Tuesday, 22 September 2020

Value-based healthcare will optimise health initiatives'

15 November 2016 | Influencers | By BioSpectrum Bureau

Value-based healthcare will optimise health initiatives'

Dr. Xavier Xuanhao Chan, Director, IMS Institute for Healthcare Informatics

Dr. Xavier Xuanhao Chan, Director, IMS Institute for Healthcare Informatics

IMS Institute for Healthcare Informatics, a research driven entity that provides key policy setters and decision makers in the global health sector with transformational insights into healthcare dynamics, has recently expanded its presence in Singapore.

IMS Institute plans to focus on mobilizing and advancing health services and systems research by bringing together leading policy advisors, educators, researchers and medical care providers. The institute will connect clinical, economic and patient-reported outcomes data to provide all stakeholders with deeper insights for improving the care of patients and their treatment journey experience.

Dr. Xavier Xuanhao Chan, Director, IMS Institute for Healthcare Informatics, Asia shares more on the expansion plans.


Tell us more about IMS initiatives for a collaborative effort in technology to tackle healthcare challenges. What role can value-based healthcare play in achieving healthcare goals?

The IMS Institute for Healthcare Informatics in Asia is the first collaborative platform in the region that aims to improve quality of care and efficiency of healthcare spending by empowering decision makers with the data-driven insights and tools they need.

By facilitating collaboration between public and private sectors, the IMS Institute in Asia aims to harness best practices and an open exchange of ideas for better patient coverage, outcomes and quality of care in Asia, while circumventing the frequent challenges of uneven quality of healthcare delivery and resource allocation.

Value-based healthcare will optimise outcomes both through preventative health initiatives or strategies to improve care provided. It can also mitigate the most significant cost drivers such as acute events and repeat hospitalisations. This will ultimately result in a high quality healthcare system that will enable patients to quickly receive the treatments they need most to recover and feel better faster.


How effective is an analytics-driven approach in managing healthcare in Asia given the challenges in demographic and infrastructure?

The effectiveness of any health information management system depends heavily on the level of engagement and commitment of all relevant stakeholders in the healthcare ecosystem. As a neutral platform for these stakeholders, both public and private, to collaborate, the IMS Institute is laying the foundations for developing infrastructure and understanding the specific needs of each market. It also allows for sharing of data and best practice from previously disconnected sources, which are often the case in emerging markets such as Indonesia, Vietnam, Philippines and Thailand.

To ensure we are focused on the region's most pressing needs, the IMS Institute has access to an External Advisory Board (EAB), a diverse panel made up of policy makers, non-governmental organisations, private companies and patient groups. This also helps us tailor any approach to a given market's needs.


This kind of approach needs extensive collaboration from technology providers, policy makers, healthcare service providers and last but not the least, patients. How feasible is it to set up such large collaborations? What are the challenges in this approach?

Establishing the IMS Institute as the first collaborative platform for improving healthcare outcomes in Asia is a big step forward towards making this a reality. Having access to such a diverse EAB, something unique to the IMS Institute in Asia, also helps to open doors across the spectrum of care, creating more opportunities for collaboration. The Institute can also draw on the extensive networks of IMS Health, which has been working closely with regional stakeholders for more than 60 years. By bringing together governments, academia, healthcare institutions, private companies and patients, we hope to facilitate the open exchange of ideas and best practices, and ultimately influence better decision making at the policy level.

This approach has already resulted in a series of MoUs to improve outcomes in stroke and cancer across the region, as well as facilitate the creation of new treatments.

Of course, such an approach does not come without challenges. Every stakeholder comes with differing priorities and ability to implement change. For example, emerging market health systems often lack technology and regulatory framework to access and share real world data. Many specialist healthcare providers collect patient data but have limited capacity to engage in research. In order to build capacity, the IMS Institute in Asia invests in building and strengthening specialist physician networks to enable data sharing and collaborative research. Through our networks and collaborative partners, we aim to also galvanise resources to improve clinical and academic capacity to collect and analyse longitudinal patient data. One of our goals is to then work with academic medicine practitioners to publish research reports on key issues, policy options and data-driven approaches to improving the regulatory environment.


How much time and cost can such methods save for patients and clinics?

A value-based healthcare approach allows healthcare systems to effectively track outcomes and actual cost of care for each patient to understand what is working, what isn't, and how to minimise waste. For patients, this means they can expect treatment and disease intervention that is tailored to their needs, introduced at the right time and focused on improving their quality of life.

Through the Institute's work with Duke-NUS on the Singapore Stroke Model, we uncovered that stroke intervention strategies are often synergistic. For example, public awareness campaigns are only effective when linked to one or more other interventions, such as a targeted effort to increase use of thrombolysis or endovascular therapy. Incorporating all stroke practice improvement strategies led to a gain of 14,330 quality-adjusted life years (QALYs) versus only 166 QALYs gained by implementing only a public awareness campaign for the full Singapore population.


Are there any specific diseases that can be managed through value based healthcare or can it be applied to all diseases?

For healthcare systems in Asia to fully realise the benefits of value-based healthcare, all stakeholders must join in the effort of maximising the role of health informatics and decision modelling in guiding clinical practice. There has been growing recognition that value-based approaches can optimise healthcare for the population and patients in a cost-effective manner. There has also been growing recognition of the importance of real-world health data and analytics to improving healthcare, as stakeholders have witnessed the progress made to identify best treatments, improve patient outcomes, and optimise resource allocation.

However, to maximise the benefits value-based healthcare models can provide in Asia, all stakeholders, including hospitals, government institutions, academia, clinicians, insurance agencies, payers and manufacturers should revise their focus from the volume and profitability of services provided (i.e. physician visits, hospitalisations, procedures, and tests) to tailored services (i.e. health-related social services) that optimise patient outcomes.

Currently, the Institute is carrying out decision modelling for diseases like diabetes and stroke to simulate different treatment choices and its respective health and economic outcomes. Insights gathered from modelling such scenarios can inform decision making processes to maximise the value passed on to patients. This real-world data-driven modelling process can be similarly applied to other diseases as long as there is sufficient data available for analysis.


Currently what is the reach of this model and how do you intend to expand it in different countries? Do you have partnerships with stakeholders in countries other than Singapore?

While the Institute is based in Singapore, its aim is to tackle and improve treatment outcomes for some of the most pressing diseases in the region. Tapping on Singapore's connectivity and pool of expertise will help to establish the Institute as a Centre of Excellence for the region and ultimately develop a better Asian capability for delivering high quality and affordable healthcare.

The MoUs we recently signed reflect this approach. For instance, the Institute's partnership with National Cancer Centre Singapore will establish the first Asian Lung Cancer Registry and first Asian Patient Registry on Long-term Effectiveness and Safety Evaluation for Immuno-oncology agents. We are also working with the National University Health System to establish the first Gastro-Esophageal Patient Registry in Asia. These efforts will identify unmet medical needs to shape better care pathways and enhance treatment outcomes in the region.

The IMS Institute in Asia welcomes partnerships to create real-world evidence-based solutions, innovative value-based healthcare and business models, technology and applications, advanced predictive analytics, and thought leadership in life science, medical technology and consumer health.

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