This is how healthcare should be

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Person-Centred Value-Based Health Care shifts the focus from treating a condition to treating a person, by focusing on their values, goals and preferences

Professor Christobel Saunders AO, University of Melbourne

Professor Christobel Saunders AO

Published 4 September 2024

Imagine a healthcare system where every decision, every treatment and every care plan revolves around what truly matters to you.

A system where your values, goals and preferences are not just considered, but are central to how your care is delivered.

Three people walking arm in arm beside a river
Healthcare focused on the patient’s values, goals and preferences is becoming a reality in Australia. Picture: Getty Images

This vision of healthcare, known as Person-Centred Value-Based Health Care, is becoming a reality in Australia, transforming the way clinicians and patients work together to achieve better health outcomes.

A new way of thinking

Charlotte* is a 68-year-old woman living in Werribee. She was recently diagnosed with diabetes, which requires careful management to maintain her health and well-being.

The Royal Melbourne Hospital, where she was receiving care, is an hour away by public transport, so she needed a new, more accessible and personalised treatment plan.

Traditionally, this would mean a series of appointments and treatments primarily decided by her doctors, with Charlotte having limited input. However, with the Person-Centred Value-Based Health Care approach, things are different.

Charlotte’s journey began with a conversation with her healthcare team that focused not just on her condition but on her values, goals and preferences. Charlotte shared that one of her core values is personal achievement and staying active, and her primary goal was to manage her diabetes effectively while training for a half marathon – a challenge she was excited about.

Her healthcare team listened carefully and developed a personalised care plan that reflected these priorities.

Instead of immediately considering insulin, which would increase the risk of low blood sugar and the need for frequent adjustments due to her training, the team opted for an approach that included dietary modifications, regular physical activity and meticulous blood sugar monitoring.

They also arranged for local regular check-ups to minimise travel and fit into Charlotte’s busy training schedule.

This tailored approach allowed Charlotte to manage her diabetes in a way that supported her training goals and overall lifestyle, ensuring she could pursue her marathon ambitions while keeping her health on track.

Smiling group of people jogging beside a lake
A personalised care plan should reflect the priorities of the patient. Picture: Getty Images

Three core principles

The Person-Centred Value-Based Health Care approach has three core principles:

  1. Personal Values, Goals and Preferences: This approach shifts the focus from treating a condition to treating a person. For Charlotte, this meant prioritising her training and other lifestyle preferences like playing music and spending quality time with family.

  2. Shared Decision Making: Charlotte was actively involved in discussions about her treatment options, helping to choose the ones that best fit her life.

  3. Outcome Measurement: Charlotte’s progress was regularly reviewed to ensure her treatment was effective and aligned with her desired outcomes.

The clinician as a collaborator

The essence of Person-Centred Value-Based Health Care lies in collaboration, where clinicians and patients work together. This partnership empowers patients to actively participate in their care, leading to decisions that are more meaningful and effective.

Mahmood*, a first-generation migrant, has been managing major depressive disorder and has recently been struggling with the side effects of his medication. The medication affects his ability to engage in community activities that are important to him, like participating in local cultural events and spending time with family.

His GP, Dr Brown*, takes a holistic approach to Mahmood’s treatment. Instead of merely adjusting his medication based on clinical metrics, Dr Brown explores alternative treatments that align better with Mahmood’s lifestyle and cultural values.

This might involve adjusting the dosage, switching to a different medication with fewer side effects, or integrating complementary therapies such as culturally relevant support groups or mindfulness practices.

By focusing on Mahmood’s values, goals, and preferences, and involving him in the decision-making process, Dr Brown helps create a care plan that not only addresses Mahmood’s medical needs but also respects and enhances his cultural values and quality of life.

Large family sitting down to a shared meal
Treatments should be tailored to the patient’s lifestyle and cultural values, not just clinical metrics. Picture: Getty Images

Benefits across the healthcare system

The impact of Person-Centred Value-Based Health Care extends beyond individual patients. It benefits all levels of the healthcare system:

  1. Individual Level: Patients like Charlotte and Mahmood experience better outcomes and higher satisfaction with their care. When care is aligned with personal values, goals and preferences, patients are more likely to be engaged, adhere to their treatment plans and achieve their desired health outcomes.

  2. Organisational Level: Healthcare providers see improvements in patient satisfaction and efficiency. By focusing on what matters most to patients, healthcare organisations can reduce unnecessary treatments and hospital readmissions, leading to cost savings and more efficient use of resources.

  3. Systemic Level: By adopting this approach, Australia’s healthcare system can become more responsive and adaptable to the diverse needs of its population. Data collected from patient interactions can inform policy decisions, leading to a more equitable and effective healthcare system.

Challenges remain but a new chapter in healthcare awaits

While the benefits are clear, implementing Person-Centred Value-Based Health Care comes with challenges. It requires a cultural shift within healthcare organisations, investment in training for clinicians and the development of systems to capture and use patient data effectively.

In Australia, initiatives are underway to address these challenges.

The introduction of the PerEmpo (Person Empowerment Tool) by the Global Centre of Excellence for Person-Centred Value-Based Health Care is a significant step forward. This tool aims to empower both patients and clinicians by supporting shared decision-making and enhancing the use of personal values, goals and preferences in care planning.

A man in a hospital bed talking to doctors
A new chapter in healthcare is emerging in Australia. Picture: Getty Images

The shift towards Person-Centred Value-Based Health Care in Australia represents a new chapter in healthcare.

Charlotte and Mahmood’s stories are just two examples of how this model is making a difference.

As Australia continues to embrace and refine Person-Centred Value-Based Health Care, we can look forward to a healthcare system that truly revolves around what matters most to each individual, creating a healthier, more engaged population and a more efficient healthcare system.

To learn more about Person-Centred Value-Based Health Care, you can download two recent reports. The first introduces the approach, and the second offers a guide on how clinicians and patients can use values, goals and preferences for shared decision making.

*Fictional people used to illustrate best practice.

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