Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Integration of Chronic Care in a Fragmented Healthcare System; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 3 4292 10.34172/ijhpm.2022.7143 EN Miek Smeets Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium 0000-0001-7725-4429 Karolien Baldewijns Mobilab & Care, Thomas More University of Applied Sciences, Mechelen, Belgium 0000-0001-7842-5736 Bert Vaes Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium 0000-0001-5244-1930 Hilde Vandenhoudt LiCalab, Thomas More University of Applied Sciences, Mechelen, Belgium 0000-0003-4403-9567 Journal Article 2022 02 01 <span class="fontstyle0">The authors of “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” present a fresh perspective on the inertia of integrated care (IC) implementation. They conclude that the decisive power in Belgium is fragmented and undermines efforts towards IC. As researchers in integrated heart failure (HF) care and active primary healthcare professionals, we comment on the three policy initiatives evaluated by Martens et al from a bottom-up perspective. A Learning Healthcare Network (LHCN) was established September 2019 to overcome fragmentation, the lack of evaluation and capacity loss each time a pilot project ends. This commentary wishes to illustrate that a LHCN can be a powerful meso-level mechanism to engage in alignment work and to overcome macro-level barriers that are often difficult to change and not supportive of IC</span> https://www.ijhpm.com/article_4292_8d8f733a7c2a2ea60df6439a28a2b9a3.pdf