann et al)
123 and 153 Evaluating the 'Health
Links": A Case Study using the
Organizational Context and
Capabilities for Integrating Care in
Ontario, Canada
Agnes Grudniewicz, Assistant
Professor, Telfer School of
Management, University of
Ottawa, Ontario, Canada
195 HealthLinks: Incentivising
better value chronic care in
Victoria (Ferrier, Denise et al.)
135 The value based Logan
Wellbeing Program successfully
diverts inpatient funding,
improving patient and economic
outcomes (Crompton, David et
al.) *
222 Outcomes Based
Commissioning - can the care
really follow the patient? An
Australian perspective
(Sheather-Reid, Rachel) *
104 Flexible funding for
effective, individualised,
integrated care
Dr Jennifer Smith-Merry and
Associate Professor James
Gillespie, University of Sydney
17
6. Education & Training:
Changing attitudes: enabling
health workforce to provide
holistic care
Using action research for
workforce development and
planning in integrated care
(150)
(Akehurst, Beverley JOY)
133 How do health
professionals work in a
recovery-oriented way?
(Ehrlich, Carolyn) Combined
with: 132 Uncovering the work
involved with personally
supportive recovery-oriented
practice (Chester, Polly et al.)
189 Integration of Respiratory
Services in Hawke's Bay
Trish Freer, Health Programmes
Manager PHO, Health Hawke’s
Bay – Te Oranga Hawke’s Bay
14 An investigation into the
barriers and facilitators of
acceptance, and use of Bay
Navigator Pathways by general
practitioners in the Western Bay
of Plenty
Dr. Anel Reyneke, Department
of General Practice and
Draft Programme – subject to change
18
Rural Health, University of
Otago and GP in Papamoa, New
Zealand
20.00
Congress Dinner
Friday, 25 November 2016
Main Theatre
8.30 – 10.30
PLENARY 4 – Engaging people and communities
Chaired by
Dr Viktoria Stein, Head of the Integrated Care Academy ©, International Foundation for Integrated Care (IFIC)
From cooperation to partnership and patient leadership: reflections from the English NHS
Jocelyn Cornwell, CEO, The Point of Care Foundation
WHO efforts in measuring people and community engagement in healthcare
Dr Hernan Montenegro, Coordinator, Services Organization and Clinical Interventions Unit, Service Delivery and Safety Department, World
Health Organization (WHO)
xxx
Awerangi Tamihere, Director Strategy and Design Thinking for Outcomes, Te Whānau O Waipareira
Questions and discussion
10.30 – 11.00
Refreshments
Draft Programme – subject to change
19
11.00 – 12.45
PARALLEL SESSIONS 6
1. Asking people what they
want
2. Putting people first –
changing regional health
systems
Chaired by Helen Rodenburg
Chaired by Shelley Frost
194 Pacific peoples’
perspectives of Integrated Care
services
Dr Debbie Ryan, Principal,
pacific perspectives
61 'Doing Better Together':
Developing a cross-agency
regional child health and
wellbeing plan (Shaw, Miranda
Jane)
82 Self-determination: what do
people who experience severe
mental illness want from public
mental health services?
(Mattner, Sandra)
55 Delivering an integrated
system of care in Western New
South Wales, Australia
(McLachlan, Scott et al.)
99 Frail older people’s use and
experience of the Irish
healthcare system: a mixed
methods study to inform the
design of integrated models of
care (Roe, Lorna Dorothy et al)
220 Networks for care:
Improving quality of hospital
care for rural communities
Dr Carol Atmore, University of
Otago, New Zealand
63 Mixing it up: private, public,
federal, state, seeking health
outcomes in an integrated
primary care centre – the Oran
Park Family Health experience!
(Duggan, Justin et al)
29 An Integrated Health
Collaboration – A Localized
Solution (Pennock, Rene et al)
Draft Programme – subject to change
3. Measuring what matters:
incorporating values as
outcome measures
Chaired by Awerangi Tamihere
4. Incentivising integration of
services – innovative funding
models
5. Implementation: Integrated
care in AsiaPacific
Chaired by Jason Yap
33 An Evaluation of Payment
Incentives for Community-Based
Psychiatric Care in Ontario,
Canada (Rudoler, David)
34 Paying for primary care: The
relationship between payment for
primary care physicians and
selection of patients based on
case-mix (Rudoler, David Michael
et al.) (one presentation)
94 Irish Integrated Care
Programme for Chronic Disease Supporting General Practice Dr.
