Member blog by: Christobel Saunders, Professor of Surgery/Consultant Breast Surgeon, All.Can Australia, All.Can International
What does value-based healthcare offer in cancer care?
Value-based healthcare (VBHC) is the next paradigm in how we deliver healthcare, offering a shift to a more transparent, value-based approach to how we determine the outcomes and costs of a patient’s disease and treatment, and how we use this information to improve care.
In Western Australia, we are implementing a multi-institutional programme of research that seeks to bring VBHC to public and private healthcare settings through a programme of research called The Continuous Improvement in Care – Cancer (CIC Cancer) Project. The key to success, we believe, is through measuring and acting on variations in outcomes that are important for people diagnosed with cancer. We are doing this in the care of people with five of the most common cancers: breast, lung, colorectal, prostate and ovarian.
To achieve this, we are establishing IT-enabled routine measurement of clinical and patient-reported outcome measures – using the International Consortium for Health Outcome Measures (ICHOM) standard data sets. The information will be fed back to the clinicians caring for these patients to improve the care of the individual patient as well as producing unit-level data which can be used for cancer services to assess and improve their practice.
How will value-based healthcare improve information flow between the patient and their doctor?
A key theme that emerged from the All.Can patient survey was regarding how and when patients were given information, as well as their involvement in discussing treatment options. Most clinicians believe they do a pretty good job of eliciting how a patient is doing with their health and treatment regimens. Yet we know that, in reality, a 10- or 15-minute consultation will likely not uncover many of the symptoms and concerns that are very real for the patient. This resonates with the findings of the All.Can patient survey, where 28% of Australian respondents were not given enough information about their cancer care and treatment.
By capturing standardised outcomes before the consultation and highlighting the main patient concerns with advanced analytics and data visualisation tools, information flow is improved. This will help bring out what is really important for the patient – and may make the consultation more efficient and productive.
Collation of outcomes for the entire cancer unit, and across the trajectory of multidisciplinary care, will then provide benchmarks against similar practices, enabling variations in care to be identified and quality improvement measures to be undertaken. We all want to offer the very best care – but if we don’t know our outcomes and cannot compare them to others, it is hard to improve them.
Access to patient outcomes data must be simple, acceptable, and relevant to all users so that the information is more likely to be utilised, and implemented, at healthcare sites. This is how we can ensure improved outcomes for all patients.
Please note: figures in this blog post taken from the All.Can patient survey refer to to country-specific data collected in Australia. These data are unweighted and cannot be compared with responses from other countries, or with the data from the international survey, which were weighted. For more information on data weighting, a full methodology and survey findings from other countries, please see https://www.all-can.org/what-we-do/research/patient-survey/