Experience of implementing a value-based approach in radiation therapy: EIT Health methodology

Abstract

Introduction. Over the past ten years, healthcare has made a big step towards the transition from the traditional payment-for-service model to a value-based model. The Russian experience of oncological and radiotherapeutic care, and the experience of implementing similar projects in patients with skin cancer, has not yet been described. Given the complexity and resource-intensive implementation of such projects, it is necessary to evaluate the methodology at the early stages of implementation. Purpose: to present the experience of implementing a value-based approach using the EIT Health methodology in the radiotherapeutic care. Material and methods. The experience of implementing the EIT Health methodology in three sites of the budgetary healthcare system is analyzed and summarized. Possibilities of application in radiation therapy are described. The following tools were used: assessment and standardization of processes, “patient’s pathway” analysis, cost estimation, patients’ values evaluation, shared decision-making, patients’ compliance with diagnosis and treatment, satisfaction with the quality of medical services, assessment of quality of life. Results. The use of the proposed technique proved to be justified as all eight tools were applicable in each of the three sites. The success of using these tools was also facilitated by their using to have a specific highly specialized focus as X-ray therapy rooms were used as a research base, and the objects of the study were patients with non-melanoma skin cancer. Limitations of the research are related to the X-ray therapeutic cabinets of the oncology dispensaries and non-melanoma skin cancer patients. Conclusion. Healthcare needs applied research aimed at forming an evidence base of quality improvement projects. Current research provides further guidance of dissemination the value-based approach in practice.