Orlaith O Reilly, National Clinical
Advisor and Programme Lead,
Health & Wellbeing, Health
Service Executive – South (SE)
Public Health
211 Innovative funding models to
incentivise integrated care (Prior,
Emily)
16 Local Resource Based
Community Care Development as
Asset for the Silver Economy of
the Region (TSARTSARA, Stella I.)
76 The challenge of making
health services peoplecentred: how are policymakers in Asia approaching it?
(Tan, Clive)
121 Integrated care in China,
challenges and opportunities
Dr HAO CAI, Postdoctoral
Researcher, Department of
Health Science and
Technology, Aalborg University
167 Developing of social and
community prescription model
as the third system for
sustainable community-based
integrated health care system
Toshiro KUMAKAWA, Senior
Researcher, Department of
Health and Welfare Services
National Institute of Public
Health, Japan
60 Implementing an Integrated
Care Framework in Singapore:
The Experience of the
20
152 Effects of provider incentives
mechanism in integrated
healthcare delivery system
reform: a quasi-experiment on
patients with chronic diseases in
rural China
Dr Wenxi (Kammy) Tang, Assistant
Professor in School of
International Pharmaceutical
Business, China Pharmaceutical
University
6. Implementation: Changing
organisations and management
to change service provision
147 GOODBYE COMAND &
CONTROL – HELLO CIRCLES!
(Saberi, Vahid)
120 & 131 Leadership and
Professional Engagement in the
Implementation of Integrated
Care: Lessons from 9 Cases in
the iCOACH Project, Ross Baker
+ Jay Shaw, Women's College
Hospital
SingHealth Regional Health
System
Professor Julian Thumboo,
Director, Health Services
Research & Evaluation,
SingHealth Regional Health
System, Singapore Health
Services
156 A Model of Care for a
Regional Health System
Dr Ng Yeuk Fan,
Deputy Director (Special
Projects),
Khoo Teck Puat Hospital,
Alexandra Health System
7. Workshop: Introducing the
Special Interest Group on
Managing Complexity
Chaired by Prof Anne Hendry
209 Learning from iCOACH:
implementing integrated care
for older adults with complex
health needs (Wodchis, Walter P
et al)
78 What does one learn from
the implementation of a
mandated integrated network
for older adults across three
different settings in Quebec
(Breton, Mylaine et al)
Draft Programme – subject to change
21
122 Can complexity dynamics
be harnessed to improve
integration of care? The
implementation of the Health
Links in Ontario, Canada
Agnes Grudniewicz, Assistant
Professor, Telfer School of
Management, University of
Ottawa, Ontario, Canada
166 Tima’i mo se taeao fou new beginnings for a new
tomorrow
Le’aupepe Elisapeta Karalus,
Chief Executive Officer, K’aute
Pasifika Trust and Kim Holt,
General Manager, K’aute
Pasifika Trust
138 The Future of Chronic
Conditions Management in
NSW: Integrated Care for People
with Chronic Conditions
Erin Lilley, Integrated Care
Program Manager, NSW Ministry
of Health and Adam Jogee,
Manager - Australia, Francis
Group International (FGI)
196 Anticipatory Care Planning
in Scotland (Cumming, Stuart)
12.45– 14.00
Buffet lunch, exhibition, posters, networking and lunchtime workshops
13.00 – 14.00
Lunchtime Workshops
1. Oral Poster Session:
Workforce redesign - the future
workforce
2. Oral Poster Session:
Measuring integrated care
outcomes – improving access
57 Promoting the delivery of
integrated care to citizens
through the area managers (de
Matos, Rosa Valente)
15 Cost effectiveness of
integrated care in patients with
acquired brain injury
Dr Aine Carroll, National
Director for Clinical Strategy
and Programmes, Health
Service Executive, Ireland
52 Building better systems on
strong relationships: A co-
Draft Programme – subject to change
22
design case study of a local
initiative
Dr Paul Cooper, Clinical Director
Acute Care Team, Central PHO
53 Non-medical prescribing in
New Zealand: Is it achieving its
aims? (Smith, Alesha)
101 Quality Enhancement
Program: A Delirium-caring
Culture Nurturing Program in
Acute Geriatric Setting- 2-years
Review (Tang, Lap Nin)
87 Turning the patient promise
into reality
Jane Cullen, Quality
Improvement Advisor, Health
Quality & Safety Commission
6 Remodelling care for low back
pain: tripartite partnership
among general practitioners,
physiotherapists and hospital
specialist’s
Dr Jasper W.K. TONG, Deputy
Group Director, Group Allied
Health, Singapore Health
Services
228 Different organizational and
financial outcomes in middle
sized primary care practise in
Poland after basic care
Draft Programme – subject to change
41 Evaluating integrated social
care by utilizing regional
resources in Japan
Masaaki Otaga, Researcher,
National Institute of Public
Health, Japan
170 Integrated Care
Management in Patients with
Atrial Fibrillation
Dr Jeroen Hendriks, Derek
Frewin Lecturer, Centre for
Heart Rhythm Disorders,
University of Adelaide
65 Integrated psychological care
in Inflammatory Bowel Disease
outpatients: Early data from a
new initiative
Taryn Lores, Psychologist /
Health Psychology Registrar,
IBD Service, Royal Adelaide
Hospital, Adelaide SA Australia
175 Understanding the
audience: Improving the impact
of public performance reporting
on quality of care. (Kelaher,
Margaret et al)
148 ICD (Integrated Cardiac
Device) Care through PACED
(Patient-centred and Cardiac
Nursing Engaged Device)
23
coordination model
implementation. (Prusarczyk A)
14.00 – 15.30
Services in a Hospital in Hong
Kong (Leung, Yuen Wa et al.)
