Virtual Healthcare Communities of Practice: The Basque Country Primary Care Case

Communities of practices (CoPs) are powerful tools for healthcare innovation. CoPs' ability to foster knowledge sharing and creating are well known. The introduction of information communication technologies that make possible the virtualization of relationships among healthcare professionals has strengthened the power and ability to implement CoPs. A virtual CoP can serve as a hub for information sharing among professionals distributed in a large geographical area and/or the constraints to interact face-to-face in large healthcare institutions. CoPs that utilize social network technology enable the managing of information (i.e., archiving, analysis, and reporting) in ways that were much more costly and complex before the advent of ICTs. Distributed CoPs do, therefore, make possible not only the generation and sharing of innovations but the ability to evaluate its implementation and sustainability. This is the case we report in this paper.

Healthcare system innovations in the Basque Country have included the implementation of a community of practice (Ezagutza) across a large geographical area in 2008. We report on how an online CoP has begun to be a central force in fostering innovation across the Basque healthcare system (i.e., patient's safety, development of primary care guidelines, transparent management). The CoP has not only functioned as a hub for professionals to share their questions, ideas, and proposals but also, in 2011 (HOBE4+), has begun to be a core protagonist in the evaluation of ideas that are supported and lead by middle and upper health care management. A mix of spontaneity—typical of informal social networks—and an intentional attention to the CoP activity by the central administration has made possible the introduction of innovations that are adopted by those who collaborated in their design. We report on the history, lessons, and evaluation of this CoP and explore its institutional and policy implications for healthcare systems change.