Redefining quality through the lens of value-based healthcare
Outcomes is a way of talking about quality. However, quality has been a word that has created more issues than solutions in the healthcare world, as its definition has often been incorrectly used. In Steve Jobs words “quality is more important than quantity. One home run is much better than two doubles”.
Getting clarity on the definition of quality and how it gets delivered, should therefore be one of the main goals of medical technology companies. Focussing on that goal implies to be able to rethink the way they are organized to deliver care that maximizes value, as well as, developing the tools to be able to measure whether they deliver that value or not.
While true value-based healthcare remains in its infancy stages of practical implementation, many companies in the life science industries are showing great improvements in adopting value-based approaches. They focus on delivery models that follows the goal to provide the best possible outcomes for patients in relation to the costs related to the episode of care. They emphasize on providing high-quality care that are increasingly getting more effective, efficient, and patient-centred.
As a result, delivering true “Quality” through value-based healthcare is an incredibly important initiative which will have an increasing impact within the healthcare world going forward.
Taking the plunge into value-based healthcare: 3 golden rules
Leading medical device companies in value-based healthcare don’t see the same challenges that their followers do, and they have success through delivering on the following three key points.
- Organizing the value offer around the patient and the care givers
Medical device companies in value-based healthcare manage to put the patient and care givers at the center of care emphasizing on the use of data and evidence-based practices to guide decision and improve care delivery.
This is driving a more human approach to healthcare. They encourage healthcare providers to measure and track outcomes, collect patient feedback, and continuously learn and improve their processes.
- Leveraging the right technology to increase collaboration to decrease costs
Leading value-based healthcare companies are making sure that they are exploiting technology in the best way possible to deliver better services. This can take different forms. For example, many medical device companies have started to use consumer technology to improve the quality of care. Digital health integration can both advance healthcare and address patient needs before, within and beyond the healthcare system walls such as mobile health (mHealth) apps, electronic health records (EHRs), electronic medical records (EMRs) as well as telehealth and telemedicine. Also, AI is having major impacts on the healthcare industry by improving efficiency, cutting costs, providing information management and clinical decision support. The industry is expected1 to hit $150 billion by 2026.
- Harnessing the power of data
Data that are captured as part of normal operation processes often sits within the organization without being properly exploited for other purposes. Collecting and making use of actionable (smart) data is a key factor of success.
Data allows for the measurement and evaluation of the outcomes, including health outcomes, patient satisfaction, quality of life, and functional status. By analyzing data, healthcare providers can assess the effectiveness of interventions and identify inefficiencies such as treatment approaches, resource utilization, and costs. By understanding these variations, healthcare organizations can standardize best practices, reduce waste, and optimize resource allocation while supporting evidence-based practice.
Finally, data empowers patients to actively participate in their own care. Access to their health information, including test results, treatment options, and outcomes, enables patients to make informed decisions and engage in shared decision-making with their healthcare providers.
The opportunity is huge. The evidence is showing that it is having an impact on the way healthcare is delivered however, we are still in the early stages of progressing value-based healthcare.
True Value-based healthcare remains in its initial stages of practical implementation
Even though the procurement frameworks have been evolving since the 2014 Most Economically Advantageous Tender (MEAT) framework of the EU procurement directives and guidelines (2014/24/EU), it must be noted that healthcare and payment systems aren’t yet synch up to value.
Implementing value-based healthcare can be challenging due to four main reasons:
- Complexity of Healthcare and regulatory framework
Coordinating and aligning the interests and incentives of numerous stakeholders (healthcare providers, payers, manufacturers, and patients) around value-based procurement can be difficult. Value-based procurement requires healthcare providers to adopt a more patient-centred approach, collaborate across disciplines, and embrace continuous quality improvement.
Existing regulations and legal frameworks may not fully support or align with value-based procurement models. Addressing regulatory barriers, ensuring compliance, and adapting legal frameworks to facilitate innovation and collaboration can be time-consuming and complex.
- Data and evidence-based practices
Healthcare data is often fragmented. Standardizing data collection, sharing, and analysis is a significant hurdle. Also, measuring outcomes in healthcare is multifaceted and can be subjective.
- Mitigating risks and uncertainties
Value-based procurement introduces risk-sharing arrangements and alternative payment models. Calculating and allocating risks appropriately among stakeholders, such as insurers, providers, and patients, is challenging.
- Transition from Fee-for-Service
Many healthcare systems still operate under the traditional fee-for-service payment model, which rewards quantity over quality. Shifting to value-based procurement requires a fundamental change in reimbursement structures and financial incentives. This transition may face resistance and require substantial coordination among payers, providers, and policymakers.
Overcoming these challenges requires strong leadership, collaboration among stakeholders, robust data infrastructure, appropriate incentives, and ongoing evaluation and refinement of value-based procurement models.
Quality is the result of high intention
Value-based procurement is growing in maturity and the days of price as the unique factor influencing the buying process lie in the past. Instead, it is moving its focus towards quality, services and solutions.
How well did the patient do relative to how much it costs the healthcare system to deliver those outcomes? If today you have improved outcomes without escalating any cost, you’ve succeeded! If you have delivered equally good outcomes more efficiently, you’ve succeeded! If you didn’t do one of those two things, you failed delivering “Quality”.
In William A. Foster’s words “Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives”.