Value in Healthcare

Value Keyboard Button - GotCreditBlog post by Colin Hung

Over the last few months I have been reading and hearing a lot about “value” in healthcare and I thought it would be an interesting topic to explore together on an #hcldr tweetchat.

Back in December, the Healthcare Information and Management Systems Society (HIMSS) launched a new Value Score measurement methodology. This new framework was designed specifically to help healthcare organizations determine the clinical and financial value of healthcare information technology (HealthIT) investments.

The release of this new value measurement is timely. With the ending of the financial incentives for EHR adoption, many healthcare organizations are reflecting on the thousands/millions of dollars they have invested in HealthIT. Some physicians and organizational leaders have even begun to question their rush to implement complex, difficult-to-use EHRs that don’t interoperate with other systems.

I personally believe it’s healthy to periodically question the value of an investment. What may have made sense years ago may not be a wise investment in the current situation. Digitizing medical records back in 2000 was a fantastic idea. Digitizing medical records in silos and forcing physicians/nurses to use complex electronic documentation routines in 2016 is not something we should continue to fund. In a sense, what was valuable in 2000 isn’t valuable today in 2016.

So what is “value” in healthcare? Michael Porter describes it best in his “What is Value in Health Care” article:

Value is defined as outcomes relative to costs, it encompasses efficiency. Cost reduction without regard to the outcomes achieved is dangerous and self-defeating, leading to false ‘savings’ and potentially limiting effective care.

…but is value as simple as this? Does the definition of value differ for patients, physicians, nurses and administrators?

Porter goes further to describe the ideal system where value for patients is rewarded appropriately:

Creation of value for patients should determine the rewards for patients should determine the rewards for all other actors in the system. Since value depends on results, not inputs, value in health care is measured by the outcomes achieved not the volume of services delivered

What Porter is describing is the fundamental tenent of the Value-Based Payment (VBP) model in which people who provide healthcare are only paid if patients achieve particular clinical outcomes. The movement towards VBP has been happening slowly over the past few years. It has been very difficult to shift healthcare away from the current fee-for-service model. Part of the reason for this lack of momentum is the lack of clarity on the definition of a “valued outcome” for patients. It varies from patient to patient. For example, I may consider a higher quality of life more valuable than an extension of life that has mobility restrictions

I feel confident that in 2016 we will all be hearing more about the value in healthcare. Whether it’s in the context of HealthIT, pharmaceuticals, treatments, big data, wearables and even healthcare social media. On this last topic, my friend John Lynn (aka @techguy) recently asked me what value I had seen from all my social media involvement – other than networking/building connections. John was genuinely curious and frankly I had to think hard to come up with answers.

I ended up talking to John about the wealth of knowledge I had gained via social media. I definitely feel that one of the biggest benefits/values of being involved in social media is the exposure to different perspectives, healthcare innovations and thought leadership. I feel that my understanding of healthcare is shaped by all the voices I hear on social media – and because of that I believe I make better decisions at work.

I am curious to know what you think.

Join us on January 5th 2016 at 8:30pm ET (for your local time click here) for our weekly #hcldr tweetchat where we will be discussing value in healthcare.

  • T1 What do you feel is over-valued in healthcare? What have we attributed too much value to?
  • T2 What do you feel is under-valued in healthcare? Where could we invest more?
  • T3 How would you define value in healthcare as a patient? Nurse? Physician? Or Administrator?
  • T4 In addition to connections/networking what value have you realized thru healthcare social media?

References

“What Is Value in Health Care?”, Michael E Porter, New England Journal of Medicine, December 23 2010, http://www.nejm.org/doi/full/10.1056/NEJMp1011024?viewType=Print&, accessed January 2 2015

“Getting Real About Health Care Value”, David Blumenthal and Kristof Stremikis, September 17 2013, https://hbr.org/2013/09/getting-real-about-health-care-value, accessed January 2 2015

“Value-Based Health Care Is Inevitable and That’s Good”, Toby Cosgrove, September 24 2013, https://hbr.org/2013/09/value-based-health-care-is-inevitable-and-thats-good/, accessed January 2 2015

“Value-Based Payments: But Is There Any Value for Doctors?”, Leigh Page, Medscape, October 8 2015, http://www.medscape.com/viewarticle/848306, accessed January 2 2015

“Measuring Success in Health Care Value-Based Purchasing Programs”, Damberg et al, Rand Health, November 2014, http://www.rand.org/content/dam/rand/pubs/research_reports/RR300/RR306/RAND_RR306.pdf, accessed January 2 2015

“The road to value-based care”, Wendy Gerhardt et al, Deloitte University Press, March 20 2015, http://dupress.com/articles/value-based-care-market-shift/, accessed January 2 2015

“HIMSS Launches Value Score, Healthcare’s First International Quality and Value Measurement for Health IT”, HIMSS Press Release, December 3 2015, http://www.himss.org/News/NewsDetail.aspx?ItemNumber=45839, accessed January 2 2015

“The Value of Health Information Technology: Filling the Knowledge Gap”, Robert Rudin et al, AMJC, January 26 2015, http://www.ajmc.com/journals/issue/2014/2014-11-vol20-sp/the-value-of-health-information-technology-filling-the-knowledge-gap, accessed January 2 2015

“How to measure the value of health IT”, Mike Miliard, Healthcare IT News, March 7 2014, http://www.healthcareitnews.com/news/how-measure-value-health-it, accessed January 2 2015

“Costs and Benefits of Health Information Technology”, Shekelle, Morton and Keeler, Agency for Healthcare Research and Quality, April 2006, http://www.ncbi.nlm.nih.gov/books/NBK37992/, accessed January 2 2015

“Doctors spending more on EHR tech, but is it worth it?”, Lisa Hoover McGreevy, Fierce Content Management, September 30 2015, http://www.fiercecontentmanagement.com/story/doctors-spending-more-ehr-tech-it-worth-it/2015-09-30, accessed January 2 2015

Image Credit

Value Keyboard Button – GotCredit https://flic.kr/p/rBzSdA

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