The world is in a dire need of creating a more sustainable and efficient healthcare system that delivers value to its patients and improves the overall wellbeing of the entire community it serves.
Value-based healthcare may seem like a novel idea, but it has been around for more than twenty years, helping medical centres, pharmaceutical companies and insurance companies to have the greatest impact on patients while improving cost-efficiency in health care services.
What’s Value-Based Healthcare?
Value-Based Healthcare is a transformational concept whereby health care providers are compensated for the health and well-being of their patient population rather than for services rendered.
This paradigm shift began in the heavily privatized healthcare landscape of the United States of America, but has spread around the world over the past couple of decades, adapting to different systems and philosophies.
To put it shortly, value-based healthcare puts the positive health outcomes of the patients at the top of the pyramid of priorities.
What’s a Health Outcome?
Health outcomes are an interrelated set of attributes that describe the consequences of disease for an individual. These include impairments, symptoms, functioning, participation in activities and social roles, and health-related quality of life.
Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being.
The paradigm shift made real
Although this may seem counterintuitive to many, traditional approaches to healthcare assume the task of improving patient wellbeing as a given and let it rest on the shoulders of doctors and other professionals.
By putting all the focus of the system on curing the disease and forgetting about any other part of the healing journey, traditional healthcare systems often ignore the importance of rehabilitation or prevention in an effort to maximize profit or reduction of costs.
Ironically, this approach often forgets about the added cumulative cost of a bad rehabilitation program or the lack of prevention campaigns in the population.
However, the paradigm shift that comes with value-based healthcare is not a mere theoretical concept still far away from our reach, but a reality in many medical centres and systems that are putting into practice some of the following principles:
1. Speed up the connection between scientific progress and patient care
The main goal of value-based healthcare is to improve the community’s overall health. To achieve this, it is of vital importance that, while keeping the necessary safety procedures in place, we speed up the application of cutting edge scientifical advances to the medical field.
There is a plethora of knowledge being generated by our best researchers that is either being under-utilised or totally unknown, as most medical professionals don’t have the time to keep up to date with the progress made in their field.
A good example of this phenomenon is artificial intelligence, a field that has been experiencing exponential growth over the last couple of years and which is finding incredible applications for these developments in many areas of medicine.
Yet despite this, many doctors, driven by fear, complacency, or lack of knowledge, refuse to add this new tools to their toolkit.
2. Re-think the traditional profit-focused model of the pharmaceutical industry
The pharmaceutical industry is one of the main pillars of our modern healthcare system, and plays an essential role in ensuring the safety and health of the population. Trying to build a value-based healthcare without the cooperation of these companies is a futile endeavour.
This is why, the current profit focused business model of many pharmaceutical companies must change in order to achieve a fully sustainable yet competitive value-based healthcare.
While this is particularly evident in the US market, where drugs such as insulin have become prohibitively expensive for patients, insurance companies and health centres alike, it is a reality that extends to all the corners of our globalized world.
Focusing on positive health outcomes will allow pharmaceutical companies to maintain their profit margins while helping to build a more healthy future for all of us.
3. Align the interests of patients and health care providers
One unsustainable reality of our current healthcare system is that having a patient is more profitable for the medical centre than not having one, while obviously the patient is better off not being sick at all.
This ambivalence needs to end in order to achieve a value-based healthcare. And until we can make all diseases and health problems magically disappear, we must make sure the interests of the health care providers are properly aligned with the patients’ needs.
4. Reduce the cost, improve the quality of care
One of the big paradigm shifts for most medical centres is transitioning away from filling hospital beds to creating a healthier community.
With this cost reduction, it must be borne in mind that medical centres should focus on providing better care, not more care. Getting rid of redundancies, streamlining the derivation process, speeding up the diagnosis and reducing the rate of misdiagnosis are key goals of the value-based healthcare roadmap.
Additionally, the pandemic has shed a light on the idea of telemedicine and its potential benefits to both the public and the healthcare community. Those who take advantage of these emerging technologies will be at the forefront of developing sustainable and profitable value-based healthcare.
5. Focus on the social determinants of health
Lastly, it is important to keep in mind the social determinants of health. Problems such as obesity, tobacco addiction, alcoholism, or opioid abuse cause most health issues, especially in the long term. Preventing and controlling this kind of factors, not only through conscientization campaigns but also through the day-to-day fieldwork of the doctors, is a key step towards ensuring a healthier population.
We cannot forget about other social issues that plague our modern society and might impact the health outcomes of the patients, such as unemployment, poor housing conditions, lack of nutritional and health education or difficulties in accessing certain technologies.
While our healthcare system cannot solve all these kinds of issues, it is important that doctors, insurance companies and medical centres are mindful of them in order to provide value-based healthcare that benefits us all.
Evidence-based medicine: how Legit.Health is leading the way
Evidence-based medicine is fundamental to the delivery of high quality and effective medical care. However, it is a process that requires time, resources and expertise. That’s why Legit.Health is leading the way in implementing artificial intelligence (AI) solutions in healthcare, specifically in dermatology.
This tool can prioritise the most urgent cases, allowing patients to receive the necessary care at the right time and reducing waiting time. In addition, the tool helps to remotely track pathologies and improve education and training for primary care. It also personalises treatment for each patient according to the severity of their skin pathology. All this contributes to improving the quality of medical care and optimising available resources.
The paradigm shift of value-based healthcare is already happening on multiple fronts across the world, and the current debate is not so much about whether its principles should be applied, but how to apply them.
The healthcare community continues to work towards a brighter future where the well-being of the patient is the top priority of all parts involved in the care cycle. And it is our duty as professionals in this sector to continue working to improve the systems that take care of our health.
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