Introducing a method for implementing value based health care principles in the full cycle of care: Using atrial fibrillation as a proof of concept

Background: Value Based Health Care (VBHC) is a well-known strategy in most countries, amongst whom the Netherlands, to improve patient-relevant outcomes and reduce healthcare costs. However, a methodology to implement VBHC principles in the full care cycle is lacking. This study describes a stepwise approach to implement and continuously improve patient-relevant outcomes in the total care delivery value chain.Methods: Key principles of VBHC are used to develop a stepwise methodology in which healthcare providers of primary, secondary, and tertiary care collaborate in a physician-driven initiative called the Netherlands Heart Network. The methodology incorporates the Plan-Do-Study-Act cycle to ensure continuous improvement of patient-relevant outcomes. To outline the presented methodology, the medical condition atrial fibrillation is used as a proof of concept.Results: Using the stepwise methodology results in an adequate registration of patient-relevant outcomes and a structured evaluation of adherence to prevailing guidelines. Based on the followed methodology, detailed improvements are defined in order to optimize patient-relevant outcomes.Conclusions: The presented methodology provides a description how to implement VBHC principles in the full cycle of care. Since this methodology is a first concept, future research should apply and assess the stepwise methodology in other fields and for different medical conditions.