Eahm2019 | Antoine Malone - How integrated care impacts future health…

28th Congress of the European Association for hospital managers

Mr Malone Antoine

Pôle Prospective, Europe, International at Fédération hospitalière de France Responsable

Healing architecture

How integrated care impacts future health organisations

Antoine Malone is a Phd Student at Ecole Nationale d’Administration Publique (ENAP) in Montreal and young researcher at Université de Montréal’s H-POD. He is Director of Research for the French Hospital’s Federation (Paris).

His research interests include comparative Health Care policies, knowledge management in health care organizations, policy and transformative capacity in health care and clinical integration. He regularly teaches at Sciences Po Paris, on health care reforms.

As Director of Research for the French Hospitals Federation, he is currently charged with developing and implementing a large scale clinical integration and population health project.


Integrated care has become the Holy Grail for most health care organizations, for good reasons. An ageing population and the rising prevalence of chronic diseases make integration mandatory.

But from the patient’s perspective, integration remains far too often a mirage, in the same way that the Holy Grail was for most of the Knights of the Round table. This might be because in reality, integrated care may mean different things for different people. Curry and Ham have identified five dimensions of integrated care for instance. What’s more, even though new types of organizations emerge, and some of them –such as Accountable Care Organizations in the USA- look promising, actually implementing integrated care is heavily dependent on country and system specific values and norms, which will in turn shape the way you drive transformation.

To illustrate this point, we will draw heavily from a large scale integrated cared experiment that we are currently undertaking in five territories in France, covering a population of around 1.4M habitants. Even though our general approach is without a doubt inspired by new organizational models that have appeared in the last few years, such as ACO’s in the United States, it is designed to leverage specifically French drivers, which leads in turn to specific organizational arrangements.

We started working on this project around two years ago, and we have now entered the core of the operational phase. We will therefore be able to share a few thoughts about how this approach has already changed in our organizations, about the changes that are likely to come in a medium to long term perspective.

This will in turn allow us to offer a number of takeaways on how integrated care is changing our health care organizations, and our hospitals in particular.