Kick-off meeting of the TOWWERS showcase project: 1^st collaborative value-based healthcare anchored on real-world data involving the 5P+

Figures & data

Figure 1. A transformation system moving from a sickcare toward collaborative value-based healthcare anchored on RWD.

*RWD composed of economic markers

** RWD composed of economic and health markers customized for specific therapeutic indications

Table 1. Thematic summary of stakeholder (5P+) Statements

Theme	Stakeholder Insight
Privacy and Security	Security is a serious issue
Need for Real World Data	There is a clear need for RWD. We must establish a process to overcome this hurdle in order to move forward. This point was endorsed by all committee members. Decisions currently taken based on results of clinical trials could be greatly improved by the availability of RWE via a dashboard detailing the patient’s overall treatment. There are no tools in Quebec presently to collect RWE
Accessibility to Integrated Patient Data	The main weakness of the healthcare system is the difficulty in accessing data. Pharmacists can have access to patient information only within the confines of a GMF (family medicine group). Family physicians have difficulty understanding the reports of specialists. We need to see the data over the long term, rather than the short-term data from demonstration projects. Existing electronic records do not interact with each other [14]. Health practitioners require access to health outcomes to measure the efficacy of their therapeutic plans which involve behavioral interventions as well as prescription medications. A platform accessible to all health professionals, to link their documentation, would be highly beneficial. Pharmacists could assist with documentation of patient compliance Professionals want to monitor the care they are administering as well as their patients’ adherence; if they note that a patient in non-compliant, they recognize that they need to change the treatment plan.
Patient-centredness	Patient-centeredness must be applied in the context of a VBHC system We must identify the needs of patient to determine value. Developing partnerships with the patients would allow health care professionals and the system to become more patient-centered
Interdisciplinary Effective Healthcare Team	There is little evidence of concrete interdisciplinarity. Team members are unaware of the responsibilities of the other members [8]. The Quadruple Aim [15,16] which includes Care Team well-being as a key component to a quality healthcare system, as reflected in personnel shortages during Covid-19 which reduced patient access to care.
Value Based Healthcare and Innovation	The practical application of VBHC will demonstrate its value. We must measure costs in the trajectory and identify an optimal healthcare pathway. Quebec is in a good position for transition as it has a culture of measuring and gaining a clear vision, underlining the importance of evidence-based data. Resistance to measurement is based on a perceived sense of judgment by some practitioners and is not understood as continuous quality improvement. We are working in silos [8,14] and that there is much work to be done. Costs are currently considered in silos and not in relation with the value of each innovation and that this culture needs to change

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