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Deep Dive: High Value Care

6th November 2020

Evidence-based transformation in patient care  

 

Healthcare systems in Europe are struggling under growing, unsustainable demand for their services, but the solution cannot be more care - we must deliver better care. True impact in healthcare relies on meeting the patient needs that enhance their quality of life.

High Value Care (HVC) is the term used for the restructuring of healthcare delivery towards measurable outcomes that have high impact and matter most to patients. For this to occur, we need to set standards for measuring the right outcomes and incentivising the healthcare industry to pay for outcomes rather than services.

In response to the need to support healthcare professionals to drive transformation in healthcare systems, EIT Health has developed the HVC Forum. This strategic initiative is designed to help all stakeholders understand and adopt the measurable patient-focused approach that HVC demands through education, training and best practice sharing.

Join us at the EIT Health Summit Series on 26 November, where we will explore patient outcomes, how we can measure their impact, and why incentives are key to the successful adoption of HVC.

Hear from leading expert Dr Christina Åkerman (Dell Medical School) as she speaks to Pieter de Bey (Santeon) about how bringing patients into the decision-making process has improved treatment outcomes. Following this, Dr Henk Veeze (Diabeter Nederland) and Dr Jan Hazelzet (Erasmus MC) will discuss incentives and rewards in this space. 

Dr Christina Åkerman

Christina Åkerman is a medical doctor and specialist in clinical pharmacology. She is affiliate faculty at the Dell Medical School, a senior advisor to EIT Health, a senior institute associate at Harvard Business School, and on the steering committee of the Coalition for Health, Ethics and Society at the European Policy Centre.

Until August 2018, she was the president of the International Consortium for Health Outcomes Measurement and has also served as director general for the Medical Products Agency in Sweden and been a board member of the European Medicines Agency.

In this short video, Christina introduces herself and outlines some of the core content that will form her EIT Health Summit Series session, including the importance of establishing payment models and what this means to the culture of an organisation.

A Framework For Implementation

Discover how leading healthcare pioneers have already made the switch to HVC and access the EIT Health implementation matrix in the Implementing Value-Based Healthcare In Europe report – a framework to guide the successful implementation of HVC in real-world settings.

Pieter de Bey & Santeon

Pieter de Bey is managing director of the Santeon hospital group and is responsible for executing strategy via shared programmes across seven member hospitals. Santeon’s guiding principle is value-based healthcare; a subject which Pieter has extensive expertise in, and is extremely passionate about.

Santeon is a Dutch group of seven private teaching hospitals. With 29,000 employees, Santeon delivers 11% of the nation’s hospital care volume. Starting in 2016, the seven locations began working together to measure and compare outcomes, costs and relevant process indicators across five patient disease groups, including breast cancer.

In the 18 months after implementing its HVC plan for breast cancer, Santeon reduced re-operations due to complications by up to 74% at some locations, and unnecessary inpatient stays by nearly 30% across the seven hospitals. Santeon achieved these results in just one-and-a-half years by following clinical guidelines while also emphasising transparency and open benchmarks across medical teams.

This case study illustrates how Santeon succeeded in creating a learning community of hospitals where clinician-level data could be shared transparently without fear of punishment or retaliation, making value-based improvement possible.

EIT Health’s HVC Forum

EIT Health’s HVC Forum helps healthcare professionals and providers drive transformation in healthcare systems. Our resources help them to understand and adopt the measurable patient-focused approach that HVC demands.

Having identified a lack of adequate training opportunities around the implementation of HVC, the HVC Forum is addressing this need by providing education and training for healthcare professionals, patients, families and carers, decision-makers and policy-makers, as well as sharing best practice about how to implement HVC.

In this video, Jan-Philipp Beck (CEO, EIT Health) and Dr Christina Åkerman introduce the HVC Forum.

Dr Henk Veeze & Diabeter Nederland

Henk Veeze worked as pediatrician for 20 years. In 2006, together with fellow pediatrician Henk-Jan Aanstoot, he started Diabeter Nederland to provide better, complication-free care for children and young adults living with type one diabetes.

Diabeter’s Dutch group of certified clinics was acquired by Medtronic in 2015, marking Medtronic’s first entry into an integrated care model focused on diabetes. This strategy offers more than pumps and sensors, but rather a holistic diabetes management solution focused on patient outcomes and costs.

In 2019, Diabeter cared for more than 2,400 patients in their five locations across the Netherlands. The Diabeter outpatient care model includes four visits per year, virtual consultations, clinical and administrative staff services, a 24-hour medical hotline, lab costs, data platform and sensor equipment.

As this case study shows, Diabeter operates as part of Medtronic, but maintains its professional autonomy and independence in clinical decision-making, therapy and brand choice, to ensure that patient care and patient data remain in the hands of clinicians.

In this video, Henk talks about the importance of focus, and how better patient pathways also benefit the payer.

Case Studies

The following case studies show how leading healthcare pioneers have already made the switch to HVC, supported by EIT Health’s HVC Forum.

Basel University Hospital – public hospital case study

As one of five Swiss university hospitals in the country, Basel University Hospital (USB) was the first to implement HVC in 2016. With a staff of 7,200 employees and a budget of €1 billion in 2018, USB treats nearly 38,000 inpatients and one million outpatients every year. As a tertiary care facility, USB offers prolific translational research activities in partnership with leading life science companies.

GLA:D – not-for-profit case study

Founded in 2013 by a research team from the University of Southern Denmark, Good Life with osteoArthritis in Denmark (GLA:D) is a non-profit organisation training and certifying physiotherapists to deliver neuromuscular exercise to patients with osteoarthritis. With more than 800 sites and 1,300 certified caregivers across five countries in 2019, the GLA:D initiative has helped 50,000 patients to maximise outcomes. GLA:D supports the application of exercise as first line treatment. It has built an outcome-based registry, enabling a learning community of care-givers around the design of non-invasive care pathways engaging patients and reducing unnecessary surgeries and imaging.

NHS Wales – health system case study

The National Health Service (NHS) Wales delivers universal healthcare for 3.1 million Welsh residents with a 2019 budget of £7 billion (€8.2 billion). In 2014, the Welsh Minister for Health and Social Services launched a policy called Prudent Healthcare, focusing on co-production with patients, equity, reducing over-medicalisation and unwarranted variation in care. Subsequently, high value care has become a vehicle for delivering Prudent Healthcare under the overarching policy of A Healthier Wales. To implement this plan, NHS Wales created a national HVC team led by Dr Sally Lewis, with the ambition “to improve the health outcomes that matter most to the people in Wales.”

Dr Jan Hazelzet

Jan Hazelzet is professor of healthcare quality and outcome at Erasmus MC. His main topic of interest is value-based healthcare leading to patient-centric solutions with the best outcomes and lowest costs. This focus is also expressed in his role as clinical lead of the Erasmus Centre for Value-Based Healthcare where he develops and implements strategies for driving demonstrable improvements in the value delivered for patients.

Jan is also a member of the NFU Quality of Care Consortium - a joint effort by eight Dutch university medical centres to improve healthcare quality by stimulating learning, research and education in the field of patient-centric care and improved outcomes.

In this session preview, Jan proposes that value-based healthcare is about much more than just measuring the outcomes; it’s about implementation, a team-based approach and continuous improvement.