“Empanelment = Core of PCIC, PCIC = Huge”

JLN Network Manager

“Empanelment = core of PCIC, PCIC = huge”

So said one of the participants of the Person-Centered Integrated Care (PCIC) collaborative’s third workshop, held February 13–15, 2019, in Bangkok, Thailand. The workshop was led by Ariadne Labs and Qualis Health and graciously hosted by Mahidol University, through Dr. Borwornsom Leerapan, Assistant Professor Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, and the able team at the International Medical Conference Promoting Center.

This was our final workshop and in-person meeting for this phase of the PCIC collaborative, which ends April 30, 2019.

The PCIC collaborative began in early 2017 and accelerated in October 2017 at our first in-person meeting in Hanoi, Vietnam, as one of the collaboratives participating in the Joint Learning Network for Universal Health Coverage’s (JLN) scoping workshop. At this workshop, the collaborative identified empanelment and multidisciplinary teams as top priorities for primary care service delivery, but ultimately selected empanelment as a foundational element of PCIC and chose it to be the primary area of focus for the collaborative’s efforts moving forward. Empanelment was a new term and concept for many participants, which prompted the collaborative to develop an Empanelment Summary and a consensus-derived definition of empanelment. These were further developed during the second workshop, held in Accra, Ghana, in March 2018, and by a country participant workgroup formed following the workshop, that met virtually to continue work on the summary and definition.

At the February 2019 workshop, participants provided finishing touches to both the summary document and empanelment definition. This final endorsement of the document as well as plans on how to use the product marked an important milestone and accomplishment by the 10 countries attending the workshop, including China, Ghana, Indonesia, Malaysia, Mongolia, Morocco, South Korea, Sudan, Thailand, and Vietnam.

At the second workshop, in March 2018, members also identified the need for an empanelment implementation guide, but, with discussion, realized that before such a tool could be used it would be necessary for countries and primary care facilities to assess and improve their readiness to implement empanelment. No such assessment tool currently existed, so the collaborative decided that its second key output would be a tool to assess empanelment readiness, and we formed a second workgroup–the “Tool Workgroup.”

Between the second and third workshops, this workgroup developed a draft national, sub-national, and facility-level assessment tool, and during the recent Bangkok workshop, we meticulously reviewed and improved both sections of the Empanelment Assessment Tool. While work remains to incorporate the rich feedback, the country participants’ efforts during the workshop substantially progressed the Empanelment Assessment Tool. Our goal is to have a pilot-ready tool by April 30, 2019.

During our third workshop, we learned more about PCIC and empanelment in China, Indonesia, and Mongolia, and we conducted site visits to two primary health facilities in Ayutthaya, Thailand:

  • Wat Phra Yatikaram Health Center
  • Wat Intaram Health Center

The site visits began with presentations about the primary health system in Thailand, successes in strengthening primary care, and Thailand’s constitutional commitment to “Establishing a primary health care system in which there are family physicians to care for the people in an appropriate proportion.” We then took a guided tour of the facilities to see multidisciplinary teams in action, providing primary health care services.

The facilitation team, led by Ariadne Labs and Qualis Health, expresses deep gratitude and appreciation for the engagement, commitment, and contributions from our country participants. Empanelment was an interesting and at times challenging topic to tackle, especially as we added new countries and participants along our journey together. Throughout the collaborative, there has been strong and positive regard for the work at hand along with an eagerness to actively participate, to advance a shared understanding of empanelment, and to develop two products.

The PCIC collaborative is well on its way to a final version of the Empanelment Summary and a pilot-ready version of the Empanelment Assessment Tool after incorporating the rich feedback from the recent workshop. We look forward to completing both products ahead of April 30.