ValueCare - A Paradigm Shift for Integrated Health and Social Care
Introduction
ValueCare was an EU-funded project that ran from 2020 to 2024 and aimed to further the understanding and development of integrated value-based care, enabled by IT. The project’s vision was supported by a robust, secure and scalable digital solution that was tested and evaluated in seven large-scale pilots in Europe, based on a methodology created in collaboration with experts and end-users.
“We looked at the outcomes,“ said Prof. Hein Raat, who coordinated the project at lead partner Erasmus Medical Centre in Rotterdam.
“We care about the values of the people who come to us in the hospital or in the clinic or to the social service. The outcomes for us are the values of the patients and the clients.”
Value-based health care (VBHC), is an approach to care originating in the United States, where providers work with patients to determine a treatment plan that suits their needs and desires, and then measure both the clinical outcomes and the costs as it is implemented. This approach has been shown to improve patient outcomes and reduce cost.
The goal of the ValueCare project was to investigate how this approach could work in Europe, and how it could be supported by digital tools. To truly understand how this could work in practice, a diverse range of inputs from different backgrounds and demographics were needed.
“We had large pilot sites in seven countries. The countries are all over Europe, and they had different contexts,” said Hein.
“We wanted to test the new innovation in the different sites, in the different types of community, the different type of healthcare system. So our solutions should be robust and should be applicable to the whole of Europe, but even outside Europe.”
Following the conclusion of the pilots, the ValueCare team analysed the results, which showed real promise for the further implementation of the value-based care approach.
“We see many lights in the results. Quality of life was improved. There were cost savings we see in the data. So although there is much to be done in the future, we see we are on the right track, and that makes me happy.”
To learn more about the ValueCare results, check out the the following pages:
Who was the ValueCare project aimed at?
The project had a pre-post controlled study design, with an intervention and control group and three measurement time points (baseline, post-intervention after 6-12 months, and follow up after 10-18 months.)
The specific demographics and conditions in each pilot site were different, but covered older people with multimorbidity and/or frailty and/or mild to moderate cognitive impairment.
Each pilot site had to include 120 older people in the intervention group, 120 older people in the control group, 50-70 informal caregivers, 30-40 health and social care practitioners, and 5-10 coordinators, managers, or IT experts.
The pilot sites were Rotterdam in the Netherlands, Cork-Kerry in Ireland, Rijeka in Croatia, Valencia in Spain, Coimbra in Portugal, Athens in Greece, and Treviso in Italy.
“That’s a really broad coverage of Europe,” said Prof. Vanja Vasiljev from MEDRI at the University of Rijeka, who led the pilot programme.
“Something that was considered was how do you get as many different voices and experiences?
All the participants were older than 65, but the target groups within each pilot site were different. For example, in the Rijeka pilot we were dealing with older people that suffered myocardial infraction and went through the process of rehabilitation. In Rotterdam they were working with stroke patients.”
At the close of the pilots, the ValueCare pilot site leaders shared their experiences and reflections, which you can check out in the video below:
What’s next for ValueCare?
The ValueCare project closed in September 2024, following the Conference on Innovations in Outcome-Based Integrated Care with Digital Solutions, held in Rotterdam, where members of the team gathered to discuss the projects results with leaders from the field of value-based care.
Natalia Alegretti from ECHAlliance, who led the projects exploitation efforts, felt the same.
“We have achieved a number of different results to augment or enhance the knowledge in the field of value-based healthcare. We are trying to make sure that the this research and the development projects don’t fall into the so-called ‘valley of death’, and that they can be used and implemented to create a positive on wider society.”
She highlighted the ValueCare book was one of the most important results, and a great starting point for anyone who wants to explore the project.
Members of the ValueCare team have also completed training to educate people directly in how to implement value-based care, and will be exploring this further in the future.
Members of the ValueCare team have also completed training to educate people directly in how to implement value-based care, and will be exploring this further in the future.
The ValueCare team also came up with a set of policy guidelines which can help decision makers to reshape their systems to facilitate value-based care.
Tamara Alhambra Borrás from Polibienestar Research Institute at the University of Valencia, who led on policy development, said that ValueCare identified a number of important challenges that need to be addressed.
“We have identified a total of six challenges based on the existing literature and from the outcomes of the ValueCare project, and these challenges have been validated at local workshops in each pilot site, in which we invited local stakeholders to see and explore those challenges.”
The policy guidelines recommend the following priorities:
- Facilitate the engagement and empowerment of older people
- Co-define, co-monitor and co-evaluate the quality of care
- Enhance collaboration, coordination and communication mechanisms around older people’s living environments.
- Focus on prevention, health and digital literacy.
- Improve working conditions, satisfaction and wellbeing of health and social care professionals.
- Support alternative payment models that reward high quality care delivery.
However, while the project closed, Prof. Raat said that it marked the beginning of a wider conversation about the project results and how they can be implemented elsewhere.
“It doesn’t feel like an end,” he said.
“This closing of the project is in fact the beginning of a new period. We will be active in spreading the news and finding new partners to bring this further”