COVID-19: A Value Based Healthcare approach
Dr Lucinda Gabriel, from our Value Based Healthcare team, discusses working with the International Consortium for Health Outcome Measures (ICHOM) to define and report on the outcomes that matter to COVID-19 patients.
The COVID-19 pandemic has highlighted tensions in healthcare systems across the globe in an unprecedented way, including issues of healthcare inequity and affordability, wellbeing, and waste. King’s Health Partners has collaborated with leaders across the world and the ICHOM to develop a set of outcome measures that will help institutions worldwide provide the best possible care for patients with COVID-19.
Value Based Healthcare focuses on ensuring the best possible care for patients, based on the outcomes that matter to them, using the resources available. Examples include integrating care delivery systems, building centres of excellence and harnessing new technology to measure outcomes and costs.
A key element of a Value Based Healthcare approach is defining the outcomes that matter to patients. This ensures clinicians can focus on what matters most to the populations they serve. Better understanding the needs of patients with COVID-19 could lead to significant improvement in their care. However, collecting patient outcomes can be complex and come with several challenges, particularly in the current circumstances and the fact that COVID-19 is still considered a novel disease.
ICHOM established an international working group, bringing together experts from both developed and developing nations, to create a Standard Set of outcomes for COVID-19 patients. A Standard Set encompasses patient reported outcomes, the measurement tools required, the timeline for measuring these outcomes and the risk factors involved. This Standard Set ensures that patients remain at the centre of their care by defining what matters to them, and that the outcomes are accessible and free to use for healthcare communities across the world.
How these outcomes measures were developed
Working with ICHOM relied on defining outcomes that matter to patients on a global scale. Given that COVID-19 is a novel disease, evaluating and comparing the outcomes in clinical settings across the world has been crucial to ensure the Set is representative of the global disease burden, making it broadly applicable to diverse populations.
The development of the Standard Set involved developing outcome measures based on four phases:
- defining the scope of the project.
- prioritising and defining outcomes that matter to patients.
- evaluating and selecting outcome measures that would be used.
- defining variables between patients.
To select these outcomes, a group of experts were each given a series of questionnaires to complete in rounds. Each round generated key discussion points that helped lead to a clear and agreed answer. To improve care for patients, it was determined that the following needed to be recorded:
- frequency of the outcome.
- impact on the patient.
- potential for modifying the outcome.
- feasibility of measuring the outcome.
How this collaboration will improve care for COVID-19 patients
This work has been made possible through international collaboration. The working group rapidly mobilised to produce these outcomes measures specific to COVID-19 patients. The scale and urgency the pandemic created has helped accelerate implementation of the outcome measures developed.
It is hoped that this Standard Set will represent the most important end results of care that are meaningful to patients with COVID-19. With support from ICHOM, this set will provide a comprehensive, quantifiable view of a patient that will ensure institutions across the world can deliver the best care possible for COVID-19 patients.
The result of this work in collaboration with ICHOM can be found here.
Learn more about Value Based Healthcare at King's Health Partners.