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Healthcare Performance Intelligence Professionals

Periodic Reporting for period 2 - HealthPros (Healthcare Performance Intelligence Professionals)

Reporting period: 2020-01-01 to 2022-03-31

Healthcare performance measurement, performance-based healthcare governance mechanisms and the utilization of healthcare performance intelligence by different end-users are key to today’s healthcare system challenges. Globally, healthcare systems are under strain because of ageing populations with demands based on multimorbidity, unmet needs of vulnerable populations, overuse/underuse of healthcare services and the advent of (disruptive) technologies and personalized diagnostics and treatments. Healthcare systems need to achieve the Triple Aim: a balance between improving population health, delivering quality care for individuals, and containing costs.
HealthPros aimed to develop tools and implement methods to streamline healthcare performance measurement, governance and utilization that match the different health care systems in the Netherlands, Denmark, Germany, UK, Italy, Hungary and Canada, and will support the transferability of the tools and methods to other countries.
A number of key objectives were addressed by several workpackages:
1. An Immersion Community-based approach to PhD training: an innovative programme of collaborative, multi-disciplinary, and entrepreneurial training exposing fellows to many career opportunities and also securing interaction with key stakeholders to ensure applicability of the results.
2. Develop Healthcare Performance Intelligence Professionals with transferable skills relevant to the current research environment (data handling and interaction with stakeholders).
3. Develop new and evaluate existing tools and methods to measure, interpret and translate healthcare performance data into actionable healthcare performance knowledge and indicators. Transfer them to healthcare governance mechanisms enabling performance-based healthcare supporting the achievement of the Triple Aim.
4. Gain understanding of factors affecting utilisation of healthcare performance intelligence by end-users.
5. Broaden the adoption of Immersion Community centered training of researchers and the utilisation of healthcare performance intelligence through example-based promotional efforts .
The key research findings by the network were condensed into a collection of reports providing methodological, practical, and policy guidance tailored to different audiences, published as the ‘Healthcare Performance Intelligence Series (HPIS)’.
WP1 produced 3 reports in the HPIS; (I) practical recommendations to implementing disparity and composite measures in large-scale routine quality improvement work to support transferability to other healthcare systems; (II) a practical guide towards actionable healthcare performance indicators: how to select healthcare performance indicators that are fit for purpose and use for various stakeholders; (III) a policy guidance on advancing the performance assessment of integrated healthcare systems optimizing the use of data. In summary, WP 1 contributed to both broadening and deepening of methodological expertise on the measurement of performance on indicators.
Focus of WP2 was to harness governance tools commonly applied in the private sector and to test their suitability and applicability for the public health sector. WP2 produced 4 reports in the HPIS: (I) a summary of guidance on the use of Patient Reported Experience Measures (PREMs); (II) results-based tools in healthcare management, focusing on COVID-19 dashboards, but also data dashboards in healthcare in general identifying seven features, common to highly actionable dashboards; (III) a business model for effectively involving patients in the financial decision-making of health insurance funds; (IV) best practices for linking financial incentives to health care performance at individual health care provider, institutional and regional level. In addition, in WP2, the fellows made significant contributions to a broader understanding of how performance indicators, both based on patient reported as well as on clinical or other data sources can be used to provide insights on health system performance and guide improvement efforts.

WP3 produced HPIS report dealing with policy recommendations on the role of nudging for health care performance assessment agencies. Furthermore, all fellows contributed to providing evidence to facilitate the utilization of Healthcare Performance Intelligence by different end-users focusing on specific matters: the role of individual behaviors in adopting professional practices and the influence of practice networks; the role of organizational arrangements in quality of care variation and improvement and the use of routine data from various data sources; disease registry algorithms to extract patient cohorts to compare standards in type 2 diabetes; the need to explore variability in healthcare practices like medication prescription and the contribution of benchmarking to the performance of healthcare organizations; the effective measurement of long-term care at national and international level, both in high and middle income countries.

In WP4, all ESRs participated in the training weeks organized by the HealthPros network, and in various other local training activities.
HealthPros addressed a major societal challenge -the sustainability of healthcare systems- and its research will have direct and high level of impact. The projects developed new ways of measuring performance and assuring performance indicators are acted upon and delivered advancements in how stakeholders are engaged in healthcare performance measurement, governance and improvement. Most studies were executed in close collaboration with organizations directly involved in data collection and analyses (registries in Denmark and the UK, claims data bases in Germany, CIHI in Canada) and/or the governance and use of performance intelligence (national and regional governments/insurers in Italy, Portugal, Hungary and the Netherlands) as well as international organizations (EU, WHO/EURO, OECD, HOPE, EPSO). HealthPros’outputs can immediately be applied as a product or service for assessing healthcare performance by the respective “co-developers”. The challenge is the broader adoption and effective use of healthcare performance indicators into healthcare governance mechanisms. HealthPros has improved this by developing better-suited indicators as well as models and tools for engaging stakeholders across sectors to work together in healthcare performance measurement and governance.
HealthPros actively promoted (and investigated) the key role of health system performance intelligence for managing a public health crisis, posed by the COVID-19 pandemic. Various fellows worked to improve the actionability of public national COVID-19 dashboards intended for ministries of health and/or the general public and were involved in reviewing and advising international and governmental strategy documents. Results were validated and discussed in a (WHO/EURO supported) learning community with representatives from institutes responsible for the development of national dashboards. The coronavirus outbreak highlighted the need for health system performance intelligence analysts and methods that can robustly detect signals from different (routinely available) data sources and the importance of the buy-in from policy-makers to support the development and use of performance intelligence for the enduring transformation of pandemic-resilient health systems.
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