Dermatology Research Unit, Ghent University, Ghent, Belgium.
Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
Dermatology. 2023;239(3):334-344. doi: 10.1159/000529398. Epub 2023 Feb 14.
There is a need to revise the current healthcare organization due to the ever-rising costs and variation in quality of delivered care. Over the past decades there have been several strategic frameworks attempting to tackle this problem. Value-based healthcare (VBHC) is one of those frameworks which has gained increasing popularity the last years. The framework is formulated on the premise that the healthcare sector should deliver integrated care, using integrated practice units (IPUs), and strive to maximize the value created. Value in this context is defined as the health outcomes achieved per costs made. We have designed a lean IPU called PsoPlus in which psoriasis patients are managed by a multidisciplinary team which has all the expertise and skill to manage psoriasis and its associated conditions. In addition, we have developed and implemented guidelines for the management of psoriasis-associated comorbidities, enabling us to deliver integrated care in the Belgian healthcare setting. Finally, we have designed a supporting information technology platform, called PsoSmart, which brings data from patients and healthcare providers together and provides actionable insights for clinical decision making. The created value is documented and captured using a value-based outcome set. Cost assessments at the individual patient level are also performed. To conclude, we describe here a comprehensive IPU setting for psoriasis which incorporates the VBHC principles. This IPU goes further and delivers a higher level of integrated care than other multidisciplinary psoriasis clinics. Monitoring outcomes and costs provides us with further insights to optimize psoriasis care. In addition, a software program designed to enhance psoriasis care is being developed further; however, advances in healthcare technology are needed.
由于医疗成本不断上升和医疗服务质量的差异，需要对当前的医疗保健组织进行改革。在过去的几十年里，已经有几个战略框架试图解决这个问题。基于价值的医疗保健（VBHC）就是其中一个近年来越来越受欢迎的框架。该框架基于这样一个前提，即医疗保健部门应该提供综合护理，使用综合实践单位（IPU），并努力最大限度地创造价值。在这种情况下，价值是指每单位成本所实现的健康结果。我们设计了一个名为 PsoPlus 的精益 IPU，其中银屑病患者由一个多学科团队管理，该团队拥有管理银屑病及其相关疾病的所有专业知识和技能。此外，我们还制定并实施了管理银屑病相关合并症的指南，使我们能够在比利时的医疗保健环境中提供综合护理。最后，我们设计了一个支持性的信息技术平台，称为 PsoSmart，它将患者和医疗保健提供者的数据汇集在一起，并为临床决策提供可操作的见解。所创造的价值通过基于价值的结果集进行记录和捕获。还对个体患者层面的成本进行评估。总之，我们在这里描述了一种综合的银屑病 IPU，其中包含 VBHC 原则。该 IPU 更进一步，提供了比其他多学科银屑病诊所更高水平的综合护理。监测结果和成本为我们提供了进一步优化银屑病护理的见解。此外，正在进一步开发旨在增强银屑病护理的软件程序；然而，需要医疗技术的进步。
