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Healthcare services as they currently exist were not designed to deliver value based healthcare. 

To design and implement value based healthcare requires a different way of thinking. A means of determining how to proactively implement a healthcare system focused on value would be to start with a tabula rasa (blank slate).  Looking at healthcare from a tabula rasa immediately breaks down silos and affords one the opportunity to focus on patients. 

Through the Value Based Healthcare Programme you will gain access to the world’s leading thinkers on value based healthcare and they will work with the key stakeholders in your healthcare system to populate your tabula rasa with answers to the following key questions:

1: How much money should be spent on healthcare?

2: How much money should be top-sliced for research, education, information technology and specialised commissioning?

3: Has the money for healthcare been distributed to different parts of the geography by a method that recognises variation in need and maximises value for the whole population?

Once the money has been distributed comes the question  

4. Has the money for care been distributed to different patients groups, e.g. people with cancer or people with mental health problems, by a process of decision-making that is not only equitable but also maximises value for the whole population?

Then once the allocation, both between programmes and within programmes (eg between different types on cancer or different types of respiratory disease) has been answered, two further questions have to be asked relating to each system of care (eg the system for people with headache or atrial fibrillation or frailty).

5: Are the resources that have been allocated being invested in the right balance of    interventions?

6: Are the right patients being offered the high value interventions?

Then there are a set of questions primarily the responsibility of people who manage services, the first of which focuses on personal value.

7: Are we sure that every individual patient is getting what is right for him or her?

Questions 8, 9 and 10 deal with efficiency, or technical value, improving outcomes by increasing quality and safety and decreasing cost, although efficiency can be improved simply by reducing cost.

8: Is the quality of care being optimised?

9: Are clinical risks being minimised?

10: Can costs be cut further without increasing harm or reducing effectiveness?

Answers to these ten questions will generate a plan and strategy that you can use as a guide and will keep you focused on creating a value based healthcare system.

 

To learn more about how the tabula rasa approach can help you, contact anant.jani@phc.ox.ac.uk.