PLENARY 5 – Funding and incentives that promote health outcomes
Chaired by
Dr Nick Goodwin, CEO, International Foundation for Integrated Care (IFIC)
Keynote address: xxxxx
Hon Bill English, Deputy Prime Minister, Minister of Finance and the Minister Responsible for Housing New Zealand Corporation
Funding and incentives to promote health outcomes considering you experience of alliance contracting in Canterbury
Carolyn Gullery, General Manager - Planning & Funding, Canterbury DHB & West Coast DHB
XXXXXX
Gabriel Makhlouf, Secretary and Chief Executive, The Treasury
A funding model of shared savings on a regional meso-level – possible for countries with sickness funds or state owned health systems:
The OptiMedis-model of Gesundes Kinzigtal in Germany
Helmut Hildebrandt, CEO, OptiMedis and Gesundes Kinzigtal
Questions and discussion
TBC
CLOSING CEREMONY
Poster Display Only (no oral presentation time allowed)
1.
31 SNOMED Browser and Web Services: Enhancing Primary Care & Emergency Services in New Zealand, Dr Ahmed Javad, President Technical Services, Valentia
Technologies Limited, Ireland
Draft Programme – subject to change
24
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
84 Cardiovascular disease risk and management in people who experience serious mental illness (Lockett, Helen et al)
9 Clinical advisory pharmacists within general practice Dr Linda Bryant, Chair Clinical Advisory Pharmacists Association and colleagues
70 Analyze and improve the patient flow in hospital environments, with improved layout different sectors: A case study of Shahid Beheshti hospital, Iran (Sadeghi
et al)
140 HIV – PEP(Post-Exposure Prophylaxis) ACCESS PROJECT Sid Kaladharan, Project Officer- HIV & Sexual Health, HIV FOUNDATION QUEENSLAND
44 Organ transplant in India (OTII): Progress and challenges through net working system (Barik, Mayadhar et al)
23 What do patients' want? Time to innovate medicine information leaflets Amber Young, PhD Candidate, Associate Professor June Tordoff, Project supervisor,
and Dr Alesha Smith, Project supervisor, School of Pharmacy, University of Otago
45 Integration of cure and care motivated by the hospital budget (Szynkiewicz, Piotr Rafal et al.)
214 A comparison of the policy and institutional environment relevant to community-based primary health care in Ontario, Quebec and New Zealand
(Tenbensel, Timothy Gerard et al.)
79 Client-service engagement in social service provision as co-creation of value (Nicholas, Graeme)
4 Health professionals’ reactions to patients’ social media posts about treatment (Wynn, Rolf et al.)
173 A Lifespan of Care – Connecting the Dots a National Intestinal Failure Service Approach Briar McLeod, Clinical Nurse Specialist, NZ National Intestinal Failure
Service
48 Antiepileptic drug exposure in pregnancy and pregnancy outcome from national drug usage data (Richards, Noni)
112 Geographic and Perceived Healthcare Access Equity among Patients with Acute Cardiovascular Event in China Xiaoguang Ma, Associate professor, Zhejiang
University
88 What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China
(Zhang, Yan et al)
181 The New Zealand health care system: Digital disruption, innovation and the opportunity for new approaches to integrating care (Marmoush, Ahmed et al)
227 Spiritual Care Advance Directive (SCAD) ®: A guide for a spiritual counselor to provide therapeutic and creative interventions at End-of-Life care
James H. Kim, Board Certified Chaplain, Certified in Thanatology, Spiritual Care, Torrance Memorial Medical Center, Torrance, CA USA
For further information, contact:
Fiona Lyne, Director of Communications, International Foundation for Integrated Care [email protected]
Draft Programme – subject to change
25