Outcome-based healthcare: From policy to action and impact

SUMMARY

Outcome-based and patient-oriented approaches in medicine and health are experiencing a boost because of new opportunities arising from digitisation, information technologies and big data. By extension, outcome information (both medical and non-medical) is increasingly seen as vital for healthcare providers and patients to make shared decisions about the most suitable care or treatment.

In the past couple of years, the Netherlands has moved into the vanguard of countries seeking to embed these principles in policy frameworks, strategic planning, health system support services and stakeholder engagement models. It is also driving international collaboration around outcomes thinking and measurement through organisations such as the OECD, ICHOM and World Economic Forum.

Similarly, since 2016 the Science|Business Healthy Measures initiative has been investigating patient outcomes and health data as a driver of change and innovation in different European health systems. On April 4, it will convene its latest high-level roundtable in Amsterdam to discuss key factors behind the Dutch transition to outcome-based healthcare, progress made and lessons learned to date, and the wider implications for other EU member states and health decision-makers.

CONTEXT

In October 2017, the leaders of four political parties in the Dutch Parliament released their new Coalition Agreement, which signalled that future policies – in particular those relating to curative care – would place increasing emphasis on patient outcomes. The Agreement also signalled that these commitments would not demand radical reform, rather a well-managed and -resourced process of continuous improvement, supported by the development of enhanced outcome indicators. 

Since then, the Netherlands has become a leading test-bed for outcome-based healthcare models and methods, translating political ambition into concrete action. A five year national plan was launched in mid-2018 by the Ministry of Health, Welfare and Sport (VWS), supported by the National Health Care Institute (ZiNL), structured around four central objectives:

• More insight into outcomes
• More shared decision-making
• Organisation and funding of care focused more on outcomes
• Better access to relevant and up-to-date outcomes information

To deliver on these commitments, the government is working closely with expert advisory groups (e.g. Linnean Initiative), hospital alliances (e.g. Santeon, Samen Beslissen), international consortia (e.g. ICHOM, PROMIS) and a wide range of other stakeholders to develop key metrics and a robust knowledge base of what works, what can be scaled, and what needs to happen for outcome-based approaches to be streamed more effectively throughout the health system.

Against this backdrop, the Science|Business Healthy Measures roundtable will seek to go deeper into the Dutch experience from various angles, including policy formulation, patient and stakeholder inclusion, new technologies and data management, among others. It will bring together 30-35 senior representatives from the Netherlands and elsewhere in Europe in a dynamic format of open and reflective dialogue – the key findings from which will be captured in a Science|Business publication and distributed to over 20,000 international readers.