'Focus on the patient and the rest will follow'

Stakeholders at the Evening Keynote virtual session, ‘From Volume to Value – A Paradigm Shift’, at the HIMSS & Health 2.0 European Digital Conference, agreed that striving for quality requires a fundamental shift to value-based care.

The session moderator, Jens Grueger, president of the Professional Society for Health Economics and Outcomes Research (ISPOR), defined value as “outcomes that matter to patients over cost”.

The virtual panellists were Dr Valerie Kirchberger, head of the value based healthcare team, Charité Hospital, Germany, Professor Janne Martikainen, school of pharmacy, University of Eastern Finland, Finland and Hans Winberg, secretary general, leading health care foundation, Sweden. 


The proposed model would focus on value and quality of care in the interests of the patient, which according to the panellists would improve clinical outcomes and reward healthcare providers. In a traditional, volume-driven, model, for example, patients get treatment and pay for the treatment at specific points. In a value-based care model, patients receive treatment, with major systematic differences. For example, the hospital might be contracted to oversee the patient’s treatment pathway for the next five years and there would be reimbursement for patient care and add-on payments for the prolonged period. According to Jens Grueger, measurements of value could include clinical impact on patients, net costs, productivity, reduction of uncertainty, insurance value, severity of disease, value of hope, equality and scientific spill-over.     


Hans Winberg, leading health care foundation in Sweden, strongly believes networks should be organised around patients. And he insists that local developments need local data, not generalised indicators, However, he acknowledges that it can be difficult to standardise values because healthcare is contextual and chronic diseases, for example, do not always conform.

Professor Janne Martikainen, University of Eastern Finland, said that data driven insight supported service design for services such as chronic care management, which led to better health outcomes. He said future value equalled innovation in outcomes and “personalisations”. He added: “We need locally, clearly defined, outcomes and measurement standards.” And he agreed there was a need for value-based payment models.

Dr Valerie Kirchberger, Charité Hospital, Germany, believes the number, and complexity, of surgeries are more important than just outcomes. She said there were still obstacles to implementation of value-based care In Germany: “It is a no-brainer but the healthcare industry is a very conservative and hierarchical industry, and for us to shift our view and say, this is actually about the patients, then leads to the idea that it is about outcomes for the patients.

“But at the moment we are very self-centred and thinking inside, about me and my speciality, and this is the reason we are a couple of decades behind other industries and understanding that good quality is actually a competitive advantage.”

Hans Winberg agreed healthcare was lagging behind other industries: “I could remove all the waiting lists in Sweden in one day, by just raising the price, but that is not an option, which means that there are things in other industries that are not options within healthcare, and that actually causes trouble.”  

Dr Kirchberger said her take-away message from the session would be: “Focus on the patient and the rest will follow”.

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