In a European society where a growing number of people live with co-morbidities, non-communicable diseases, and in need of complex care interventions, health and social care ecosystems are expected to give greater importance to value-based outcomes, but not ignoring input and process indicators. In a well-functioning ecosystem, the creation of value for patients and citizens should be the main objective of all actors co-designing well-functioning clinical pathways. Value-based health and social care is a concept supported by the nursing profession, as end-user and co-designer.
To provide a better quality and safe care outcome, it is central to have a stronger focus on health and social outcomes (as both are linked), and more robust outcomes measurement, including nursing-sensitive data to intensify continuity of care. In particular, the measurement of “outcomes” needs to be designed with and for the end-user, to make integrated care a reality, not just a theoretical concept.
But, when it comes to measuring outcomes, the main challenge relate to “who will collect the data” and what impact this will have on nurses’ direct patient time, knowing they are already overstretched with data collection, increasing their administrative workload.
Therefore, to safe time, technologies, such as blockchain, should support patients and frontline nurses in collecting “the” relevant outcome data, across their entire healthcare journey – spanning hospital, ambulatory and community care, as well as mental health and long-term and social care outcomes. It is important to use new technologies (AI) to compare these outcome data, steer clinical pathways, easy to interpret by all end-users. So why not designing with the nurses a Personalised Electronic Health Records (PEHR) based on a chain where patients/citizens hold the key for access.
The current discussion on value-based healthcare, not including the social aspect related to health, is often approached as a disruptive model for Europe, that is less supportive to frontline end-users. To achieve better value, value-based health and social care needs to focus on continuity of care with health and social care teams being educated and trained as a team, using the available data to plan the care pathway in a more effective and efficient way, bringing the end-user closer to the direct patient care. There is no need to blame and shame in value based systems, or be disruptive, in contrast, it is key to keep the healthcare professions in their profession. To this purpose, it is crucial to invest in the education of a highly motivated nursing workforce and in the right workforce composition that facilitates nurses daily job, keeping them in the nursing profession, with the ambition to increase the direct patient care with minimum 6% in the coming 5 years.