RT Journal Article
SR Electronic
T1 Building a Data Bridge: Policies, Structures, and Governance Integrating Primary Care Into the Public Health Response to COVID-19
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 4
OP 10
DO 10.1370/afm.2900
VO 21
IS 1
A1 Leslie, Myles
A1 Hansen, Brian
A1 Abboud, Rida
A1 Claussen, Caroline
A1 McBrien, Kerry
A1 Hu, Jia
A1 Ward, Rick
A1 Aghajafari, Fariba
YR 2023
UL http://www.annfammed.org/content/21/1/4.abstract
AB PURPOSE The effective integration of primary care into public health responses to the COVID-19 pandemic, particularly through data sharing, has received some attention in the literature. However, the specific policies and structures that facilitate this integration are understudied. This paper describes the experiences of clinicians and administrators in Alberta, Canada as they built a data bridge between primary care and public health to improve the province’s community-based response to the pandemic.METHODS Fifty-seven semistructured qualitative interviews were conducted with a range of primary care and public health stakeholders working inside the Calgary Health Zone. Interpretive description was used to analyze the interviews.RESULTS SARS-CoV-2 test results produced by the local public laboratory were, initially, only available to central public health clinicians and not independent primary care physicians. This enabled centrally managed contact tracing but meant primary care physicians were unaware of their patients’ COVID-19 status and unable to offer in-community follow-up care. Stakeholders from both central public health and independent primary care were able to leverage a policy commitment to the Patient Medical Home (PMH) care model, and a range of existing organizational structures, and governance arrangements to create a data bridge that would span the gap.CONCLUSIONS Primary care systems looking to draw lessons from the data bridge’s construction may consider ways to: leverage care model commitments to integration and adjust or create organization and governance structures which actively draw together primary care and non–primary care stakeholders to work on common projects. Such policies and structures develop trusting relationships, open the possibility for champions to emerge, and create the spaces in which integrative improvisation can take place.