From parallel practice to integrative health care: a conceptual framework

TLDR

Integrative health care is a widely used term for collaborative care teams, yet it remains poorly defined and varies across contexts. This paper develops a conceptual framework to describe, compare, and evaluate team‑oriented health care practices in Western systems. The framework presents seven models—parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary, and integrative—arranged along a continuum and organized around four components: philosophy/values, structure, process, and outcomes. The framework enables patients, clinicians, policymakers, managers, and researchers to identify appropriate practice styles, track the evolution of team models, and investigate their links to health outcomes.

Abstract

"Integrative health care" has become a common term to describe teams of health care providers working together to provide patient care. However this term has not been well-defined and likely means many different things to different people. The purpose of this paper is to develop a conceptual framework for describing, comparing and evaluating different forms of team-oriented health care practices that have evolved in Western health care systems. Seven different models of team-oriented health care practice are illustrated in this paper: parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary and integrative. Each of these models occupies a position along the proposed continuum from the non-integrative to fully integrative approach they take to patient care. The framework is developed around four key components of integrative health care practice: philosophy/values; structure, process and outcomes. This framework can be used by patients and health care practitioners to determine what styles of practice meet their needs and by policy makers, healthcare managers and researchers to document the evolution of team practices over time. This framework may also facilitate exploration of the relationship between different practice models and health outcomes.