As part of measuring effectiveness of care coronary artery disease patient-reported outcomes are systematically collected and analysed in a pilot project in the Central Finland Health Care District.
In a first for Finland, The Central Finland Healthcare District has implemented Philips VitalHealth’s Questlink, a tool specialised in patient self-reporting of their symptoms and ability to function. In co-operation with Nordic Healthcare Group (NHG), a pilot project has been launched in March, taking the assessment of treatment effectiveness towards a new value-based operational model, in which patient experience of the outcomes are heard as part of the treatment. With the help of the new tool, coronary artery disease patients in Central Finland Health Care District have the opportunity to assess factors related to their own state of health and ability to function. The information is collected systematically and linked to other outcome measures and costs. This unique project combines three separate perspectives to measure the effectiveness of the treatment holistically: clinical outcome measures, costs, and patient-reported outcome measures.
Before, treatment efficacy has been measured mainly by focusing on factors like mortality and reoperations, which do not give adequate information on the patients’ well-being, such as their symptoms and daily health. Patients should be asked questions relevant from their point-of-view, such as chest pain and dyspnoea for coronary artery disease patients.
In the future, information collected on patients’ state of health and ability to function does not only help to develop better care but also to steer and manage the whole coronary artery disease chain of care, especially when this information is connected to clinical outcomes and costs of the healthcare system. By getting the patient to answer questions, possible relapses and decreases in the ability to function are noticed allowing the healthcare provider to react to them. The patients’ and healthcare systems’ partnership deepens as the patient has a chance to give feedback on the effectiveness of the treatment. Based on the pilot project, similar value-based models, including patient-reported measurements, can be easily applied to other patient groups.
The Central Finland Health Care District’s chief development physician Pirjo Mustonen is strongly of the opinion, that in addition to volumes (such as numbers of visits and operations), the real value and effectiveness of the treatment should be assessed. “Central Finland Health Care District wants to prepare for the future, in which systematic measurement of the value of the care chain is a key factor in the development of care. In specialist health care, coronary artery disease patients’ well-being has been followed up usually for one month after the procedure. Listening to patient feedback systematically for a longer period gives us information not only on the long-term benefits of the treatment but also on the functioning of the whole care chain. For the development of care, this is vitally important and is the path to be taken in the future. The patient-centred ICHOM metrics excellently suit this purpose”, Mustonen commented.
Internationally, patient-reported outcomes are already measured relatively widely: value-based health care also brings better care in Finland
Internationally, different tools for the measurement of patients’ health and ability to function are already relatively widespread, for example, Philips VitalHealth’s Questlink is part of the treatment process in several hospitals, such as Maritin-Klinik in Germany and Mayo Clinic in the United States. The tool utilises international ICHOM standards, which aim for international comparability of the results. Patient-reported metrics of effectiveness are usually divided into two categories: Patient-Reported Outcome Measures (PROM) measuring the patient’s ability to function, and Patient-Reported Experience Measures (PREM) which measure the patient’s customer experience.
In September 2018, the Nordic Healthcare Group conducted a survey on the use of outcome metrics in specialist healthcare in Finland. The survey showed that patient-reported metrics are only rarely used in specialist healthcare for now, but the majority of respondents (71 %) wanted to increase the use of patient-reported metrics in healthcare, and 23 % of the respondents planned on implementing patient-reported metrics of patients’ state of health, ability to function, and patient experience within the next two years.
Nordic Healthcare Group’s Executive Vice President Vesa Komssi sees that value-based health care includes significant opportunities for the future. “Measuring effectiveness is needed even wider in all significant patient groups. Value-based health care is the way to guarantee better care with limited resources to everyone in Finland. We are glad that Central Finland Health Care District is a forerunner in piloting value-based metrics and they have understood the value of patient-reported outcomes in the development of good care. We look forward to seeing the results of the pilot project and the possibilities to expand the operating model to other patient groups”, Komssi commented.
More information
Nordic Healthcare Group (NHG), Executive Vice President Vesa Komssi, +358 50 331 7978, vesa.komssi@nhg.fi
Central Finland Health Care District, chief development physician, specialist in internal medicine and cardiology Pirjo Mustonen, +358 142 695 290, pirjo.mustonen@ksshp.fi
The Central Finland Health Care District is owned by 21 municipalities in Central Finland and provides specialist health care at Central Finland Central Hospital in Jyväskylä. The Central Finland Health Care District is the largest non-university hospital district in Finland, with services in nearly all medical specialties. Our strengths lie in our motivated and highly professional staff, our investments in extensive research and education, and our seamless collaboration with health centres. https://www.ksshp.fi/en-US
Nordic Healthcare Group (NHG) is a Finnish company founded in 2004, expanding in the Nordics and internationally. NHG is specialising in supporting quality services for social and healthcare. Our clients include hospital districts, municipalities, private service providers, pharmaceutical companies, private equity investors, and healthcare technology companies. We employ more than 120 experienced professionals. https://nhg.fi/en/
Nordic Healthcare Group is Philips VitalHealth’s partner in Finland. Nordic Healthcare Group is also a sponsor for the International Consortium for Health Outcomes Measurement (ICHOM), which is an international non-profit organisation developing value-based health care worldwide.