Mutual Adoption of Soft Systems Methodology, Co-Creation, Enterprise Architecture, and Balanced Scorecard for Continuous Assessment and Improvement of Programmes on Integrated Care for Multimorbid Patients

Although there are several healthcare and Information Technology (IT) practices in Implementing and Managing integrated care for Multimorbid patients (IMM), a synchronized perspective of the existing and emerging practices is still lacking. Our earlier research initiated the adoption of Soft Systems Methodology (SSM) to derive a model, that specifies strategic drivers for guiding alignment of healthcare and IT practices in IMM. However, the model does not directly reveal details of how a programme can implement and continuously assess specific healthcare and IT practices in a coherent/integrated way, so as to realize goals and outcomes of IMM. This implies the need to extend the model by providing a mechanism that synchronizes specific elements of healthcare and IT practices, with the strategic goals of delivering integrated care for multimorbid patients. Such a synthesis of best practices in IMM, can serve as Scorecard for Continuous Assessment and improvement of programmes on Integrated Care for multimorbid patients (SAICO). To design SAICO, SSM’s multi-level thinking technique was mutually adopted with Co-Creation, Enterprise Architecture, and Balanced Scorecard approaches. SAICO’s design was enhanced using a Co-Creation by validation approach, that involved 18 co-creators or subject matter experts from Spain and Uganda. Findings from SAICO evaluation affirmed its usefulness and provided insights that improved its design, understandability, and usability. SAICO can be perceived as an evolving reference map of elements/capabilities that shape a programme’s capacity for IMM, because it can be used to conduct continuous self assessment and identify actions for improvement.