Abstract
Introduction: The perspective of value-based care proposes that the evaluation of health services should not be based on the measurement of performed activities, but on the health outcomes they aim to achieve. Furthermore, these outcomes have to be relevant for the patients. In this context, the patients’ role shifts from a passive service receiver to an active decision-maker. The new ‘patient-centered service’ design and evaluation paradigm requires not only a comprehensive health outcome framework and associated assessment but also that clinicians involve patients in healthcare discussions and decisions on desired and realistic health outcomes.
Aims, Objectives, Theory or Methods: The EU project ADLIFE (GA875209) aims to achieve gains in patient health outcomes by providing innovative integrated intelligent outcome-based personalized care. The personalized care plans facilitate a more active role of patients and caregivers in managing their own health and symptoms. The integrated care plans provide measurable health outcomes supporting the care provision consistent with the involvement of patients in healthcare discussions and decisions. ADLIFE promotes the patient-centered approach by means of measuring valuable health outcomes. To this end, we desgned a framework to organize and categorize health outcomes to be measured in the Project.
Highlights or Results or Key Findings: The information in ADLIFE has three main purposes: (i) design the components of the digital solution, (ii) personalization and adaptation of the care plan to the dynamic needs of patients (iii) evaluation of the benefit of the ADLIFE care plan for patients and health systems. ADLIFE has developed a conceptual framework to define the relevant health outcomes that need to be assessed. The framework, adapted by a multidisciplinary team involving health professionals, from ICHOM standard sets for older people and heart failure, is structured in areas (disutility of care, symptoms, functioning quality of life, care, healthcare responsiveness,etc), dimensions (autonomy, symptom control, appropriateness, etc) and variables. (symptoms, laboratory results, service utilization, care burden, etc.). All health-related information required to achieve ADLIFE purposes has been mapped to the health outcomes framework.
Conclusions: Patient centered approach requires measuring health outcomes. Information used in ADLIFE is organized according to a health-outcomes framework. Inputs, activities and results can be traced and mapped to specific health outcomes. This allows adapting care plan to changing needs and performing a complete and thorough evaluation of its effectiveness.
Implications for applicability/transferability, sustainability, and limitations:
ADLIFE’S technology innovations will be deployed, used and evaluated through a large-scale pilot and trial in seven healthcare environments.
The conceptual data framework identifies the relevant health areas relevant for the target population of ADLIFE, patients’ people over 55 years old with severe heart failure and/or COPD.