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How can you define value in healthcare?

Joseph Casey, Deputy Director of Programme Delivery at King's Health Partners, shares insight on Value Based Healthcare from our recently developed training course.  

Value Based Care Interest over time chartThe concept of “Value Based Healthcare” has continued to gain prominence in healthcare systems around the world ever since the publication of Michael Porter and Elizabeth Teisberg’s original Harvard Business Review article fifteen years ago, and subsequently their book two years later. (The chart to the right shows Google trend analysis for search term “Value Based Healthcare”; interest over time is relative, with 100 being the “peak popularity” for the search term.)

However, many organisations and systems have struggled to turn the concept into action that improves outcomes that matter to patients by making best use of available resources.

One of the main challenges has been developing a shared understanding of what “value” means amongst teams implementing Value Based Healthcare approaches. A study undertaken by the Karolinska Institutet found that even amongst researchers in the field, a quarter of papers published failed to grasp the main aspects of the concept.

One of the main challenges is that there is no single definition of Value Based Healthcare, as highlighted in a recent report by the Expert Panel on effective ways of investing in Health (EXPH) to the European Commission. The panel proposed four pillars:

Personal value: appropriate care to achieve patients' personal goals

Technical value: achievement of best possible outcomes with available resources

Allocative value: equitable resource distribution across all patient groups

Societal value: contribution of healthcare to social participation and connectedness

The inclusion of “societal value” signals an increasing focus in conceptualising Value Based Healthcare as part of a broader approach to improving wellbeing. In this context, we have recently adopted the definition proposed in a report by the Centre for Evidence-Based Medicine, the authors for which included colleagues from King’s Health Partners and NHS Wales.

Value-based healthcare is the equitable, sustainable and transparent use of the available resources to achieve better outcomes and experiences for every person.” 

- “Defining value-based healthcare in the NHS" (Centre for Evidence-Based Medicine, University of Oxford, April 2019)

As the experience of organisations such as Aneurin Bevan University Health Board in Wales demonstrate, having a shared language and understanding is critical to successfully implementing Value Based Healthcare approaches across health systems.

We think that it is less important what specific definition is adopted or developed, and more important that the multi-professional team agree a shared definition together, working with patients as part of the team.

Therefore, we are working with other healthcare organisation across Europe, with support from Erasmus+, to develop our education and training offer to support teams implementing Value Based Healthcare. As many others have argued, better value in the NHS is driven by changes in clinical practice focussed on improving outcomes and experience for patients, and this remains at the core of our values.

This blog shares some of the content from the first module of the King’s Health Partners training course on Value Based Healthcare.

Want to keep in the loop about future training courses?

You can register your interest for future education and training opportunities with King’s Health Partners as well as with the European University Hospital Alliance; simply email khp-programmesupport AT kcl.ac.uk.

Visit our website to learn more about Value Based Healthcare at King's Health Partners.