The roadmap for implementing value based healthcare in European university hospitals - consensus report and recommendations

Abstract

Value based healthcare (VBHC) aims at improving patient outcomes while optimizing the use of hospitals' resources among medical personnel, administrations and support services through an evidence-based, collaborative approach. In this paper, we present a blueprint for the implementation of VBHC in hospitals, based on our experience as members of the European University Hospital Alliance (EUHA). The EUHA is a consortium of nine large hospitals in Europe and aims at increasing quality and efficiency of care to ultimately drive better outcomes for patients. The blueprint describes how to prepare hospitals for VBHC implementation, analyses gaps, barriers and facilitators and explores the most effective ways to turn patient pathways to a process that results in high value care. Using a patient centric approach, we identified four core minimum components that must be established as cornerstones and seven organisational enablers to waive the barriers to implementation and ensure sustainability. The blueprint guides through pathway implementation and establishment of key performance indicators in six phases, which hospitals can tailor to their current status on their way to implement VBHC.

Key Success in The Transformation from Volume-Based to Value-Based Healthcare: A Scoping Review

“…Another study mentioned that a set of Key Performance Indicators (KPI) for healthcare professionals need to be created to provide knowledge about all of the achievements/failures in health care. This way, the awareness of the importance of IPU can increase among the healthcare professionals (Annabathula et al, 2021;Cossio-Gil et al, 2022;Goretti et al, 2020;Heijsters et al, 2022;Nilsson et al, 2017;Nojszewska & Sielska, 2022;Varela-Rodríguez et al, 2021).…”

“…It is clearly essential to know how patients define value, otherwise the risk exists that care development will focus on what is easy to measure instead of what is most important and of greatest value to the patients. Some major factors affecting the implementation of measuring outcome and cost are (i) data infrastructure, (ii) a systematic approach for the identification of improvement potential and the selection and implementation of improvement initiatives, (iii) governance in which roles and responsibilities of physicians regarding outcome improvement are formalized, and (iv) implementation of outcomes within hospital strategy, policy documents, and the planning and control cycle (Ahmed et al, 2019;Allen et al, 2021;Amini et al, 2021;Bodar et al, 2020;Colldén & Hellström, 2018;Cossio-Gil et al, 2022;Goretti et al, 2020;Kuklinski et al, 2020;Lansdaal et al, 2022;Marotta et al, 2020;Nilsson et al, 2017;Ramos et al, 2021;Rutherford et al, 2021;Schraut et al, 2022;St John et al, 2021;Van Veghel et al, 2020;Varela-Rodríguez et al, 2021;Zipfel et al, 2019). In moving to bundled payments, many current initiatives have been successfully centered on creating bundled payments for surgical care to reduce cost.…”

“…time) placed on clinicians (and patients), particularly in fast-paced, business-oriented primary care settings who often see many patients in short periods. Furthermore, the IT platform should be able to provide a robust data warehouse where all the standardized outcome and cost data are integrated into the electronic medical record to give better visibility to healthcare professionals treating the patients and all other relevant stakeholders (Cossio-Gil et al, 2022).…”

Evaluation of the implementation of Value‐Based Healthcare with a weekly digital follow‐up of lung cancer patients in clinical practice

“…Third, leadership is an important enabler in the implementation process (Cossio‐Gil et al, 2021). In our study, the thoracic oncologists were the driving forces of the implementation.…”

“…Value‐Based Healthcare (VBHC) aims to maximise the value for patients by achieving the best outcomes at the lowest cost (Porter & Lee, 2013). Cossio‐Gil et al (2021) see four important areas in the roadmap for implementing Value‐Based Healthcare: (1) organise care pathways, (2) collect a set of outcomes, including clinical outcomes and PROs, (3) build an information platform and (4) actively use short‐term and long‐term outcomes for clinical decision and for improving care. Inspired by the principles of VBHC, a large Belgian hospital decided to optimise the care delivery for lung cancer patients.…”