Communicating Value: Use of a Novel Framework in the Assessment of an Enhanced Recovery Initiative

Allen, Casey J.; Thaker, Nikhil G.; Prakash, Laura R.; Kruse, Brittany; Feeley, Thomas W.; Kaplan, Robert S.; Huey, Ryan; Frank, Steven J.; Aloia, Thomas A.; Gottumukkala, Vijaya; Katz, Matthew H.

doi:10.1097/sla.0000000000004050

Cited by 10 publications

(14 citation statements)

References 9 publications

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“…6 Additionally, a radar chart that displays quantitative variables on multiple axes has been proposed as a practical tool to improve shared decision-making by providing an understandable snapshot of value. 7 Although several domains can be measured using existing data sources, other metrics such as patient-reported outcomes (PROs) and estimated costs to patients and health system are not universally available. The Centers for Medicare and Medicaid Services (CMS) developed the Oncology Care First Model, which will mandate hospitals to collect PROs in addition to traditional outcome and cost metrics.…”

Section: Measuring Value: Existing Framework In Oncologymentioning

confidence: 99%

Shifting the Focus: Value-Based Care in Surgical Oncology

Allen

Johnson

et al. 2023

Ann Surg Oncol

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Section: Measuring Value: Existing Framework In Oncologymentioning

confidence: 99%

Shifting the Focus: Value-Based Care in Surgical Oncology

Allen

Johnson

et al. 2023

Ann Surg Oncol

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“…However, alternative measures such as patientreported outcomes (PROs) and costs have been explored and may better capture outcomes that are important to patients, providers, and the health care system as a whole. Although frameworks have been developed to provide a comprehensive measure of value in health, [6][7][8][9][10][11][12] there remains disagreement on the optimal measure of value. Not surprisingly, there can be discordance in the perception of value between patients with cancer and clinicians.…”

Section: Introductionmentioning

confidence: 99%

Defining Priorities in Value-Based Cancer Care: Insights From the Alliance for Clinical Trials in Oncology National Cooperative Group Survey

Allen,

Snyder,

Horn

et al. 2023

JCO Oncology Practice

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PURPOSE We determine how stakeholders prioritize the importance of oncologic outcomes, patient-reported outcomes (PROs), and cancer-related health care costs. METHODS A survey was distributed to the National Clinical Trials Network Alliance for Clinical Trials in Oncology cooperative group membership from May 14 to June 30, 2022. Respondents were asked to rate (5-point Likert scale) and rank (1-9) evidence-based value domains: overall survival, treatment toxicities/complications, quality of life (QOL), financial toxicity, access to care, compliance with evidence-based care, health system performance, scientific discovery and innovation, and cost to the health care system. RESULTS A total of 514 members responded, including researchers (24.7%), nurses (19.5%), medical oncologists (17.9%), administrators (9.3%), surgical and radiation oncologists (9.1%), patient advocates (3.1%), and nonphysician providers (16.4%). Participants represented various practice settings including National Cancer Institute–designated cancer centers (29.8%), university-affiliated academic cancer centers (21%), hospital-owned oncology practices (21.8%), and others (27.4%). There was agreement in how respondents prioritized value domains (W = 0.39, P < .001). Respondents ranked patient QOL (mean rank: 2.6 ± 1.9) as most important above all other metrics including survival (mean rank: 3.5 ± 0.3) and access to care (mean rank: 3.5 ± 2.1; P < .001). Members engaged in direct patient care also ranked access to care of higher importance than nonclinicians ( P = .026). Cost to the health care system (mean rank: 7.5 ± 2.1) and health system performance (mean rank: 7 ± 2) were ranked as least important ( P < .001). Inclusion of PROs into therapeutic assessment (59.3%) was the most frequently selected priority of future cooperative group initiatives. CONCLUSION Oncology community stakeholders deemed patient-centered value domains as most important and considered patient QOL the highest priority. Inclusion of PROs into clinical trials was endorsed as an important component of therapeutic assessment. These findings can be taken into consideration when creating a value framework for inclusion in cancer clinical trials.

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“…10 One recent study defined other relevant outcomes to the patient: the difference between quality and harm/safety and costs when assessing an ERP initiative. 11 This adaptation of the value equation was conceived as the sum of patient-borne, third-party payer, and institutional costs. 11 There are several existing regional and global initiatives to standardize outcomes evaluation by defining standard sets of measures for several health-care fields, such as the International Consortium for Health Outcomes Measurement (ICHOM), the Meetbaar Beter -Netherlands, the consolidated databases from Medicare, Medicaid and the Navy in the United States, and the National Health Service in the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

“…The framework introduced in this Recommendations Statement might provide health-care administrators with the ability to generate information for value equation variables 11 to support the decisionmaking process of incorporating an ERP. Additionally, the use of TDABC to measure financial and time of care process outcomes for health-care redesign initiatives represents innovation and one more value attribute of TDABC for health-care management.…”

Section: The Introduction Of the List Of Recommendationsmentioning

confidence: 99%

A Standardized Framework for Evaluating Surgical Enhanced Recovery Pathways: A Recommendations Statement from the TDABC in Health-care Consortium

Etges

Stefani

Vrochides

et al. 2021

JHEOR

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Background: Innovative methodologies to redesign care delivery are being applied to increase value in health care, including the creation of enhanced recovery pathways (ERPs) for surgical patients. However, there is a lack of standardized methods to evaluate ERP implementation costs. Objectives: This Recommendations Statement aims to introduce a standardized framework to guide the economic evaluation of ERP care-design initiatives, using the Time-Driven Activity-Based Costing (TDABC) methodology. Methods: We provide recommendations on using the proposed framework to support the decision-making processes that incorporate ERPs. Since ERPs are usually composed of activities distributed throughout the patient care pathway, the framework can demonstrate how the TDABC may be a valuable method to evaluate the incremental costs of protocol implementation. Our recommendations are based on the review of available literature and expert opinions of the members of the TDABC in Healthcare Consortium. Results: The ERP framework, composed of 11 steps, was created describing how the techniques and methods can be applied to evaluate the economic impact of an ERP and guide health-care leaders to optimize the decision-making process of incorporating ERPs into health-care settings. Finally, six recommendations are introduced to demonstrate that using the suggested framework could increase value in ERP care-design initiatives by reducing variability in care delivery, educating multidisciplinary teams about value in health, and increasing transparency when managing surgical pathways. Conclusions: Our proposed standardized framework can guide decisions and support measuring improvements in value achieved by incorporating the perioperative redesign protocols.

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Communicating Value: Use of a Novel Framework in the Assessment of an Enhanced Recovery Initiative

Cited by 10 publications

References 9 publications

Shifting the Focus: Value-Based Care in Surgical Oncology

Shifting the Focus: Value-Based Care in Surgical Oncology

Defining Priorities in Value-Based Cancer Care: Insights From the Alliance for Clinical Trials in Oncology National Cooperative Group Survey

A Standardized Framework for Evaluating Surgical Enhanced Recovery Pathways: A Recommendations Statement from the TDABC in Health-care Consortium

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