Around the world, every health care system is struggling with rising costs and uneven quality, despite the hard work of well-intentioned, well-trained clinicians. Health care leaders and policy makers have tried countless incremental fixes—attacking fraud, reducing errors, enforcing practice guidelines, making patients better “consumers,” implementing electronic medical records—but none have had much impact.
It’s time for a fundamentally new strategy. At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost.
In this Harvard Business Review article by Michael E. Porter and Thomas H. Lee, they write about a strategy for moving to a high-value health care delivery system comprising six interdependent components:
organising around patients’ medical conditions rather than physicians’ medical specialties,
measuring costs and outcomes for each patient,
developing bundled prices for the full care cycle,
integrating care across separate facilities,
expanding geographic reach, and
building an enabling IT platform.
The transformation to Value Based Health Care (VBHC) is well under way. Some organisations, such as the Cleveland Clinic and Germany’s Schön Klinik, have undertaken large-scale changes involving multiple components of the value agenda.
The result has been striking improvements in outcomes and efficiency, and growth in market share.
It’s often said, “What gets measured gets managed,” a quote often attributed to management consultant Peter Drucker.
Collecting patient feedback can be vital to guiding general practice services and meeting patient needs.
Collecting and responding to patient feedback is considered such a key aspect of general practice operations that it is enshrined into the RACGP’s Standards for general practices (4th edition) (the Standards). Patient feedback can help guide the improvement of quality in service delivery, which can then result in better clinical outcomes for patients.
Learn how Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs) enable doctors to have a more concrete measure of the effectiveness of their general practice services.
In a recent book, “Using Patient Reported Outcomes to Improve Health Care”, the authors, Appleby, Devlin and Parkin, demonstrate how in multiple ways Patient Reported Outcome Mesasures (PROMs) can improve healthcare.
It is a practical, introductory guide to the best use of Patient Reported Outcomes (PROs) to improve the quality of health care and patient health.
Introduces, explains and shows how PROMs can be best used to improve healthcare and patient outcomes
Includes real life examples and case studies of PROMs in practice
Assesses the growing evidence base for PROMs in practice
Editor team from the UK Office of Health Economics (OHE), The King’s Fund and King’s College London with contributions from practising clinicians, GPs and other healthcare professionals
The inaugural Value-Based Health Care Conference will be held in Perth and online in May 2021 to raise awareness of value-based healthcare (VBHC) and the work being done in this area across any/all disease types or conditions. VBHC focusses on delivering the outcomes that matter most to patients at the optimal cost. This approach is already transforming whole health services e.g. NHS Wales, the Dutch health system and has been adopted by some of the largest health care providers worldwide e.g. MD Anderson.
The aim of the conference will be to showcase and celebrate Australian value-based healthcare innovation, initiatives, implementation, research, and training from all areas of the health care system, with discussion on topics as diverse as cancer, stroke, dental health, and more.
In early civilisations, there was no distinction between “rational science” and magic, and so far as to sometimes involve the calling of deities. However, empirical observations of illness and the reaction to treatment eventually were systematically recorded, later following scientific methods.
In the West, it was in the early 17th Century that medicine began to separate physical and spiritual in what is now considered “Newtonian medicine”. In short, much like Newton’s Laws of Motion where reaction arose from action, the reasoning was applied to the body in that normal and abnormal functions could be explained by mechanistic changes in the body. This is a mechanistic model taking the human body as a machine.
As scientific methods and tools improved over the centuries, so too did medicine. Systematic analysis of symptoms, reactions to treatments, and understanding of the body rapidly increased. We were able to study the “machine” in much greater detail.
In the 19th century, old ideas of infectious disease epidemiology were gradually replaced by advances in bacteriology and virology. By the late 19th and early 20th century, statistical methods such as correlations and hypothesis tests were introduced making much more sophisticated analysis possible. Now, we were able to study the great variety in “machines” across populations.
Public health became more prominent and important in the 20th century especially during the 1918 flu pandemic. Managing the healthy running of society’s many “machines”.
With all the specialisation in science and medicine, it wasn’t until the mid-late 20th century that medicine began to revisit holistic care in systems theory and the concept of health as a dissipative system.
Systems theory is the multidisciplinary study of systems to investigate phenomena from a holistic approach. Dissipative systems are what’s known as open systems, that is, a system having the capability to operate outside of equilibrium or a stable steady-state, and constantly exchanging matter, energy and information from the external environment with automatic self regulation among other features. In other words, a hyper-complex “machine” interacting, and evolving with its environment.
Patient Reported Outcomes Measures (PROMS) have been shown (ref) to be effective means to bridge the traditional Newtonian medicine practiced widely today, with the systems theory and dissipative systems concepts with the aim of delivering holistic wellbeing for patients. This includes social, lifestyle and environmental elements.
PROMS are also a key part of providing Value Based Health Care (VBHC) to populations such as groups of patients of a medical practice, employees, customers, through to state, national and worldwide populations.
eHealthier is a digital platform for managing PROMS built by medical practitioners for the healthcare sector. An effective diagnostic tool now available to physicians and public health managers to help identify, measure and track wellbeing, eHealthier simplifies patient data capture, data management and analysis, all in a secure easy to use cloud platform.
Contact eHealthier today for a discussion about improving wellbeing and a demonstration of the eHealthier platform.
January 2017 produced two publications that are likely to add significantly to interest and uptake of ePROMs in 2017.
Lancet On-line Lead Article of the 8th Jan 2017 was a 4 part paper entitled “Right Care” These papers confirmed again that overuse of healthcare was estimated as 30% of the expenditure on healthcare in developed countries. eHealthier’s ePROM platform addresses this issue in particular the preventive population ePROMs will enable healthcare providers to create and monitor health in their patients individually and in that provider’s patient population. This will begin the transformation from a health system that concentrates on sick treatments to one that begins to create and measure functional health status in individuals. This will automatically result in the prevention of preventable hospital admissions beginning to reduce the largest cohort of overuse expenditure.
Reorienting Health Systems to become more people centred
Implement new health statistics to measure and compare Patient Reported Experiences and Outcomes in healthcare.
Essentially, they are recommending the implementation of standardised ePROMs across the full gamut of medical conditions and across the OECD. This is reflected in the OECD’s agreement to commission ICHOM to assist in this implementation. eHealthier notes that this paper is called the Next Generation of Health Reforms and feels that eHealthier’s outlined Next generation of ePROMs will significantly enhance this reform agenda.