Theme Networked Health Organizations and Professionals

The institutional context of healthcare is extremely complex, consisting of healthcare organizations/groups, regulators, insurance agencies, patient advocacy groups, for-profit and not-for-profit private sector partners, and professional associations. These actors must work together to help promote and maintain health and deliver care in a cost-effective manner. As a result, a wide range of strategic forms of collaboration are developing in this dynamic sector.

In the Netherlands, which is characterized by managed competition, collaboration usually develops as a result of government reform initiatives or market dynamics. For example, the Integrated Care Agreement (IZA, Integraal Zorg Akkoord) was introduced in 2022 to strengthen regional cooperation between providers and increase collaboration between primary care and other sectors (e.g., social care, specialist care, long-term care). In 2023, the Healthy and Active Living Act (GALA, Gezond en Actief Leven Akkoord) further elaborated the agreements made in the IZA on regional cooperation between insurers and municipalities. With such initiatives, the Dutch government aims to simultaneously improve the accessibility, quality, and affordability of healthcare. These kinds of reforms are not unique to the Netherlands, but are part of a wider phenomenon in Europe and beyond whereby healthcare systems are being reimagined as networks of closely cooperating organizations.

Professionals are key to understanding why and how changes in healthcare systems are being introduced and what their impacts will be. A more connected healthcare system in which network coordination adds to and partly replaces hierarchical and market coordination, needs health professionals’ buy-in since the changes have critical implications for them. This is not exactly straightforward given the dynamic tension between so-called “old professionalism” (which stresses mastery and professional autonomy) and a “new professionalism” which emphasizes multidisciplinary collaboration in networks.

Many initiatives focusing on greater cross-sectoral cooperation aim to address these different professionals. For example, to address the shortage of professionals, some initiatives aim to promote collaboration between healthcare providers, professional associations, and agencies active on the labor market. To make professionals better informed and more prepared service providers, some reforms aim to integrate different types of care types through digitalization.

Over time, a health system that relies on network collaboration may also change the demands placed on professionals. Networks create space for other new forms of organizational, professional, or clinical relationships. In some cases, they require the involvement of experts from outside of the medical professions. For example, with new forms of networked collaboration comes a need for monitoring. This could lead to changes in existing ways of assessing financial performance, quality, and health outcomes; it could create demands for controlling and coordinating finances across organizational boundaries using digital tools. These changes would require managers, accountants, IT specialists, and clinicians to reassess each other’s complementary competencies, (re)negotiate roles, and engage in new forms of collaboration. 

Against this background, our experts seek to explore whether, when and how (new) networked forms of collaboration affect the demands placed on clinical and other professionals, and how these professionals cope with the resulting challenges. It is still unclear how professionals might deal with newly created responsibilities, new multidisciplinary and person-centered standards of care, or new regulatory constraints on evolving practices. We seek to identify what kinds of expertise are needed to develop not only inter-organizational, but also cross-sectoral collaboration, and how to these competencies can be organized; what modes of governance best fit the chosen form of collaboration, and what kinds of supporting systems will best enable a networked health care system.