A toolkit for Philips to support transformation to value-based care in living labs

Abstract

Healthcare systems in developed countries are under extreme pressure due to multiple factors. The challenge is to deliver high quality of care while dealing with limited budgets. An ageing population and in increase in chronic diseases leads to an growing demand for care. This growing demand leads to an increase in costs in the system, but the required budgets are not available. The rapid rise of costs makes healthcare systems unsustainable, a transformation is needed. Not only the costs, also other signs show that healthcare systems need drastic change. Patients are not satisfied, healthcare staff is dealing with burnouts and health outcomes are not as good as is desired. These different signs together show that the healthcare deals with a systemic problem. To address a system problem, the different factors should not be seen in isolation, the interlinked effect of factors should be considered. What is needed is a transformation towards value-based care (VBC). Theory proposed by Porter and Teisberg (2006) explains that the basis of healthcare systems need to shift from delivering volume to delivering value. From their perspecitveg value in healthcare means to improve relevant health outcomes while reducing the costs. The transformation to value-based care can be guided by the quadruple aim. The quadruple aim is a framework developed by Spinelli (2013) and used by Philips to show the different dimensions that need to be addressed in transformation: 1)improving health outcomes, 2) improving patient experience, 3) reducing costs and 4) improving staff experience. The quadruple aim is a suitable approach to guide transformation to VBC as it is widely used across the health system. The quadruple aim is seen as most complete overview compared to other frameworks, because all important dimensions of a healthcare system are included in the quadruple aim. However, the theory on VBC and the quadruple aim is general and needs a translation into a specific context. In other words, the global strategy of VBC needs to be made specific to guide local action. In this thesis, living labs are the context for defining local action. Philips wants to set up living labs with multiple stakeholders and learn how to initiate living labs for transformation to VBC. A key element in the initiation of a living lab is the construction of a common vision, because based on this vision actions need to be defined. This thesis results in a toolkit to supports the definition of a vision for a living lab and translate the vision into action. The toolkit can be used in co-created sessions with partners in the living lab. The toolkit provides tools to define purpose, partners and objectives in a local setting. The purpose for the living lab is defined first. An overview of the global challenge, vision and enablers in VBC is presented visually. Following the step-by-step approach will support the lab partners in defining a local challenge, vision and enablers. Based on the identified local vision, the partners and objectives for the living lab can be systematically discussed using tools. To support the co-creation sessions, the toolkit consists of four elements: A global purpose visualization. Work sheets that need to be printed and filled in during the sessions. A slidedeck to use during workshops. Facilitator instructions to support the facilitator in explaining the process. The toolkit has been tested within Philips and determined valuable for their business. Based on a test session suggestions for improvements are identified and included in the report. It is recommended to further test the toolkit in real-life settings. The toolkit shows to be relevant by providing a integrated overview of theory on VBC in a visual way. Besides, by outlining the process of initiating a living lab, this thesis is a foundation to develop more tools that can be used in living labs.