System integration can be defined broadly as the provision of services with high levels of coordination, communication, trust, and respect among service agencies so that they are better able to work together to achieve common objectives. (Greenberg and Rosenheck, 2010, p. 185)
Systems Integration is a formalized coordinated approach to planning, service delivery and management. An integrated system is an intentional, coordinated, suite of services that is centrally funded and managed. Systems integration aims to align services to avoid duplication, improve information sharing, increase efficiency (e.g. reduce wait-times) and provide a seamless care experience for individuals and families.
Systems integration uses a “no wrong door” approach. This means that no matter where a person enters the system, he/she can access any services that are needed. Service-access is not granted on a “first-come, first-served” basis. Rather, streamlined assessment and referral protocols are used to ensure that people receive the services they need and want at any given time.
The term, vertical integration is used to describe a centralized approach to planning, management and service delivery within a single organizational context. Vertical integration can occur within a small organization (e.g. a shelter) or a large complex institution (e.g. a school board or hospital). In vertical integration, work processes are coordinated across departments, such that each department supports a single aspect of a comprehensive plan of care.
The term, horizontal integration is used to describe a centralized approach to planning, management and service delivery across a network of organizations/institutions within a sector (e.g. the homelessness sector) or between sectors (e.g. between education, mental health and homelessness). Horizontal integration can occur at the community, provincial or federal level. In either case, integration requires a bottom-up (i.e. local, grassroots) meets top-down (i.e. regional, institutionalized or governance-oriented) approach.
Considerable planning and collaboration are prerequisites for an integrated service delivery model at any level. An evidence-based, systems-planning framework facilitates integration. The plan should identify “priority populations” and appropriate service pathways for each group. Across the system, organizations need to agree to use a uniform screening, referral and intake process to ensure people entering the system get access to targeted services, no matter where their first point of contact is. Organizations also need to identify and clearly communicate their activities, programs, target populations, and service eligibility criteria using shared terms of reference (e.g. episodically homeless, Housing First) so that service providers can facilitate timely and appropriate referrals. Any communication and assessment tools (e.g. scales used to capture various factors shaping a person’s experience of homelessness) that facilitate common language-use and streamlined inter-organizational processes contribute to an effective systems-response to homelessness.