Value Based Health Care Delivery Seminar - Harvard Business School

Sotirios Nedios, MD

May 30, 2019

Centers of Expertise (COEs) are innovative cross-specialty educational opportunities supported by Partners Healthcare. They complement clinical training by providing residents and fellows with exposure to 4 important areas of health care delivery: global and humanitarian health, health policy and management, healthcare quality and patient safety, and medical education.

In January 2018 and during my Electrophysiology Fellowship in the Massachusetts General Hospital, I had the opportunity to visit the Value Based Health Care Delivery (VBHD) Seminar in Harvard Business School. Prof. Porter, Prof. Teisberg and their team brought together a big group of residents and fellows providing conceptual frameworks for Health Economics and sparking discussions on actual in-depth case studies from around the world. The curriculum included concept presentations, case studies, instructor teaching notes, videos of guest protagonists, and other videos designed to assist instructors in the teaching of the material.

Dr. Sotirios Nedios

Thanks to this seminar I got a better understanding on a variety of topics like Value-Based Health Care, Outcome and Cost Measurement, Patient-Reported Outcomes (PROMs), Overview of Projects etc. I gained valuable knowledge from real-world examples both in advanced (e.g. Partners, Cleveland Clinic, Boston and Texas Children's Hospital) and primary health care (Oak Street Health) in the U.S. and abroad (e.g. Martini Klinik in Germany, OrthoChoise in Sweden, PIH Community Care in Haiti).

This gave me a different perspective on how economics can transform health care by improving value for patients, defined as the outcomes achieved per unit of cost spent. Since significant improvements in value will require major strategic and organizational changes in how health care is delivered, measured, and paid for, it is important for future leaders to get more training on these topics. This will facilitate a new thinking on health care delivery and more meaningful future policy reforms.

By the time I visited VBHD, I had been attending the 1^st DAS-CAM leadership course: “Diploma of Advanced Studies in Cardiac Arrhythmia Management” for almost a year. This course is a joint collaboration between the Maastricht University Medical Center, the European Heart Academy and the European Heart Rhythm Association (EHRA), aiming to train future leaders to deliver state-of the-art cardiovascular services in the next decade and beyond. This program brings together renowned experts to cover topics concerning both content and context of cardiac arrhythmias, including team and unit management, epidemiology/statistics, economics and innovation.

After the VBHD course, I returned refreshed to the DAS-CAM course and actively advocated for more case-based learning and more value-based health care. This resulted in lively discussions about the different health care systems in Europe and about possible ways to move forward. For example the knowledge from VBHD and DAS-CAM has helped me personally to advocate for ultrasound-guided access in the electrophysiology lab both based both on clinical and economic data regarding the value of the patient outcomes and the reduction of costs. I am confident that courses that cover healthcare economics, like VBHD, truly enhance our clinical practice and improve the quality of care provided.

Value Based Health Care Delivery has changed the way I evaluate structural and organizational changes. It has given me the incentive to further develop my interest and my future career towards Health Economics. Experiences like this, esp. while in training, are important because they allow trainees to discover their interests and better plan their next steps. Cross-specialty educational opportunities provide a better armory for future physicians by offering a different perspective. This in turn could be the solution to many problems of the increasingly complex world of health care. After all, “no problem can be solved from the same level of consciousness that created it.”