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A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London

BACKGROUND: Value-Based Health Care (VBHC) is an evolving model of healthcare delivery aimed at achieving better patient outcomes at lower costs to the healthcare provider. The practise of VBHC requires efficient information systems with good reporting capability and subsequent outcome measuring. In...

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Autores principales: Burnhope, Emma, Waring, Michael, Guilder, Andrew, Malhotra, Bharti, Cardoso, Jorge M, Razavi, Reza, Carr-White, Gerald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795220/
https://www.ncbi.nlm.nih.gov/pubmed/33256480
http://dx.doi.org/10.1177/0951484820971442
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author Burnhope, Emma
Waring, Michael
Guilder, Andrew
Malhotra, Bharti
Cardoso, Jorge M
Razavi, Reza
Carr-White, Gerald
author_facet Burnhope, Emma
Waring, Michael
Guilder, Andrew
Malhotra, Bharti
Cardoso, Jorge M
Razavi, Reza
Carr-White, Gerald
author_sort Burnhope, Emma
collection PubMed
description BACKGROUND: Value-Based Health Care (VBHC) is an evolving model of healthcare delivery aimed at achieving better patient outcomes at lower costs to the healthcare provider. The practise of VBHC requires efficient information systems with good reporting capability and subsequent outcome measuring. Information systems within the National Health Service (NHS) are often multiple and not necessarily integrated to one another. We therefore developed a systematic approach to collecting, validating and analysing data from multiple sources and information systems, with the aim of designing and endorsing an automatic system to capture health outcomes data in heart failure to support future VBHC models. METHODS: A retrospective cohort of heart failure patients with reduced ejection fraction undergoing Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) procedures within a limited geographical area in South London were evaluated. A purpose built database was created to integrate, transform and validate health care data from multiple information systems. RESULTS: Validation analysis shows that our implemented methodology has produced a robust dataset. Our limited cohort of 134 patients does not allow for any complex statistical analysis however has identified some important themes related to outcomes and costs. CONCLUSION: We have created a validated database specific to our Trust that can be upscaled locally with ease and transferred to other health diseases. Due to variations in local procedure from one Trust to another, this methodology now requires implementation across multiple sites to understand differences in transformation of data and outcome measuring.
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spelling pubmed-87952202022-01-29 A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London Burnhope, Emma Waring, Michael Guilder, Andrew Malhotra, Bharti Cardoso, Jorge M Razavi, Reza Carr-White, Gerald Health Serv Manage Res Primary Research BACKGROUND: Value-Based Health Care (VBHC) is an evolving model of healthcare delivery aimed at achieving better patient outcomes at lower costs to the healthcare provider. The practise of VBHC requires efficient information systems with good reporting capability and subsequent outcome measuring. Information systems within the National Health Service (NHS) are often multiple and not necessarily integrated to one another. We therefore developed a systematic approach to collecting, validating and analysing data from multiple sources and information systems, with the aim of designing and endorsing an automatic system to capture health outcomes data in heart failure to support future VBHC models. METHODS: A retrospective cohort of heart failure patients with reduced ejection fraction undergoing Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) procedures within a limited geographical area in South London were evaluated. A purpose built database was created to integrate, transform and validate health care data from multiple information systems. RESULTS: Validation analysis shows that our implemented methodology has produced a robust dataset. Our limited cohort of 134 patients does not allow for any complex statistical analysis however has identified some important themes related to outcomes and costs. CONCLUSION: We have created a validated database specific to our Trust that can be upscaled locally with ease and transferred to other health diseases. Due to variations in local procedure from one Trust to another, this methodology now requires implementation across multiple sites to understand differences in transformation of data and outcome measuring. SAGE Publications 2020-11-30 2022-02 /pmc/articles/PMC8795220/ /pubmed/33256480 http://dx.doi.org/10.1177/0951484820971442 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Primary Research
Burnhope, Emma
Waring, Michael
Guilder, Andrew
Malhotra, Bharti
Cardoso, Jorge M
Razavi, Reza
Carr-White, Gerald
A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London
title A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London
title_full A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London
title_fullStr A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London
title_full_unstemmed A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London
title_short A systematic approach towards implementing value-based health care in heart failure: Understandings from retrospective analysis methods in South London
title_sort systematic approach towards implementing value-based health care in heart failure: understandings from retrospective analysis methods in south london
topic Primary Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795220/
https://www.ncbi.nlm.nih.gov/pubmed/33256480
http://dx.doi.org/10.1177/0951484820971442
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