Integrated care in the unified health system of Brazil: The laboratory for innovation in chronic conditions in Santo Antônio do Monte.

The growing burden of chronic diseases is challenging health systems as well as economic and social development in many countries. Integration of care delivery is one of the key strategies to tackle these issues. Transitioning towards integrated care requires the capacity of managing change. This article explores the experience of the Laboratory for Innovations in Chronic Conditions in the municipality of Santo Antônio do Monte (Brazil), as a promoter and facilitator of the shift towards an integrated chronic care model. The purpose of this paper is to describe, analyse and extract relevant lessons from this experience concerning the role of a change agent to (1) overcome the challenges of diffusion of integrated care innovations at scale and pace and to (2) promote learning for implementation of integrated care delivery. Following a detailed description of the experience in itself, covering its background, context, core elements at the different levels of care and financing model, the main preliminary results obtained are presented. The article closes with the main lessons learnt: (1) the experience of the Laboratory shows that health care delivery systems that promote learning and innovation are more flexible and better prepared to face the challenges imposed by a complex epidemiologic, demographic and socioeconomic environment; (2) the development of healthcare networks requires a solid blueprint and change agents supporting the process, and to tackle the challenge of chronicity is essential to reinforce primary care but not sufficient, as integrated care models are also needed. [ABSTRACT FROM AUTHOR]