J Am Med Inform Assoc - Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes.

Tópicos

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Resumo

JECTIVE: To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes).MATERIALS AND METHODS: In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement.RESULTS: A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care.CONCLUSIONS: The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value.

Resumo Limpo

jectiv develop expediti pragmat modular extens softwar framework understand improv healthcar valu cost relat outcomesmateri method multidisciplinari team assembl leadership univers utah health scienc center charg rapid develop pragmat action analyt framework understand enhanc healthcar valu base analysi relev prior work valu analyt framework known valu driven outcom vdo develop use agil methodolog evalu consist measur project object includ implement timeli system perform complet accuraci extens adopt satisfact abil support valu improvementresult modular extens framework develop alloc clinic care cost individu patient encount exampl labor cost hospit unit alloc patient base hour spent unit actual medic acquisit cost alloc patient base util radiolog cost alloc base minut requir studi perform relev process outcom measur also avail visual layer facilit identif valu improv opportun highvolum highcost case type high variabl cost across provid initi implement complet within month project object fulfil framework improv iter now foundat tool deliv highvalu careconclus framework describ can expediti implement provid pragmat modular extens approach understand improv healthcar valu

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