Transformation of Health Care—Perspectives of Opinion Leaders

Joanne  Disch; Thomas W. Feeley; Diana J. Mason; Richard L. Schilsky; Ellen L. Stovall; Shelley Fuld Nasso

Article | Seminars in Oncology Nursing | May 2016

Transformation of Health Care—Perspectives of Opinion Leaders

by Joanne Disch, Thomas W. Feeley, Diana J. Mason, Richard L. Schilsky, Ellen L. Stovall and Shelley Fuld Nasso

Abstract

"What Health System Transformations Do You Believe Are Necessary for the Future of Health Care?" We need to transform to a true value-based health care delivery system. That means organizing care around medical conditions, not simply around hospitals and doctors. We need to do more team-based medicine and to better integrate specialty care with primary care. We need to be doing a better job measuring health outcomes that matter to patients, which includes patient-reported outcomes and clinician-reported outcomes. These need to be used for internal improvement in health care delivery organizations, as well as for public reporting, so that patients can make informed choices about their health care. We need to do a better job measuring, reporting and controlling the costs of health care so that our economy can improve and so that patients can make informed decisions. We must move away from fee-for-service reimbursement, which incentivizes doing more, and begin paying for good outcomes. Health care organizations need to stop duplicating every service and have centers of excellence with high-volume experts. Finally, we need better health information technology systems to facilitate knowledge transmission and communication.

Keywords: Perspective; Health Disorders; Performance Improvement; Health Care and Treatment; Transformation; Health Industry;

Format: Print

Citation:

Disch, Joanne, Thomas W. Feeley, Diana J. Mason, Richard L. Schilsky, Ellen L. Stovall, and Shelley Fuld Nasso. "Transformation of Health Care—Perspectives of Opinion Leaders." Seminars in Oncology Nursing 32, no. 2 (May 2016): 172–182.

As the diffusion of value-based health care efforts accelerates globally, the need for interoperable information technology systems that support value-based care is essential. Such systems are needed to facilitate dramatic improvements in patient outcomes and efficiency and, importantly, to end an era in which health IT has entrenched the status quo, perpetuated silos, and blocked reimbursement reform. A value-enabling IT platform must organize data around conditions and must enable integrated practice units to integrate care both within and across health systems. In addition, the electronic health record should be the sole source of costing information so that accurate costs for every encounter can be tracked, aggregated, shared, and used for improvement. This is the next generation of health care IT.

Article | Journal of Medical Systems | January 2020

Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement

O. Allin, RD Urman, AF Edwards, JD Blitz, KJ Pfeifer, TW Feeley and AM Bader

A shift in health care payment models from volume toward value-based incentives will require deliberate input into systems development from both perioperative clinicians and administrators to ensure appropriate recognition of the value of all services provided—particularly ones that are not reimbursable in current fee-for-service payment models. Time-driven activity-based costing (TDABC) methodology identifies cost drivers and reduces inaccurate costing based on siloed budgets. Inaccurate costing also results from the fact that current costing methods use charges and there has been tremendous cost shifting throughout health care. High cost, high variability processes can be identified for process improvement. As payment models inevitably evolve towards value-based metrics, it will be critical to knowledgably participate in the coordination of these changes. This document provides eight practical recommendations from the Society for Perioperative Assessment and Quality Improvement (SPAQI) aimed at outlining the principles of TDABC, creating process maps for patient workflows, understanding payment structures, establishing physician alignment across service lines to create integrated practice units to facilitate development of evidence-based pathways for specific patient risk groups, establishing consistent care delivery, minimizing variability between physicians and departments, utilizing data analytics and information technology tools to track progress and obtain actionable data, and using TDABC to create costing transparency.

Keywords: value-based health care; outcomes; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Management; Value; Activity Based Costing and Management;

Citation:

Allin, O., RD Urman, AF Edwards, JD Blitz, KJ Pfeifer, TW Feeley, and AM Bader. "Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement." Journal of Medical Systems 44, no. 1 (January 2020). View Details

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Since its establishment in 2005, Hamburg’s Martini Klinik had single mindedly focused on prostate cancer care with a commitment to measure long-term health outcomes for every patient. A wholly owned subsidiary of the University Hospital Hamburg, Martini Klinik was a “hospital in a hospital” in close proximity to other medical departments and services. By 2019, Martini Klinik had become the largest prostate cancer treatment program in the world with 8,000 outpatient cases and more than 2,500 surgical cases annually. Patients came from all over Germany and from around the world. A new and expanded facility was under construction to have the capacity to manage more patients with prostate cancer.

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Transformation of Health Care—Perspectives of Opinion Leaders

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