A short introduction to value-based healthcare and how to start.
Hi there! Welcome to our first blog post. My name is Andries, I’m co-founder of Tiro.health and I want to discuss some of our foundational values with you. We have built an application for clinicians that supports them in documenting daily clinical practice. But who would need this? Isn’t this available yet?
All caregivers, including physicians, nurses, physiotherapists and many others are working hard every day to help people like you and me who happen to be in an unfortunate situation. We better make sure they receive all the support they need to do what they do best, guarding our health.
Nowadays, one of the biggest changes in healthcare is the shift from a fee-for-service to a fee-for-value system. This is explained in the value-based healthcare framework, introduced by two Harvard Professors Michael Porter and Elizabeth Teisberg in 2006.
What is value-based healthcare?
Fee-for-value is the cornerstone of value based healthcare. In this healthcare delivery model providers, including hospitals and physicians, are paid based on patient health outcomes. This is called “bundled payment”, a reimbursement of health care providers "on the basis of expected costs for clinically defined episodes of care”. On the opposite, in a fee-for-service approach, providers are paid based on the amount of healthcare services they deliver.
A team-oriented approach to patient care is fundamental in the Value-based healthcare model and sharing of patient data is crucial so that care is coordinated and outcomes can be measured easily.
Outcomes, the numerator of the value equation, are inherently condition-specific and multidimensional. For any medical condition, no single outcome captures the results of care. This makes it quite challenging for hospitals and management to implement. A “one-size-fits-all” approach will not work and dedicated tools are necessary if we don’t want to increase the administrative burden on our healthcare professionals.
As described in the article by prof. Porter: “Rigorous, disciplined measurement and improvement of value is the best way to drive system progress. Yet value in health care remains largely unmeasured and misunderstood.”
How can we start measuring value in healthcare?
Small steps can make big changes… And luckily for all of us, others with a common goal are willing to share their experience. The International Consortium for Health Outcomes Measurement (in short ICHOM) has defined global Standard Sets of outcome measures with the mission to unlock the potential of value-based healthcare. They bring together a multidisciplinary group of patient representatives, leading physicians, and registry leaders to prioritize a core set of outcomes, taking into consideration outcomes from different treatments. Through the implementation of these Standard Sets, you can begin to measure, analyze and improve outcomes achieved in the delivery of care.
Are stakeholders committed to implementing VBHC?
The Belgian government introduced its “Pay for performance program” (P4P) in 2018. Hospitals are financially rewarded if they achieve good results on a selected set of indicators. These indicators are a yardstick for the organization and processes within the hospital, the care provided, and the health outcomes of the treated patients. Is your country or hospital also orienting towards a VBHC approach? Get in touch so that we can grow this list!
Bringing the pieces together
Michael Porter and Elisabeth Teisberg laid out the fundamentals for a value-based healthcare delivery framework. Many organizations and scientific communities are involved with defining what to measure and its timing. However, its adoption and implementation in real-life practice remain challenging.
Tiro.health does not just offer a note-taking application. We have built a tool for clinicians to increase data quality, directly captured at the source & reducing their administrative burden in the process. Together with the healthcare professionals, we enable better outcome reporting to truly improve value for patients.
Want to learn more?
Check out these two New England papers on VBHC:
- What is value in health care?
- What is Value-based healthcare
Here you can find ICHOM’s standard sets
Read some additional information on the P4P program in Belgium.