Expert explains surprising findings from value-based care research

In this video, Randall A. Lee, MD, discusses what surprised him and his coauthors from the European Urology Focus study, “Transition to Value-based Healthcare: Development, Implementation, and Results of an Optimal Surgical Care Framework at a National Cancer Institute–designated Comprehensive Cancer Center.” Lee is as an assistant professor in the Department of Urology at Fox Chase Cancer Center in Philadelphia, Pennsylvania, and a member of the Fox Chase-Temple Urologic Institute.

Transcription:

What findings from this study were surprising to you and your coauthors?

When we talk about what was surprising, it was interesting that all the core metrics did apply across all the procedures. And when we looked at what was deemed optimal surgical care, which was they've hit all those checkmarks, is that we saw increases in all our procedure groups; it was about a 20% to 25% increase across all of them. And that was despite seeing an increase in the number of patients we saw and the number of procedures that we did over a 5-year span. I think the other thing that was surprising was that this allowed us to really pinpoint where we were dragging our feet. And I think that allowed the methodology and the implementation and the process of doing this to evolve. We were able to see and tweak things as we were going through it. It wasn't simply a plug-and-chug and see how things happen in 5 years. I mean, this was a continual process, in which we were able to identify which drivers of non-optimal care that we were finding, and from that we can really implement and fine tune our quality improvement. The other thing I think was surprising was that our focus was to answer that question of what is value. And I think circling back, why we're doing all this is a financial reason, in that we're spending too much. So when we look at our cost analysis, specifically in minimally invasive partial and radical nephrectomy, we did see improvements in spending and cost reduction. And I think that was surprising to us because that was initially not our goal. Obviously, there are things that we can do with our framework to focus on a financial aspect to reduce cost spending. But I think that's another steppingstone into the next step of what we see with this framework.

This transcript was edited for clarity.