Standards of Functional Integration in Health System

Dr. Shahram Yazdani

Main Functions of Health System

Provision

Stewardship Finance

Resource Creation

Sub-functions of Stewardship

Provision

Stewardship

IntersectoralLeadership

IntrasectoralGovernance

Policy Making

Finance

Resource Creation

Sub-functions of Provision

ProvisionClinical

Care

Health Risk Factor Management

Social Determinants

of Health

Stewardship Finance

Resource Creation

Sub-functions of Finance

Provision

Stewardship Finance

Pooling

RevenueGeneration

Purchasing

Resource Creation

Sub-functions of Resource Creation

Provision

Stewardship Finance

Resource Creation

Research

Innovation &Industry

Education

Different Levels for Each Sub-system

Clinical Services Public Health Education Innovation

Policy Policy Policy Policy Policy

Administration Administration Administration Administration Administration

Operation Operation Operation Operation Operation

Research

Operation Operation Operation Operation Operation

Administration Administration Administration Administration Administration

Vertical Integration within Each Sub-system

Clinical Services Public Health Education Innovation

Policy Policy Policy Policy Policy

Research

Vertical Integration

Policy

RegulatoryStandard Performance

Monitoring

GoverningLevers

AlignedOperation

Horizontal Integration Between Sub-systems

Operation

Administration

Education

Policy

HorizontalIntegration

Communication

Cooperation

Coordination

Collaboration

Structural Integration

Operation

Administration

Public Health

Policy

Operation

Administration

Policy

Research

Operation

Administration

Clinical Services

Policy

Operation

Administration

Innovation

Policy

Horizontal Integration Between Sub-systems

HorizontalIntegration

Operation

Administration

Education

Policy

Communication

Cooperation

Coordination

Collaboration

Structural Integration

Operation

Administration

Public Health

Policy

Operation

Administration

Policy

Research

Operation

Administration

Clinical Services

Policy

Operation

Administration

Innovation

Policy

Throughout The Cross-organizational or Cross-boundary

Processes

Cross-Organizational & Cross-boundary Processes

Education

Intra-organizational Process

Cross-Organizational & Cross-boundary Processes

Education

Cross-organizational Process

Cross-Organizational & Cross-boundary Processes

Research

Education

Cross-boundary Process

: کار مراحل

( از بیش فرایندها اولیه 500فهرستفرایند(

اصالح و کيفيت ارتقاء ھای کميتهفرايندھای

مختلف های حوزه کارشناسان و مدیران بین و سازمانی بین فرایندهای فهرست

از ) بیش ای (150حوزه فرایند بهبود برای تعامل راهکارهای بررسی

ای حوزه بین و سازمانی بین فرایندهای در تعامل استانداردهای تدوین

ای حوزه بین و سازمانی بین فرایندهایاز) (300بیش استاندارد

Research Sub-system

Feedback of health system to academy about research needs

Involvement of health system in the process of research priority setting in academy

Research on policies of health system in academy Research on management (administration) of health

system in academy Funding of academic research by health system Joint research projects and corporate R&D by academy

and health system Knowledge management (appraisal, synthesis and

customization) by academy for health system usage Utilization of new academically generated knowledge by

health system

Innovation & Industry Sub-system

Role of academy in protecting intellectual property (e.g. patent office) Venture nurturing activities and units in academy (Searching for ideas

that can be commercialized, creating fertile ground for spin-off activity, protecting the technology base, business coaching, and facility management)

Science and technology parks, business parks University consultancy and contracting services Knowledge brokering in academy Knowledge purveyering in Academy Supply of scientific and technical services to third parties (business

sector and public administration) Diffusion of information, knowledge and technology towards economic

and public operators acting at the interface between suppliers and users. (Innovation centers and liaison units at universities)

Technology Policy making (technology assessment offices) Diffusion of scientific culture through science museums, science

centers

Education Sub-system

Involvement of academy in community needs assessment

Involvement of academy in workforce planning Involvement of academy in service gap analysis Defining and approving new educational programs

according to community needs Community orientation (alignment of objectives and

content with community needs) in academic educational programs

Community based (authentic educational settings) in academic educational programs

Continuous education of providers or producers by academy

Continuous professional development of providers or producers by academy

Provision Sub-system

Academy role in Setting standards and norms of services

Academy role in Licensure and certification of providers

Academy role in Distribution of workforceAcademy role in Monitoring and control of

service performance or qualityAcademy role in Coordination of services

Ownership and Governance

1. The legal relationship between the medical school and the faculty practice plan

2. The legal relationship between the medical school and other components of the clinical enterprise (Ownership, contractual, consortium, separate)

3. The functional interdependence of the academic enterprise and the clinical enterprise

4. CAO role in CE governance5. CAO role in chairs/chiefs appointment (Appoints, vetoes,

consulted) 6. CE role in CAO appointment7. CAO role in CE CEO appointment (CAO hires in line relation,

participate significantly, consulted)8. CAO allocation authority9. CAO budgetary authority—FPP10. CAO budgetary authority—CE (Approve budget, participate in

budgeting, receive allocation, request supports)11. Financial interdependence