VALUE-BASED APPROACH TO ROAD MAP OF MODERNIZATION OF THE ONCOLOGICAL CARE

Abstract

The value-based concept in healthcare was introduced by M. Porter in 2004 as an approach for improving the quality of medical care. The existing practice of implementing this approach in Russia and abroad by the present time has been limited by single projects and tools, while comprehensive methodology adapted to Russian oncological care isn’t created. The article presents a roadmap for implementation of value-based projects in oncology developed and based on the author’s experience. The analysis of Russian and foreign literature, standards, methods on the research topic was carried out. Project management tools and road mapping techniques are used. Processes decomposition, scenario and intermediate results were determined to achieve the goal — a value-oriented oncological care. The roadmap includes seven consecutive steps — setting up the integrated practice units in the form of centers of excellence, the multidisciplinary teams education, mapping the patient’s pathways, implementation into routine practice the patient-reported outcome measures (PROMs) and patient-relevant experience measures (PREMs), shared decision-making, and development of patient support programs. The necessary measures to support stakeholders for each stage of implementation are formulated. The present study is theoretical, representing the result of the analysis of the author’s previous experience and the synthesis of existing approaches. Since the roadmap has a long life cycle, the content of the stages may change during operation. The implementation of the approach requires reforming the healthcare system with a change in financing methods, approaches to cancer care, and the creation of rational incentives for all stakeholders. For replication a benchmarking platform and a flexible digital infrastructure with the ability to monitor the costs and results of medical care at the individual patient’s level must be formed.