Introducing a method for implementing value based health care principles in the full cycle of care: Using atrial fibrillation as a proof of concept

ABSTRACT

Background: Value Based Health Care (VBHC) is a well-known strategy in most countries, amongst whom the Netherlands, to improve patient-relevant outcomes and reduce healthcare costs. However, a methodology to implement VBHC principles in the full care cycle is lacking. This study describes a stepwise approach to implement and continuously improve patient-relevant outcomes in the total care delivery value chain.

Methods: Key principles of VBHC are used to develop a stepwise methodology in which healthcare providers of primary, secondary, and tertiary care collaborate in a physician-driven initiative called the Netherlands Heart Network. The methodology incorporates the Plan-Do-Study-Act cycle to ensure continuous improvement of patient-relevant outcomes. To outline the presented methodology, the medical condition atrial fibrillation is used as a proof of concept.

Results: Using the stepwise methodology results in an adequate registration of patient-relevant outcomes and a structured evaluation of adherence to prevailing guidelines. Based on the followed methodology, detailed improvements are defined in order to optimize patient-relevant outcomes.

Conclusions: The presented methodology provides a description how to implement VBHC principles in the full cycle of care. Since this methodology is a first concept, future research should apply and assess the stepwise methodology in other fields and for different medical conditions.

KEYWORDS:

• Value based health care
• PDSA cycle
• patient-relevant outcomes
• full cycle of care
• atrial fibrillation

Acknowledgements

The Netherlands Heart Network is supported by various medical industries (i.e. Medtronic, BMS Pfizer, Bayer, Boehringer Ingelheim, Abbott, Roche Diagnostics, Novartis, Servier & Vifor Pharma). However, the sponsors of the Netherlands Heart Network were not in any way involved in the writing of this manuscript.

Disclosure statement

Besides the funding of the medical industries, the authors declare there are no conflicts of interest.