Runners-Up VBHC Prize 2019

Part 1

Meet our inspiring Runners-up of the VBHC Prize 2019:

PROM Project for Stroke patients treated with thrombolysis. 

The aim is to qualify the dialogue at the 3 months follow-up and qualify if the MRS can be achieved from the PROM data and by extension of this, allocating resources based upon the need of the individual patient. To see, meet and handle every patient according to his or hers individual needs.

For more information about Aalborg University Hospital: https://aalborguh.rn.dk/

Implementing VBHC – a qualitative interview study of four pilot project teams experiences during two years. 

The aim of this research project was to describe and analyse the project-team members’ experiences of the implementation process and its outcomes over a period of two years. We wanted to address topics like: understanding WBHC, opportunities and obstacles, strategies, learning and leadership during the process and outcome as result of WBHC. The study results was expected to contribute to a deeper understanding of how an implementation process are constructed and about changes over time as well as to the understanding of the role of leadership and the outcome of implementing VBHC.

For more information: https://caresci.gu.se/english/about-us/staff?languageId=100001&userId=xniker#tabContentAnchor2

Incorporation of VBHC in the Cruces University Hospital (EEC Osakidetza – Basque Health Service). 

As a public health organization, we have the responsibility to evaluate the health outcomes we are achieving and to establish the necessary measures to provide the maximum possible value to our citizens. The technical assessment of an intervention or treatment is no longer enough. Now it is necessary to know the impact that we are having on our patients and confirm with them that the expected results in health have been achieved.

For more information about Cruces University Hospital: http://www.osakidetza.euskadi.eus/r85-ghhcru00/es/?lng=en

Developing IPU’s, the basis for further improvement of patient outcomes. 

Rijnstate hospital in Arnhem, The Netherlands, decided in 2016 that forming Integrated Practice Units (IPU’s) around multidisciplinary conditions is the next step in improving patient’s outcome. It is the basis of value based healthcare (VBHC) which gives us the opportunity to measure outcomes and costs over the full cycle of care. Therefore, Rijnstate started with multidisciplinary result-responsible units (RRU’s) and IPU’s around different conditions, including cancer, vascular diseases, palliative care, mother and child care and traumatology. The IPU’s are responsible for processes, quality and finances and fulfil the 11 VBHC/IPU criteria as originally defined.

For more information about Rijnstate: https://www.rijnstate.nl/

 

Part 2

 Xpert Clinic: Ten years of VBHC in hand and wrist care. 

Provide the best quality of care for patient with hand and wrist disorders against the lowest costs. The main reason for setting up Xpert Clinic was to continuously improve the quality of care for patients with hand and wrist conditions through (super)specialization, multidisciplinary and integrated care across the value chain against lowest possible costs. Through a hub and spoke model we create accessibility for this type of care for all patients in the Netherlands.

For more information about Xpert Clinic: https://www.xpertclinic.nl/

PROM Danish Value Based Health Care Initiative. National consensus on outcome goals has been reached on 8 treatments areas. On especially three treatment areas, important results and progress has been made. The hip and knee project has collected data on outcome and used it together with other healthcare data in a prediction-model. In this way experiences from former patients is used to improve healthcare decisions in real time about conducting an operation or not. This benefits existing patients who can now make an informed decision about their treatment based on the outcome of former patients like themselves (“patients-like-me”). The outcome goals for the Interdisciplinary Chronic Pain Management project are essentially the most important values in life for patients with chronic pain. Hence, the values for patients are embedded in all clinical consultations and are the foundation of patient-centred and patient involved treatment. Finally, the project of anxiety & depression has designed a systematic approach to assess the health outcome and satisfaction with treatment among patients through PROMs used for quality improvement at an organizational level.

For more information about the Danish Regions: https://www.regioner.dk/

 Stomydo B.V. 

The company Stomydo and its products originated from the ostomates, and in the meantime Stomydo has grown into a company that focuses on improving the lives of the ostomates. We do this by bringing innovative stoma devices to the market that do more than just clean, care and simplify the care. Daily stoma care can also be hygienic and easy, and can also contribute to good skin condition and an improved quality of life. Stomydo wishes everyone a positive and free life with a stoma. The Stomydo products were developed for and with the patients. A product like the stomashower does not just fall from the sky. It originated from the request of Jan Dorssers, ostomist and good friend of Peter Cox, the initiator, to think of something for the quick care of his stoma. Especially when he had to take a complete body shower,  after a leak took a lot of time and that had to be possible otherwise he thought. From this thought, the stomashower originated and Stomydo BV was founded in 2014.

For more information about the Stomydo: https://stomydo.com/nl

 Midwife led birth unit on hospital grounds. 

In Switzerland, the majority of births take place at hospitals. However, there is a trend towards giving birth at a midwife-led birth unit (MLBU). The Kantonsspital Aarau is the first hospital offering births at an MLBU on hospital grounds. We evaluate quality features of this seminal project which combines the low intervention rate of MLBUs with the safety offered by the nearness of a perinatal centre (PC). We aim to lower intervention rates during delivery in a low risk population of healthy pregnant women with physiological pregnancies whilst providing the high degree of security the proximity to a perinatal center offers.

