12

This paper presents the emerging context of integrated service networks (ISN), clarifies the concept of ISN, and highlights some of the key factors in the successful implementation of ISNs. The Quebec healthcare reform illustrates the current state of development of integrated care. The main targets of the reform are the consolidation of primary care and the development of collaborative models of mental health care (or shared care). Since they are very complex to operate (insofar as they require major system changes), ISNs are not widely developed. General practitioners are at the heart of the current reforms since they have a key role to play in the successful implementation of integrated care models, including ISN models.