As a practicing doctor and then as a consultant, much of Stefan Larsson's career has been driven by one motivation: improving healthcare. In 2012, he co-founded the International Consortium for Health Outcomes Measurement (ICHOM) and recently co-authored the book ‘The Patient Priority’ to show how putting patients first can address the multiple crises confronting the global healthcare sector.
“The aim of anyone working in healthcare should be to improve patient outcomes. Patient-reported data allow us to build replicable care models that continually improve outcomes while reducing total costs, helping tackle healthcare challenges and bringing value to providers, professionals and, most of all, patients.
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What are the challenges facing healthcare systems?
I see three key challenges. The first is a value crisis: health costs in a large part of the world are growing twice as fast as GDP. Yet 20–40% of the money spent is wasted on things that don’t really help the patient. At a population level there is little correlation between healthcare spending and healthy life years. Second, there is an evidence crisis. There has been an enormous increase in medical knowledge, but far too little comparative research on which treatments are most successful. Third, there is a purpose crisis. Doctors and nurses are suffering burnout or leaving the profession because they feel they cannot do the job they were trained to do. To address these crises, the management of healthcare needs to be more aligned with the ultimate purpose of our healthcare systems: helping patients.
So, your solution is to deploy the value-based healthcare approach at a larger scale... What does this mean for you?
Essentially it means focusing on the health outcomes that matter most to patients. Of course, the clinical data generated today is vital, but what is often missing is how the patient’s quality of life is affected by a treatment. If you only consider one single clinical outcome, such as survival for instance, you might opt for a certain course of treatment. But over time we’ve learned that there are many other factors to consider that are very important to patients. Taking these into account means you can change a patient's pathway and treatment to minimize negative consequences on quality of life. It’s a much more holistic way of managing healthcare.
How can this approach be implemented?
The starting point is to gather data using metrics that represent true success in caring for the patient. Typically, when this data is gathered today, it is not in a standardized and systematic way, making it impossible to know where the best results are achieved from the patient’s perspective. The goal of the ICHOM has been to develop patient-centered outcomes measures that standardize this information. A disease such as diabetes is the same in New York, Stockholm and Zimbabwe, and patients everywhere want the same end results, so we are able to create global standards for patient outcomes. With these in place, doctors, nurses, patients and institutions can compare their results and figure out why some have better results ––or don’t––and use this information as a source for research and inspiration to drive continuous improvement in outcomes and to reduce the waste of resources.
What is your advice for healthcare companies in terms of this transformation?
The aim of anyone working in healthcare should be to improve patient outcomes. To do so, it is essential to collect data on clinical indicators (including quality of life information shared by the patient) and make it transparent and accessible to healthcare providers. This need will continue to grow, and companies that are proactive and innovative in this space will have a key role to play in this evolution.
Thanks to data shared by the patient, we can create care pathways that enable us to continually improve outcomes, all while reducing costs to the healthcare system. Providing real value to healthcare professionals, caregivers and, most importantly, patients, is key to meeting the industry’s challenges.
