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[Session 7] Towards value-based healthcare: the contribution of digital health solutions

Value-based healthcare has emerged as a transformative approach in the pursuit of enhanced healthcare outcomes and optimised costs.

The last session of the EHTEL Symposium focused on the pivotal role of digital solutions to help driving this paradigm shift. It is helping to measure outcomes that matter to patients and increase patient engagement in shared decision making. Dipak Kalra, President of i~HD , an international health data innovation institute based in Belgium, chaired and moderated the session. Two speakers contributed insights into their experiences with value-based healthcare.

Implementation and governance of an interoperable model for Patient-Reported Outcome Measures in the Catalan health system 

Oscar Solans, Department of Health, Catalonia, Spain



Oscar Solans, from the Department of Health in Catalonia, Spain, presented the implementation and governance of an interoperable model for Patient-Reported Outcome Measures (PROMs) in the Catalan health system. Based on microservices connected to the new Electronic Health Record (EHR) in Catalonia, a new module for PROMs has been integrated into the system and can be prescribed from clinical stations and responded to from La Melva Salut, the Catalan personal health record (PHR). Results are accessible to clinicians through their clinical stations or HC3 (the Shared EHR). Interoperability across the system is achieved through SNOMED and openEHR standards. Twenty-seven different PROMs are deployed, which follow ICHOM’s standard sets. Automated reminders are sent 7 and 14 days after the first message has been sent. Preliminary results show a 68% response rate and 5.2 days average response time.


Thus, ePROMs reduce the time and the cost of obtaining patient value. The PROMS’ integration into the clinical station and the PHR was critical to having achieved wide end-user adoption. 


Patient empowerment and shared decision-making: the experience of the ADLIFE project

Rachelle Kaye, Assuta Medical Centers & K-Tor Consulting Services, Israel



Rachelle Kaye, from Assuta Medical Centers & K-Tor Consulting Services in Israel, described the patient empowerment and shared decision-making tools developed in the ADLIFE project. Aiming at improving the quality of life of patients with advanced chronic diseases, the project has developed a digital platform that has three main roles. It (1) enables joint patient care planning and management, (2) facilitates shared decision making through explicit reminders to clinicians, and (3) provides patients and carers with educational materials and feedback tools (including symptom reporting, PROMs and PREMs). This digital platform is being piloted on different sites across Europe and associated countries.


Several challenges exist. The technical challenges include  interoperability given the various legacy systems on every pilot site and the different coding systems. Organisational challenges involve the need for support from top management, resistance to change from healthcare professionals, and the low levels of empowerment and digital literacy on the part of patients. Rachelle concluded that the transition to value-based healthcare is more dependent on organisational and people factors than digital tools. Patient empowerment is more likely to happen when doctors strive to offer patients treatment options and refer to educational resources, including patient portals and mHealth apps.


The final debate and dialogue covered several contextual factors affecting value-based healthcare. They included current changes being made to digital health use in the European Union and proposed by the European Commission; the role of the Organisation for Economic Co-operation and Development (OECD); and activities run by the International Consortium for Health Outcomes Management (ICHOM) organisation.

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