For more information about Kantonsspital Aarau: https://www.ksa.ch/

Part 3

 Reducing Health Care Costs by Blocking Chronic Inflammation and Pain, Fatigue-Disease from Decreasing  Vascular Inflammatory Free Radicals to Enable the Capillary-Endothelial Cell Dance through Adolescent Lifestyle Intervention

The early, preemptive and comprehensive reduction of vascular inflammatory free radicals within end organ interstitial spaces, which has resulted from persistent maladaptive proinflammatory lifestyles and behaviors, blocks proinflammatory end organ interstitial space signaling maturation and  re -energizes   the capillary- endothelial cell dance to enable effective immune arsenal choreography to the interstitial space. This anti-inflammatory momentum ensures an optimal signaling homeostasis within the interstitial space thereby optimizing its sanitation which in turn nurtures end organ function. As capillary endothelial cells pivot and swing their outer membrane permeability and mitochondrial combustion they pace and stem powerful feedback loop signals to their allies, the mesenchymal and end organ cells, to facilitate similar or juxtaposed function. As it does, its anti-inflammatory signaling momentum ricochets throughout the interstitial space to suppress or eliminate chronic inflammatory seeds, and then backwashes through the capillary –endothelial cell and into the central circulation to permeate anti-inflammatory intent to other endothelial cells and distant end organs. This has an effect of immune enhancement, is the antidote to chronic inflammatory immune suppression, and fosters wellness through wholeness as all interstitial spaces, endothelia and end organs participate in a similar anti-inflammatory interstitial space wave.

 Maharashtra Model of Epilepsy Care in Public Health

 Epilepsy affects 1% of population worldwide and 40-50% of People living with Epilepsy have comorbid disabilities. There are close to 12 million people in India alone, living with Epilepsy. Despite such widespread morbidity, there are no coordinated and cost-effective public health initiatives to deal with this most common serious brain disorder worldwide with no age, racial, social class, national nor geographic boundaries. In order to address all the unique needs of Epilepsy patients in rural India, the Epilepsy Foundation India Trust was formed in 2009. Under the leadership of Dr Nirmal Surya, the Epilepsy Foundation India trust has perfected the “Maharashtra Model of Epilepsy Care in Public Health”. The Epilepsy Foundation India team has been delivering Epilepsy awareness, diagnosis, management and regular follow up services since 2011.

For more information about the Epilepsy Foundation: http://epilepsyfoundationindia.com/

 Uniforming pathways by evaluating outcome and costs

Bergman Clinics provides  high-quality and specialized medical care. Medical conditions are organized into several care pathways (>20). Bergman Clinics has two locations for orthopedic care. The locations use the same electronic medical record and the same patient questionnaires. Data are collected in a uniform way. This allows us to investigate different work methods in a fast and easy way. In 2018, we combined previous  initiatives into a Value Based Healthcare (VBHC) team for hip arthritis.

The goal was to enhance value for the patient in the total care pathway from developing hip complaints through return to daily activities.

For more information about Bergman Clinics: https://www.bergmanclinics.nl/

Part 4

Incorporating patient preferences in treatment decisions in older cancer patients

The primary goal of this project  is to assess whether the introduction of personalized medicine through integrated onco-geriatric care, causes a multidisciplinary tumor board to come to a treatment proposal that deviates from treatment guidelines.

The initiative aims to increase patient value by incorporating the patients treatment goals and vulnerabilities in the order to come to the best suited treatment plan for older cancer patients.

The core value of the initiative is patient-centered  treatment and lower costs.

For more information about the UMCG: https://www.umcg.nl/NL/Zorg/paginas/Default.aspx

Scaling value-based contracting & pricing through technology

Lyfegen sets out to realize lean processes for real-time outcome-based agreements and minimize deadweight loss of the healthcare system while fostering little administrative burden, transparency among stakeholders and full data security and control for patients.

The core value of the initiative is to simplify value-based healthcare agreements by providing a trusted, secure and automated solution for patients and healthcare stakeholders to make value-based healthcare the new standard healthcare model.

For more information about Lyfegen: https://lyfegen.com/

 SQOT – Standardizing Quality of life measures in Obesity Treatment

 Obesity is a rapidly growing epidemic in most parts of the developed world. There exists a variety of medical and surgical treatments of obesity, each with varying efficacy and risk profiles. The effectiveness of novel interventions of obesity should be assessed in a validated, standardized manner. Though % total weight loss (%TWL), morbidity, and mortality have often been the primary outcome measures, patients may suffer problems that are best captured with patient-reported outcomes measures (PROMs). As more novel treatments of obesity come to market, there is an increasing need for standardized, rigorous tools to assess and monitor patient-reported outcomes. PROMs data offer a reliable assessment of the patients’ perspectives of treatment of obesity and can be useful in decision-making. However, there is a lack of standardization of PROMs in the treatment of patients with obesity. The SQOT initiative was recently founded to Standardize Quality of life measures in Obesity Treatment. This initiative comes from an international collaboration of patients and experts in the field of obesity,.

The objective of this initiative is two-fold:

  • to identify valid Patient Reported Outcome Measures (PROMs) to measure quality of life in patients with obesity
  • to provide clinicians, patients, health systems and other stakeholders with (a) valid PROM(s) that are feasible to use in their research, clinical practice and registries.

+Valor

Mapcare´s +Value initiative aims to enhance Brazilian providers alignment with VBHC by preparing healthcare organizations to collect outcome data, measure costs and exchange information around similar medial conditions through the complete cycle of care.

Accountability is the value that drives Mapcare´s +Value initiative commitment to improve the quality of care thought the development of patient centred programs in every provider organization.

For more information about Mapcare: https://www.mapcare.com.br/