Living Lab Teamwork Design: Design for Value-Based Healthcare

Background

Value-Based Healthcare at Amsterdam University Medical Centers

In order to guarantee quality, accessibility and affordability of healthcare in the longer term, value-based healthcare has been on the rise for several years now. Value-based health care is aimed at maximizing the value of care for the patient and reducing the costs of care. Starting points of value-based healthcare are, among others, to organize care around clearly defined patient groups, to measure the outcomes and costs for each patient, and to support this way of care provision by technology. By jointly guiding all professionals involved in the care pathway and the patient on the outcome that matters to the patient (including quality of life and personal preferences), the expectation is that value-based healthcare leads to better health outcomes and minimization of costs. This has benefits for the patient, the care providers, the care organization and society.

At Amsterdam University Medical Centers, location VUmc, value-based healthcare also receives full attention. In various testing grounds that are related to different syndromes (e.g. diabetes, schizis, kidney damage) VUmc invests heavily in the bottom-up design of value-based healthcare. In these testing grounds three elements are central: 1) a strong multidisciplinary team; 2) measuring and discussing patient outcomes with the patient, including ‘patient reported outcome measures’ (PROMS); and 3) involving the patient in decision making (‘shared decision making’). Designing and implementing this multidisciplinary collaboration and shared decision making involves major organizational changes as well as a substantial financial investment. The creative vision of designers (design thinking) can play an essential role here.

Assignment

The central question in this assignment is: How to implement value-based healthcare in the consultation room?

Develop solutions that contribute to value-based healthcare, either by enhancing patient participation in their care process, shared decision making or multi-disciplinary collaboration.

Each student group will be assigned to a different testing ground of the VUmc. Each group will work on the same assignment, but challenges and context will differ slightly per testing ground.

More information on Schisis.

Diabetes: a new diabetes center is currently set up at VUmc. Main challenges concern the collaboration between professionals and the communication between professional and patient. For diabetes patients, life style issues are of particular importance (eg weight, exercising, smoking behaviour), but often hard to discuss.
Schizis (in Dutch 'hazelip'): the patient population for schizis concerns children and their parents. This requires a different approach than for an adult patient population.
Kidney damage: Typical challenge for the kidney damage department is the out-patient care that will be offered, the so-called dialyses at home. This requires active patient participation and a complex chain of care involving in- and out-patient care.

Knowledge will be needed about a) aspects of the health condition that the project will focus on; b) needs and current interactions between patients and care providers, c) needs and current interactions between health care professionals, d) healthcare system, regulations, and other contextual constraints to developing novel solutions. Developing a patient journey will be part of the analysis phase of the project. To thoroughly understand the needs and context of all stakeholders, interviews with patients and care providers and observations of consultations and multidisciplinary meetings will be part of this assignment.

Possible solution directions include (digital) decision aids that can be used during consultations, lay-out of the consultation room or meeting room, and information applications that support collaboration and help to improve shared situation awareness. We strongly encourage students to come up with 3D, tangible solutions that change or nudge collaborative behaviour.