Using the Integrated People Centred Health System (IPCHS) standard to structure, support and evaluate a health care system integration process

Belgium is a federal state characterized by a unique institutional complexity. Responsibilities for health care are divided between different levels of government. Elements such as training, financing or organization are sometimes handled by the federal, regional or local level.  Moreover, the Belgian health system was designed in silos, based on sectors (hospital, primary care, mental health, long term care, etc.), making it difficult to implement a more transversal approach. Various pilot experiments in this area have nevertheless been developed over the last 10 years. Recently, the Belgian federal and regional authorities affirmed their desire for a paradigm shift to move towards greater health system integration, despite its complexity.  To support Belgium in this effort, the Integrated People-Centred Health Systems (IPCHS) was used to provide a framework to guide the consultation, strategy and planning for this transformation. 

In the first part of this presentation, we will present the Belgian health system, its main characteristics, and some examples of pilot experiences fostering health system integration. This will allow us to highlight the existing obstacles to an integrated care approach as well as levers and opportunities. In the second part, we will explain the recovery plan developed by one of the Belgian regions – Wallonia – following COVID-19, and in particular the elements related to the structuring of primary care and the creation of local-regional networks required to strengthen integration.

Building on this context, we will then review work conducted over the past year using the IPHS Standard developed by Health Standards Organization (HSO), to structure the reflections around this theme, to build a consensus on the vision and objectives of integration with all the stakeholders (patients’ representatives, caregivers, payers, community and social workers) to identify the priority areas to be implemented, and to establish a work schedule for its implementation. Specifically, results from our study with the Catholic University of Leuven which leverages the IPCHS Standard (including its 10 design principles and 66 criteria) will be outlined, demonstrating how the aspirational targets support a fully integrated health system within the Wallonia region.

Through the presentation of the Belgium health system and the IPHS standard application, the added value of working with this tool built by experts who leveraged peer-based evidence, good practices and international experience will be highlighted. In particular, the first concrete results supporting the value of the standard applied within the European health system context will be outlined, including concrete outcomes from the study.

The presentation will be led by Denis Herbeux, CEO of PAQs ABSL in Belgium who will outline the health system context in Belgium, detail the study focused on health system integration in Wallonia and relay the application and assessment of the IPCHS Standard. Ms. Leslee Thompson, CEO of HSO will provide global context on the IPCHS Standard and its applicability for use by health systems, including Belgium.