Value-Based Payments Require Valuing What Matters to Patients

Lynn, Joanne; McKethan, Aaron; Jha, Ashish K.

doi:10.1001/jama.2015.8909

Cited by 57 publications

(39 citation statements)

References 7 publications

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“…Significant issues in measurement of patient preferences and values exist. 213 These concepts are highly personal, and understanding the best methods for assessing them to allow both comparisons with other patients and medical decision making is needed. Like health status, preferences and values would need ongoing monitoring and updating to account for their dynamic nature.…”

Section: Patient Preferences and Values In The Lhsmentioning

confidence: 99%

“…218,219 Finally, a number of SDM tools focused on CVD care have been developed and tested in the emergency department, inpatient, and ambulatory settings. 213,220,221 Existing tools include decision aids for management of acute chest pain, hyperlipidemia, hypertension, AF, coronary heart disease, and congestive HF; however, although many tools have been developed and tested locally, the broader implementation of these innovations into routine clinical practice has been limited. 220 To spread these innovations broadly, the Center for Medicare & Medicaid Innovations has funded a number of grants to implement SDM.…”

Section: Patient Engagement With the Lhsmentioning

confidence: 99%

See 1 more Smart Citation

The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association

Maddox¹,

Albert²,

Borden³

et al. 2017

Circulation

118

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ABSTRACT:The learning healthcare system uses health information technology and the health data infrastructure to apply scientific evidence at the point of clinical care while simultaneously collecting insights from that care to promote innovation in optimal healthcare delivery and to fuel new scientific discovery. To achieve these goals, the learning healthcare system requires systematic redesign of the current healthcare system, focusing on 4 major domains: science and informatics, patient-clinician partnerships, incentives, and development of a continuous learning culture. This scientific statement provides an overview of how these learning healthcare system domains can be realized in cardiovascular disease care. Current cardiovascular disease care innovations in informatics, data uses, patient engagement, continuous learning culture, and incentives are profiled. In addition, recommendations for next steps for the development of a learning healthcare system in cardiovascular care are presented.H ealth care has never been more complex. Clinicians and patients must make decisions that integrate the continually evolving scientific evidence base with hundreds of individual data points such as patients' vital signs, symptoms, comorbidities, medications, test results, and preferences. Furthermore, once these decisions are made, little information is available about their impact, limiting the ability to learn from and ultimately improve care delivery. This inability of the healthcare system to learn from its operation results in significant inefficiencies, substantial costs, and suboptimal health outcomes.The creation of a learning healthcare system (LHS) can potentially address these issues. The LHS uses health information technology and the health data infrastructure to apply scientific evidence at the point of clinical care while simultaneously collecting insights from that care to promote innovation in optimal healthcare delivery and to fuel new scientific discovery 1,2 (Figure 1). Thus, the LHS enables rapid, iterative learning in which "evidence informs practice, and practice informs evidence." 2 The authors argued that recent advances in information processing and connectivity, healthcare organizational design, and reimbursement policies centered on quality rather than quantity of care provided the necessary tools for the creation of the LHS. Accordingly, they called for systematic redesign of the healthcare system, focusing on 4 major domains: science and informatics, patient-clinician partnerships, incentives, and development of a continuous learning culture.

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Section: Patient Preferences and Values In The Lhsmentioning

confidence: 99%

Section: Patient Engagement With the Lhsmentioning

confidence: 99%

The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association

Maddox¹,

Albert²,

Borden³

et al. 2017

Circulation

118

View full text Add to dashboard Cite

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“…The records Electronic health was formerly construct for the purposes of billing, not for quality improvement efforts and research (Hersh et al, 2013). For that reason, the influence of EHRs on the delivery of quality healthcare have concentrated on billing precision and physician performance (Lynn, McKethan & Jha, 2015). The studies of EHR mostly focus on procedure quality metrics, analyzing the variability of physician-level, and guideline compliance, more willingly than patient outcomes or general quality improvement (Harkema et al, 2011).…”

Section: The Role Of Ehrmentioning

confidence: 99%

The Role of Using EHR on Improving the Quality of Health Care in the Health Centers in Jordan

Okour

2018

IAM

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This study aims at investigating the role of EHR (electronic health record) on improving the quality of health care in the health centers in Jordan. A questionnaire was used as a tool to collect the primary data of the study out from the study sample that is consisted of (200) workers in the health centers in Jordan who were chosen randomly form all the job ranks in the health sector in Jordan. The study tool composed of four parts that examined the level of using EHR in Jordan, the effect of using it, the main challenges facing its implementation and the readiness that those centers have to have such technology in terms of human and organizational skills. The results showed that there is a high level of implementing EHR system in the health centers in Jordan, where those centers are equipped with the needed human and organizations skills. Reducing the effort, time, cost and affording safe treatment are the effects of implementing the electronic health record in the Jordanian health centers. The results showed also that the time spent and complicated interface are the major challenges facing implementing the EHR system.

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“…The importance of engaging patients in clinical guideline development is already recognised 19. Engagement is particularly important when decisions compare values (health, financial or otherwise) between individual patients and society 20. Yet, existing efforts at engaging patients in HVC appear mainly aimed at disseminating and translating recommendations created by professional societies to patients 21.…”

Section: Not Ethically Equalmentioning

confidence: 99%

Ethics and high-value care

DeCamp

Tilburt

2017

J Med Ethics

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High-value care (HVC) is en vogue, but the ethics of physicians’ roles in the growing number of HVC recommendations demands further attention. In this brief report, we argue that, from the standpoint of individual physicians’ primary commitments and duties to individual patients, not all HVC is ethically equal. Our analysis suggests that the ethical case for HVC may be both stronger and weaker than is ordinarily supposed. In some cases, HVC is not merely a ‘good thing to do’ but is actually ethically obligatory. In others, it is merely permissible—or even ethically suspect. More importantly, we suggest further that understanding HVC as ethically ‘obligatory, permissible, or suspect’ has implications for the design and implementation of strategies that promote HVC. For example, it questions the use of adherence to certain HVC recommendations as a physician performance metric, which may already be occurring in some contexts. Properly construed, ethics does not threaten HVC but can instead help shape HVC in ways that preserve the fundamental values of the medical profession.

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Value-Based Payments Require Valuing What Matters to Patients

Cited by 57 publications

References 7 publications

The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association

The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association

The Role of Using EHR on Improving the Quality of Health Care in the Health Centers in Jordan

Ethics and high-value care

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