Defining value will drive healthcare industry disruption

A compass pointing to the word "Innovative"
Misaligned definitions of value among healthcare stakeholders may be the biggest barrier to innovative change. (Image: Getty/Olivier Le Moal)

Disruption within the healthcare industry, good or bad, seems so inevitable that the first breath of Amazon’s arrival on the scene led some to hyperventilate. Until major stakeholders agree on a uniform definition of value, however, progress toward value-based care will likely remain slow and incremental.

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The driving force behind the shift from volume-based to value-based care has been the unsustainable cost of the current U.S. healthcare system, writes John Noseworthy, M.D., president and CEO of the Mayo Clinic. He describes an approach toward disruptive innovation that relies upon partnerships that reduce the “blind spots” developed at traditional healthcare organizations.

In an article published by the Harvard Business Review, Robert C. Pendleton, M.D., professor of medicine at the University of Utah School of Medicine and chief medical quality officer at University of Utah Health, argues that the biggest blind spot may involve the definition of value itself. He points to the results of a recent University of Utah survey, which demonstrate a fundamental difference in how patients, physicians, and health plan sponsors define value when it comes to care.

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For example, where physicians see clinical outcomes as the most essential component of care, patients generally tend to be more concerned with affordability than they are with improvements to their health. The survey also showed blind spots among various stakeholders with regard to the workings of the overall system, beyond the parts with which they had direct contact.

“Both of these kinds of misalignment—regarding the relative importance of outcome, cost, service, and quality, and who is responsible for achieving specific value characteristics—demonstrate the core problem: Stakeholders have not communicated with each other effectively, at the macro and micro levels, on what value means to them,” writes Pendleton.

Any set of partners that bring all stakeholders to the table and align their views on value, he concludes, will find themselves a step ahead in terms of truly “disruptive” change.