Value Based Health Care
Comprehensive cancer care requires the coordination of multi-disciplinary specialties that is affordable, accessible and able to continually improve patient outcomes. The goal of value-based healthcare (VBHC) is to improve patient health outcomes while reducing the overall cost of healthcare. It is therefore necessary to collect clinical outcome measures in conjunction with outcome measures important to patients so as to monitor and improve both individual and system outcomes.
Health care services currently measure value as short-term cost-saving cycles which focus on the clinical absence of disease rather than enhancing long-term patient outcomes. To achieve the best outcomes for patients, whilst curbing costs, stakeholders are promoting a shift to a more transparent, value-based approach to service delivery, payment, and policy. In recent decades, there have been significant improvements in cancer care. Despite this, the present cancer care pathways remain fragmented. Silos between services create barriers to the implementation and integrated delivery of programs already known to be effective. Those engaged in cancer control agree that effective communication between health professionals with greater access to relevant, timely information would significantly improve outcomes for cancer patients. In addition, data collected by health services generally only reflects one dimension of cancer care. Whilst it is important to assess the quality, safety and cost of service delivery, the tangible effects of the service on the wellbeing of patients and their families are largely unreported. Thus the goal of value-based healthcare (VBHC) is to focus on improving patient health outcomes while reducing the overall cost of healthcare.
While many patient outcome measures exist, these are usually assessed independently from routinely-collected clinical outcome measures, and are not disease-specific, nor are they universally-applicable. The International Consortium for Health Outcomes Measurement (ICHOM) have developed a number of standardised datasets to measure clinical and patient-oriented VBHC outcomes in cancers of the lung, breast, prostate and colon. ICHOM is non-profit organisation comprised of leading health experts and patient stakeholders worldwide. Each medical condition-specific dataset consists of previously validated clinical- and patient-based quality-of-life questionnaires, a measure of co-morbidity, survival and treatment-related complications. These data are intended to be collected routinely during clinical management and follow-up. Additionally, the utilisation of a standardised dataset can provide a benchmark for patient outcomes to which new treatments are compared against for effectiveness and cost-benefit.