Confronting complexity and supporting transformation through health systems mapping: a case study.

Area of Science:

• Health Systems Research
• Healthcare Management
• Patient Navigation

Background:

• Health systems are complex, with interventions in one area impacting others.
• Effective health system transformation requires a shared understanding among stakeholders.
• Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are prevalent chronic conditions demanding integrated care.

Purpose of the Study:

• To document the initial phase of regional health system transformation in Ontario, Canada.
• To develop visual representations of the current health system for COPD and HF patients.
• To utilize a collaborative co-creation approach for system mapping.

Main Methods:

• Employed a case study methodology focusing on a regional health system.
• Utilized a co-creation approach involving multiple methods: focus groups, questionnaires, and document review.
• Developed a health care ecosystem map to visualize system components and interactions for COPD and HF.

Main Results:

• The ecosystem map identified critical components, interactions, and care needs for COPD and HF patients.
• Key findings include limited system-wide navigation for this patient group and inequitable resource distribution.
• Primary care was found to be central to accessing nearly half of the identified care elements.

Conclusions:

• The co-created ecosystem map fostered a collective understanding of the health care system for COPD and HF.
• The map serves as a blueprint adaptable to other disease states and health systems.
• Future work will focus on interdisciplinary co-creation, predictive modeling, and integration strategies.