Book

Personalized Specialty Care Value-Based Healthcare Frontrunners from the Netherlands: Value-Based Healthcare Frontrunners from the Netherlands

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Abstract

This book highlights the work of pioneers in this field, in order to inspire their peers, healthcare leaders and an interested audience. Prior to the respective care practices, the authors describe the core of personalized care and illustrate its connections to value-driven care and evidence-based medicine. The last part of the book addresses organizational and other conditions under which personalized care can thrive. In the Netherlands, substantial work is being done on value-driven care and more is currently being discussed. This book focuses on the benefits of value-driven care for patients and healthcare providers alike. To do so, it explores a range of representative cases and scenarios, such as: Scenario 1: You are able to surgically remove the most difficult tumors and find out one day that you don’t need to do so in all indicated patients. Later you can find out how to recognize when surgery isn’t the best treatment for certain patients. And now your team has a fixed routine to find the optimal choice together with the patient. Scenario 2: You consider yourself to be a patient-centered doctor who is really in touch with their patients – until you ask them to report for themselves on how they are doing. In the "patient-reported outcomes" you see that you have completely missed an important aspect. Later, you can structurally integrate this into your outpatient clinic. Scenario 3: In line with the planning principles of your hospital, you see chronic patients once a year – and of course also 'as needed' – until your data shows you that you see patients too early or too late, but rarely when it would be most helpful. Later you can discover how to offer your consultation exactly on time – based on early signals and often even before the patient calls the clinic. This is what value-driven care is all about: care is of more significance to the patient when it is tailored to his or her unique situation. Recognizing the patient’s needs, preferences and values, and structurally adapting care accordingly – that is the noble profession of value-driven care, which takes us an important step closer to the ideal of personalized care.
... In recent years, the emphasis on patientcentred care has increased in the Dutch healthcare system. 1 Patient-centredness is a key element of high-quality care and entails collaboration between the healthcare professional (HCP), the patient and their families, in which the needs, values and preferences of patients are the focus of care. 2 3 Patients no longer want to be passive recipients of care but increasingly want and need to proactively manage their own health. They also wish to be empowered and involved in decision making that relates to their care, which can contribute to patient-centred care. ...
... HCPs and supporting staff perceived that implementing a PDCP contributed to the provision of patient-centred care within the hospital. Important reasons were: (1) placing the patient at the centre of care and using digital tools to support this aligns with the strategy of Amsterdam UMC, (2) the PDCP may ensure a higher level of involvement by patients in their treatment and (3) it may facilitate better interaction between the patient and the HCP. ...
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Objective A prerequisite for patient-centredness in healthcare organisations is offering patients access to adequate health information, which fits their needs. A personalised digital care pathway (PDCP) is a tool that facilitates the provision of tailored and timely information. Despite its potential, barriers influence the implementation of digital tools in healthcare organisations. Therefore, we investigated the perceived barriers and facilitators for implementation of the PDCP among stakeholders. Design A qualitative study was conducted to acquire insight into perceptions of the stakeholders involved in the implementation of a digital care pathway in three diverse patient groups. Setting This study is part of the PDCP research project in a large academic hospital in the Netherlands. Participants Purposive sampling was used to recruit internal stakeholders (eg, healthcare professionals, employees of the supporting departments) and external stakeholders (eg, employees of the external PDCP supplier). In addition, existing semistructured interviews with patients involved in pilot implementation (n=24) were used to verify the findings. Results We conducted 25 semistructured interviews using the Consolidated Framework for Implementation Research. Content analyses yielded four themes: (1) stakeholders’ perceptions of the PDCP (eg, perceived usefulness); (2) characteristics of the individuals involved and the implementation process (eg, individuals express resistance to change); (3) organisational readiness (eg, lack of resources); and (4) collaboration within the organisation (eg, mutual communication, multidisciplinary codesign). The main barriers mentioned by patients were duration of first activation and necessity for up-to-date content. In addition, the most facilitating factor for patients was user-friendliness. Conclusion Our findings emphasise the importance of gaining insights into the various perspectives of stakeholder groups, including patients, regarding the implementation of the PDCP. The perceived barriers and facilitators can be used to improve the PDCP implementation plan and tailor the development and improvement of other digital patient communication tools.
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