What are the essential building blocks of value-based care?
To align processes and incentives, one of the initial steps towards value-based care is the standardized measurement of (patient-reported) outcomes related to costs per capita. You start by measuring outcomes that matter to a particular population segment, and then apply those insights to tailor and improve interventions across the care pathway. This forms the basis for promising care pathway innovation and lean process optimization that is really gaining momentum in healthcare. However, the all-important final piece of the puzzle comes in allocating an objective payment that is weighted according to how well the system performed for the patient.
Historically, in health systems defined by silos, fragmented ways of working, and legacy IT systems, this approach has been difficult to implement. Another challenge: as health systems and medical processes first went digital with Electronic Health Records, clinicians soon found themselves overwhelmed by data and unable to understand and interpret large swaths of digital information.
Leap forward a few years and I am pleased to say that, as digitalization of healthcare gathers momentum, the situation is quickly improving. Moreover, I am convinced that we have a golden opportunity to standardize and bring meaningful scale to value-based care. The reason I am so optimistic: the steady integration of sophisticated health informatics.
Best characterized as powerful data analytics networks, health informatics connects clinical processes and workflows end-to-end. And importantly, with the right configuration and data visualization capabilities, informatics can enable clinicians to interpret information from multiple sources and inform decision-making in real time.
The positive impact for a value-based approach is three-fold:
- Firstly, integrated health informatics can support medical staff in their decision-making, teamwork and communication – driving clinical excellence to new heights.
- Secondly, health informatics helps connect operational processes – system administrators can analyze and optimize almost every operational aspect of the health system.
- Finally, and significantly for value-based payments, health informatics can support the systematic measurement of patient-reported outcomes. This is critical to drive the performance-based payments and to incentivize much needed gains in quality, safety, and patient-centricity.
It’s complex work that requires all stakeholders in the system (clinicians, administrators, technicians, technology partners and supply-chain partners) to commit to the “measure, optimize, repeat” lean methodology. And there are also platform and systems integration challenges to be overcome. For example, seamless connectivity requires a common architecture that integrates hardware (databases and devices), software (analytics tools) and services around interoperable and secure data formats.
While not insurmountable, these factors are slowing adoption and scale. The healthcare industry must confront and overcome these issues, especially as the medical Internet of Things (IoT) reaches maturity along with next-generation 5G connectivity.