MSD and Maasstad Hospital join forces to increase patient value
Birgit van den Berg, Margreet Voorsluijs and Susan van ‘t Westeinde
Birgit van den Berg
Susan van ‘t Westeinde (on the right)
Biopharmaceutical company MSD is again partner of the VBHC Prize 2020. The idea behind this award is aligned with how MSD The Netherlands supports ‘Value Based Healthcare’ in our country: by promoting cooperation between healthcare providers and accelerating VBHC projects, in order to create more value for patients. A good example is MSD’s collaboration with the Maasstad Hospital in Rotterdam, aimed at optimizing care for lung cancer patients with non-Western backgrounds.
Birgit van den Berg and Margreet Voorsluijs (both MSD) and Susan van ‘t Westeinde (Maasstad Hospital) are closely involved in their employers’ VBHC initiatives. The three are convinced of the need to change the way care is organized in the Netherlands. “Care delivery should not be awarded in relation to quantity but to quality instead and should therefore focus on those health outcomes that are important for patients,” says Margreet, who together with Birgit is responsible for VBHC-related efforts at MSD.
It’s all about what patients themselves value. Margreet: “The only way to understand this is by asking patients and care givers. And that’s exactly what’s going to happen in Rotterdam. My colleague Birgit and Susan, who is a pulmonologist at Maasstad Hospital, are now working together on a project to understand the particular needs of a group of lung cancer patients with non-Western backgrounds. And I’m working with other partners on a VBHC project that investigates consumer and patient topics around vaccination. So, together we’re active on different therapeutic areas.”
Birgit: “This project was preceded by another collaboration, with fellow pharmaceutical company Roche and patient organization Long Kanker (lung cancer) Nederland. Our joint research focused on the ‘patient journey’ of people with lung cancer – from the moment they experience the first symptoms, through diagnosis and treatment, until the last phase of life.”
“The most important outcome was that there is a need among patients and their loved ones for more continuity, clarity and support during their ‘journey’. Continuity, in this case, includes the need to continuously have a clear point of contact throughout the journey. Clarity refers to better information on the hard facts, whereas support focuses on the ‘soft’, psychosocial aspects”, says Birgit.
“With the VBHC principles as a starting point, over 90 multidisciplinary teams are currently working on better treatment outcomes for patients, at a lower cost”
Susan: “Birgit shared the findings within our hospital and wondered if we would be interested in starting a follow-up project together. And we certainly were! The Maasstad Hospital is part of the Santeon group, which consists of seven top-clinical teaching hospitals that work closely together to continuously improve the quality of care. And VBHC is a top priority for all Santeon hospitals. This is also reflected by the fact that Santeon’s ‘Together Better’ program has been nominated for the VBHC Prize this year.”
“With the VBHC principles as a starting point, over 90 multidisciplinary teams are currently working on better treatment outcomes for patients, at a lower cost. We do this for fourteen different conditions and lung cancer is one of them.”
“Every step in a chosen treatment process should add value for the patient. To measure this, Maasstad Hospital has developed a scorecard, together with patients, that provides insight into the quality of care through three components:
1) outcomes, such as survival, complications from surgery and long-term effects of treatment;
2) processes, such as the number of outpatient visits, waiting times and cooperation with other healthcare organizations;
3) costs, including – for example – diagnostic costs, operating time, nursing days and the medicines used.”
“Working on this requires time and effort in the short term, but I’m convinced that in the longer term it results in better care”, says Susan.
“receiving people from so many different cultures is a challenge for the hospital, and that he was looking for ways to actively involve them in their own care pathway”
Many patients of the Maasstad Hospital have a non-Western background. Birgit: “I told Peter Langenbach (Supervisory Board chairman of the Maasstad Hospital, ed.) about our patient journey research. He indicated that receiving people from so many different cultures is a challenge for the hospital, and that he was looking for ways to actively involve them in their own care pathway. How do you provide care that meets the (perhaps) diverse needs of different patients? That eventually led to our current project.”
Susan: “When the corona crisis has subsided, research firm Ipsos will conduct a series of interviews with some of our lung cancer patients from non-Western backgrounds. People with lung cancer go through a tough care process. Positive developments such as the introduction of immunotherapy and so-called ‘targeted therapy’ have considerably improved the prognosis. But if patients are not eligible for targeted therapy, or do not respond to immunotherapy, then the prognosis is often still poor. How do these people experience the care they’re given? What do they need, for example when it comes to information and/or help in decision-making? Our lung oncology nurses will also be interviewed, since they are the professionals with the hands-on experience. Where do they see potential for improvement?”
Will this research identify in general different, culturally determined care needs, e.g. if it comes to joint decision-making process between doctor and patient, or substantial differences in how people experience quality of care? Susan: “I can imagine that the differences won’t be so substantial, and will be mostly of a practical nature, e.g. that they can be traced back to a language barrier and/or limited health skills. But the point is: we don’t know for sure, because it has never been professionally investigated before. The fact that we are doing that now, with support from Birgit and MSD, already constitutes progress!”
Margreet: “There is still a lot of ‘profit’ to be achieved in healthcare by better understanding what patients care about. That is precisely why MSD wants to contribute to structural improvements that bring healthcare in line with VBHC principles.” Birgit: “In this context, MSD focuses on the optimization of decision-making. The project with the Maasstad Hospital is a seamless fit. The results will give a much better picture of what is needed to improve care for this particular group of patients.”
“As part of an innovative multinational company, we have the knowledge, experience and strength to help accelerate value-driven care projects. But no one can do this alone, and neither can we. If we want to optimize decision-making, and then go on to accelerate the development and implementation of innovative care improvements, we need to work together and trust each other’s good intentions.”