New patient-centered tool could help measure value in healthcare

While the traditional model of healthcare analysis focuses on costs and spending, a new patient-centered tool will help payers, providers, and patients use data to better measure value in healthcare treatments.

The Innovation and Value Initiative (IVI), a collaboration of academics, patient advocacy organizations, payers, life sciences companies, providers, and delivery systems, launched the Open-Source Value Project (OSVP) to develop open-sourced, flexible, transparent, and patient-centered tools to help healthcare stakeholders make scientifically-based decisions about the value of treatment and services.

Linthicum

Unlike other value-based tools that are specific to various perspectives, it uses a data-driven, consensus-based approach to determine value by incorporating the input of all the various stakeholders in healthcare. This captures value in a richer, more nuanced way that isn’t captured by a specific viewpoint, according to Mark Linthicum, director of scientific communications at IVI.

“IVI focuses on determining value because not all dollars are delivering equal benefits to patients and consumers,” says Linthicum.

The concept

The effort kicked off on November 8, 2017, with the release of an open-source tool focused on measuring value in treatments for rheumatoid arthritis (RA). Patients are instrumental in the development of the RA model, which is designed to calculate different estimates of value for specific patient characteristics.

For example, patient focus groups and reviews by patient researchers help define factors in the model that may affect value from a patient’s perspective, such as whether a drug is administered orally versus by infusion.

The degree to which the RA model will be able to capture patient heterogeneity will improve as new evidence arises and the model becomes informed by clinical use.

“The healthcare system is a complex place, with many diverse actors,” says Linthicum. “A decision that benefits one stakeholder may hurt another, so any effort to move toward value-driven decision making must make all stakeholders-and especially patients and providers-part of the conversation.”

The OSVP is designed to achieve this goal; specifically:

• Each open-source model is fully transparent. IVI publicly releases research methods, assumptions, results, and external to facilitate the evaluation and replication of its work. Because the open-source model development process is iterative, these materials are made available on an ongoing basis.

• Each open-source model is freely available and usable. IVI releases code, user guides, model documentation and interactive user interfaces with each new release (all are now available for the RA model). Anyone is free to download the model as a software package or complete source code to run analyses, make changes to the model’s programming, build new models with it, or create new apps or tools.

• Each open-source model is developed through a consensus-driven process. IVI seeks input from stakeholders across the healthcare system to help ensure that the model reflects the different challenges and needs of each particular audience.

“The tool came about as healthcare is increasingly seen through the lens of value, but defining and measuring value has become extremely contentious,” says Linthicum. “The OSVP seeks to resolve this tension by finding common ground to explore value and relying on consensus to drive individual assessments. Achieving this is critical, especially as healthcare costs in the United States continue to grow.”

According to Linthicum, whereas most other assessments lack transparency into the methods and assumptions relied upon to produce results, the OSVP is entirely open-source. An open-source approach means everything IVI does is freely available for others to use, analyze, revise, and even re-engineer.

“We want to foster a critical discussion around how to measure value and move toward greater consensus,” Linthicum says.

IVI will regularly update the RA model based on comments and recommendations provided by interested stakeholders, including providers, patient groups, insurers, policy makers and life sciences companies. Comments can be submitted on the IVI website forum, or via e-mail at research@thevalueinitiative.org through January 17, 2018. A panel of experts will consider comments and produce recommendations for changes in the next official IVI version of the model, which will be released in spring of 2018.

To learn more about the model and its future uses, read this Q&A with Linthicum.