A method to provide integrated care for complex medically ill patients: the INTERMED

Area of Science:

• Nursing
• Health Services Research
• Gerontology

Background:

• Increasing prevalence of patients with multiple chronic diseases (multimorbidity).
• Challenges in coordinating fragmented care for complex patient populations.
• Need for tailored care strategies to address complex patient needs.

Observation:

• Current nursing subspecializations may not adequately address the complexities of multimorbid patients.
• Coordination problems and fragmented care are significant issues for complex patients.
• Effective risk assessment and communication are crucial for managing multimorbid patients.

Findings:

• The INTERMED (IM) method provides a systematic approach to identify patients requiring integrated care.
• The IM method quantifies, weighs, and classifies patient problem complexity.
• The IM method functions as a decision-support system for multidisciplinary teams, particularly nurse coordinators.

Implications:

• Applicability of the IM method to the nursing process for improved patient care.
• Potential for the IM method to enhance coordinated care for complex and multimorbid patients.
• Successful implementation in Europe and planned expansion to the USA pharmacy programs indicate broad utility.