Disclosure belangen spreker

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1 Disclosure belangen spreker (potentiële) belangenverstrengeling Voor bijeenkomst mogelijk relevante relaties met bedrijven Sponsoring of onderzoeksgeld Honorarium of andere (financiële) vergoeding Aandeelhouder Andere relatie, namelijk Geen / Zie hieronder Bedrijfsnamen The Decision Group/ The Decision Institute als adviseur met name qua methodiek bij de uitvoering betrokken. Betrokken als voorzitter en secretaris van medical en methodological academic council bij internationale validatie 1 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

2 Zorg voor Uitkomst Value based healthcare 2

3 Woorden van waardering van de International Academic Council This has been an extremely positive process. This project will have significant benefit to the Dutch healthcare system prof. dr. Peter Goldstraw (Royal Brompton Hospital, London) 3 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

4 Council advies voor de toekomst Het innoveren en verbeteren van de uitkomstindicatoren is noodzakelijk, vooral in de oncologie. Medisch 1. Multidisciplinaire bespreking van patiënten 2. Shared decision making, MDT en patiënt beslissen over behandeling Diagnostisch 1. Hoe beïnvloedt vroege en snelle diagnostiek uitkomsten en behandeling Organisatorisch 1. Waarborging van arts gedreven, patiënt gerichte aanpak 2. Gescheiden dataregistratie en controle 3. Data eigenaarschap ligt bij artsen 4. Toezicht vanuit statistici en methodologische, health administrative en medische experts 4 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

5 Het interpreteren en leren van uitkomstindicatoren There will be a shift towards less under- and less overtreatment. The Netherlands with respect to this regimen are currently far ahead of for example Spain, Poland or Belgium prof. Bertrand Tombal, MD PhD (Cliniques Universitaires Saint Luc, Brussel) 5 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

6 Methodologie voor uitkomstindicator ontwikkeling De definitie van de medische conditie vormt de basis voor verantwoorde uitkomstindicatoren selectie Care Delivery Value Chain voor primaire behandeling van prostaatkanker * Advice on self screening * Counseling patient and family on the * Explaining patient treatment options/ * Counseling on the treatment process * Counseling on rehabilitation options, * Counseling on long term risk * Consultation on risk factors diagnostic process and the diagnoses shared decision making * Patient and family psychological process management * Genetic counseling * Brochure KWF * Counseling on sexual consequences counseling * Psychological counseling * Informing on diagnostic procedures * Brochure on disease * Counseling on incontence consequences * Brochure on side effects INFORMING AND * Brochures on diagnostic procedures * Patient and family psychological ENGAGING counseling * Brochure on treatment 1. Medische conditie MEASURING ACCESSING * Rectal examination score * Rectal examination score * ASA score * Intervention-specific measurements * Side effects measurement * Labs * PSA * Ultrasound (TRUS) * Labs * Physical QoL (Last meter) * Physical QoL (Last meter) * Physical QoL (Last meter) * Pro-active bodyscan * Biopsy * Nutrition score (MUST or SNACK) * Nutrition score (MUST or SNACK) * Nutrition score (MUST or SNACK) * Genotyping * MRI * Comorbidity score * Pain score * Pain score * CT scan * Bone scans * PCA3 test * PSA score * Gleason score * d'amico score * GP visits * Office visits (outpatient) * Office visits (outpatient) * Hospital stays * Office visits (outpatient) * Lab visits * Office visits (outpatient) * Lab visits * Hospital visits * Visits to outpatient radiation unit * Rehabilitation facility visits * Office visits (outpatient) Geneticist * High risk clinic visits * Lab visits * Pharmacy * Pharmacy Chain link: 1. MONITORING/PREVENTING 2. DIAGNOSING 3. PREPARING 4. INTERVENING (initial) 5. RECOVERING/REHABING 6. MONITORING/MANAGING * Medical + family history * Anamnesis * Choosing treatment modality (chemotherapy, RT, Surgery) * Radical prostatectomy; or * Treatment of side effects (e.g. skin * Follow -up clinical exams CARE DELIVERY ACTIVITIES * Control of risk factors * Determining specific nature of disease * Choosing a treatment plan (timeline, dosage,...) * Brachy therapy; or damage, complications, nausea, lymphodema * Treatment for any continued or later * Clinical exams (blood sample, bodyscan) (pathology, biopsy results, TNM-stage) * Surgery preparation * External beam radiation therapy or and chronic fatigue) onset side effects or complications * Genetic screening * Medical + family history (anesthetic risk assessment, shaving, medication, nutrition) * Internal radiation therapy * In-hospital and outpatient w ound healing * Adjuvant therapy * Formulate treatment options * Chemotherapy preparation (medication, nutrition,..) * Hormonal therapy * Physical therapy (hormonal medication, radiation, salvage) * RT preparation (medication,...) * Other therapy (...) * Follow -up visit * Neo-adjuvant hormonal therapy * Diagnosing can either result in continuation to steps 3. Preparing and 4. Intervening, or in the reloop to step 1 (active surveillance) * * * Optimalisation of patient condition (nutrition, sports,...) Feedback naar monitoring na behandeling? 2. Care Delivery Value Chain Medical Specialist In hospital - no medical specialist or not per se - Other provider entity Patient Value Provider Margin 3. Uitkomstindicatoren & Initiële patiënt condities 6 6 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

7 Een historisch woud van indicatoren Verschillende indicatoren voor verschillende beslissers en gebruikers is de uitdaging. It is important to improve the healthcare system by measuring variables. This project really measures the variables that are relevant for the quality of work. The project is a great example of how to build a system for outcome measurement prof. dr. Harry Groen (UMCG, Groningen) 7 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

8 Value Based Healthcare: Arts Gedreven & Patiënt Gericht Countries in the VBHC network Number of individual heatlthcare experts and academics per continent Academic partners and Key academic partners - Cooperations Top clinical hospitals (Outside The Netherlands) 8 Zorg voor Uitkomst Value Based Healthcare February The Decision Group, All rights reserved Value Based Healthcare Center Europe,

9 Thank you for your attention C o n t a c t p : ( 0 ) e : i n f t h e d e c i s i o n g r o u p. n l w w w. v b h c. e u 9