Value based healthcare systems: a new healthcare management model | Tucuvi

Changes in supply and demand of health services, together with the increase in their associated costs, are affecting the sustainability of healthcare systems. This is resulting in an increased tendency to change the focus of care towards a model that is based on results and generating value for the patients.

This transition, however, is a slow and complex process that requires structural changes in our current healthcare systems. In order to implement this model, one of the first necessary steps is the introduction of metrics for the intensity, cost and quality of care based on information analysis.

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A change in healthcare systems is needed

The past few years have witnessed a series of changes in the supply and demand for healthcare services. In terms of demand, these changes are driven by several factors, such as population aging, the increased prevalence of chronic illness, multimorbidity or new patient profiles. On the other hand, healthcare supply is being influenced by the increase of the cost of health services, accelerated innovation in bio-medical technologies and an increase in digital disruption, among other aspects.

These changes, paired with an increase in demand of assistential services, are having a great social and medical impact, while also affecting the sustainability of our healthcare systems. At the same time, patients’ expectations are growing in terms of the quality and efficacy of the care they receive, while reducing costs and increasing accessibility for the entire population.

This new reality is driving us to develop new tools, explore new management models and implement initiatives to transform our healthcare system. A key aspect of this goal is the need to refocus medical care in such a way that the main priority is the creation of value for the patient.

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Value-based healthcare systems

Value-based healthcare systems are medical models in which the patient is at the center of the service. In other words, these models center their focus on the needs of the patient and on the generation of value for them.

In these models, medical attention is motivated by a constant focus on obtaining results that matter to the patient. Therefore, the main concern is not the quantity of services provided, but rather their quality as well as the value that they generate.

Value-based healthcare aims at refocusing medical systems to achieve an improvement in the patients’ satisfaction levels, whilst maintaining an optimal relationship in terms of costs and quality of attention. Within this framework, value is understood as the global result in health relative to the quality of care and its integral cost.

This new approach demands a broader focus, in which particular importance is given to the health of the general population and to preventive healthcare, as well as to integral attention and continuity of care.

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Main advantages of value-based healthcare systems

Value-based healthcare systems seek to achieve an optimum balance between high quality of care, high quality of life and sustainable costs. The main benefits are:

• Increased quality of medical care and better results. By making the patient the central focus point, preventive strategies can be developed that increase the quality of life of the general population. Managing chronic illness becomes an important priority, a task for which these systems are suited as they can foresee and handle the patient’s needs.

• An increase in patient satisfaction, since the quality of care increases and their needs and expectations are at the center of the process.
• An increase in the information that patients receive, since they are given the opportunity to participate in the clinical decision process, promoting self-care and knowledge of their own illness.
• An overall healthier society. These models result in a more efficient and, most importantly, more sustainable healthcare system.

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Implementation of value-based healthcare systems

The implementation of value-based systems is a challenge whose success hinges on the participation of all involved agents. To be able to move towards this type of healthcare, the following points must be taken into account:

1. The goal of clinical practice must be the improvement of people’s health.
2. Attention needs to be focused on the early stages of an illness and on lower risk levels, moving towards the promotion of health and early disease prevention.
3. Medical assistance must be organized according to patient diagnosis and the characteristic cycles of their illness.
4. Value is created from the interaction between patients and their families, together with the healthcare professional teams.
5. Creating value is a multidisciplinary task in which professionals must adopt collaborative practises which are centered on the patient.

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For the patients, value-focused systems imply safer and more effective care, with better results and a better quality of life. As for health providers, the new model implies the usage of evidence based medicine, together with treatments and techniques with proven effectiveness that can take the preferences of the patient into account.

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Challenges, technology and innovation

Despite the advantages offered by value-based care, its implementation is complex and requires deep transformations on many levels. One of the issues that are often encountered is the differences in perspective between patients, professionals and the healthcare system itself as to what the exact meaning of “value” is, and how it should be measured. The difficulty lies in the fact that quality of care is a subjective and relative parameter, whilst the real cost of the provided assistance is a complex variable to measure accurately.

This uncertainty highlights the need to continue to innovate and to establish clear measuring criteria for the quality and the real cost of medical assistance. In other words, the standardization of metrics is key in order to be able to compare the results obtained for each patient, independent from the hospital or service they are assigned to.

In this sense, technology has an increasingly important role, especially in terms of data collection and processing in the medical context. Along these lines, we can highlight the digitalization of data gathering standards and their posterior aggregation, added to the development of support tools for the healthcare professional’s decision making processes.

To achieve a value-based healthcare model, implementation isn’t enough. It is also essential to promote and incentivize its use within the care process. On top of easing access to adequate tools and information technologies, it is essential to create an evidence based data analysis and management culture that allows the placement of the patient at the center of our healthcare system.

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How Tucuvi promotes value-based healthcare

At Tucuvi, we work hard to answer the healthcare system’s needs, helping professionals plan their patient’s care in a more efficient way.

Lola, our virtual assistant, enables remote monitoring of patients in a structured way and with alerts. This increases the ability of medical teams to optimize their work, centering their efforts on patients that require more intensive care. This way, one of the benefits obtained from our followup system is the reduction of the assistential load on professionals, while at the same time increasing continuity and quality of care for the patients.

Furthermore, the fact that our protocols are customizable, both in terms of symptoms and alerts, allows us to cover a wide range of patient cases and adapt to their needs. Therefore we can offer a personalized attention that provides peace of mind, security and company, to both patients and their families.

This way, Tucuvi is integrated in the care process as a support tool for professionals, helping them control the clinical evolution of their patients and improving medical assistance at their homes.