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What is value based care and why do we need it?

Value based care is slowly becoming prominent within the Australian healthcare system. It's underlying premise is about ‘handing over the reins’ to the patient, giving them optimal care, delivered by the best medical professionals.

What is value based care?

Value based care is a theory developed by Michael Porter, Harvard University Professor in 2004. He released his findings in his book Redefining Health Care Creating Value-Based Competition on Results which was published in 2006, co-authored by Elizabeth O. Teisberg.

Value based care focuses on competition and improvement. The Harvard Institute for Strategy and Competitiveness explains.

"[Porter and Teisberg] proposed a single unifying goal for health care: to deliver value for the patient. Based on their extensive research, they proposed that to achieve value for patients, health care delivery needed to be organised around the medical conditions patients have, accurately measure the outcomes that matter to patients, and measure the cost to achieve them.

"Payment should reflect value and not volume. Networks of care that perform the right services, at the right location, with the right people are essential, and linked with an information technology system that supports all of those mutually reinforcing elements."

In the present healthcare environment, the value based care model is being favoured for increasing efficiency and relieving pressure on a practice’s bottom line.

"A successful transition to value based care requires that market players and consumers move beyond transaction-based treatment to the holistic health of populations." – Deloitte

Elements of value based care

According to Professor Porter there are six elements necessary to value based care.

1. Organise care around medical conditions: Care delivery is organised around patients' medical conditions or segments of the population.

2. Measure outcomes and cost for every patient: Outcomes and cost are measured for every patient.

3. Aligning reimbursement with value: Reimbursement models that reward both better outcomes and efficiency of care, such as bundled payments.

4. Systems integration: Regional delivery of care organised around matching the correct provider, treatment, and setting.

5. Geography of care: National centres of excellence providing care for exceedingly complex patients.

6. Information technology: An information technology system designed to support the major elements of the agenda.

Since its introduction in 2004 through a Harvard Business Review article, there has been a global uptake in implementation of these elements. According to Harvard there has been an increase in peer-reviewed publications addressing value based healthcare.

Value based healthcare in Australia

The cost of delivering value based healthcare in Australia is on the rise as a result of patients becoming more confident in demanding personalised, affordable services from local clinics.

As such, physicians and clinics need to look for new strategies to ensure the continued viability of their organisations by turning to patient care models that increase efficiency and ultimately relieve pressure on their bottom line.

Better Safer Care Victoria explains value based healthcare could help the Australian healthcare system with a number of challenges. These include;

- A growing and ageing population
- Increasing rates of chronic disease
- Health inequality in the population
- Rising healthcare costs
- Unwarranted variation in care and health outcomes
- Increasing patient expectations.

While Australia hasn't implemented it holistically there are a few state departments who are using this framework to help with combatting some chronic diseases. There is a statewide uptake in NSW and there have been successful pilots in cancer and dental care in WA and Victoria respectively.

NSW has the Leading Better Value Care (LBVC) program. According to the LBVC, it is one of the programs accelerating the NSW Health move to value based healthcare. It is a statewide priority program that aims to improve the health outcomes and experiences of people with specific conditions or risk factors.

For example, the NSW state government is using a value based healthcare system for diabetes prevention and awareness. According to the NSW health department, the initiative focuses on supporting people to manage their diabetes and minimising their need for acute care.

This is done through defining and measuring common outcomes that NSW Health and its partners will work towards, identifying and applying best practice models and care pathways across the state better, coordinating care and building capability in care providers and organisations.

The benefits of cloud in value based care

Cloud technology enables better value based care as it provides security and advanced technological care.

Ruud van der Loo, explains on Atos, enterprise health clouds help healthcare organisations to become agile businesses. A cloud can allow them to both “drive patient insights with advanced analytics,” and to “engage customers with applications designed specifically for their needs.”

Cloud technology aids in keeping in contact with the patient through their journey and prevents loss to follow up.

Cloud technology is helping healthcare organisations move towards value based care payment methods, says Out Systems. This means collaboration between doctors, departments and institutions are pivotal.

Medical providers can transfer data between each other through a cloud computing server, boosting cooperation for better treatment.

Other benefits of the cloud in value based healthcare include:

- Eliminating the excessive administrative workload that is burdensome to your team.
- Introducing smarter information collection and sharing, thus improving the speed of patient care.
- Freeing up time for face-to-face patient care.

Key steps to achieving value based healthcare

Clinic to Cloud’s CEO Rafic Habib recently outlined 3 key ways to achieve value based healthcare:

1. Adopt a patient-centric healthcare model: A patient-centric care model embodies the notion of patients as owners of their medical data and as active partners in their health. This gives them more opportunities to be involved in their healthcare journey, and, through the use of technology, allows different care providers to all come together in a connected care ecosystem.

2. Improve patient care through technology: Outdated workflows and technologies are inefficient and can cost your practice time, money and stress. The Australian Productivity Commission agrees, finding inadequate data flows prevent clinicians from delivering value-based patient care, leading to the delayed adoption of improved processes and revenue saving lessons.

3. Document processes to establish accurate benchmarks and allow for ongoing analysis: When a patient leaves a consult, what do the next steps of their treatment look like and how involved are your clinicians across the entire patient journey? How long does it take to treat a patient? What does the average medical bill look like (and how much)? Documenting processes and outcomes gives you long-term insights into the steps, costs and measures required to achieve better patient outcomes and run an efficient practice.

Value based care and Clinic to Cloud

Clinic to Cloud supports the notion of value based care as it rewards those medical professionals who strive to achieve the best for their patients. It also helps patients have the best medical care possible.

Adopting the correct mindset is as important as investing in technologies that support sustainable growth - thinking like an entrepreneur is pivotal in improving patient experience and boosting financial outcomes.

Our cloud-based software will also help those in value based care as Clinic to Cloud can capture data to help value based care.

Clinic to Cloud also allows for medical professionals to access data whenever they need it, the ability to view financial specifics in real-time and makes communication between patient and doctor easy.

For more information on Clinic to Cloud and how it can help transform your practice click here or contact us today.

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Tony Tibben
Tony Tibben is the State Lead for NSW/ACT at Clinic to Cloud. Tony has spent close to a decade in the healthcare industry; working closely with practitioners, health professionals and practice managers. More recently Tony has studied change management as part of his MBA, igniting a passion and drive to help overcome the multitude of challenges faced by people working in healthcare and a rapidly changing world.