BACKGROUND AND OBJECTIVES

Inflammatory arthritis (IA) patients are considered to be a highly burdened population who experience restrictions in daily living as a consequence of their chronic illness. The impact is not limited to patients’ overall quality of life, but also affects health economics and society. We therefore established an (digital) integrated practice unit (IPU) named “Joint Value” that aims to create and deliver better, and more value for patients as well as caregivers.

METHODS

We conducted three main programs:

1. Joint referral: An integrated care network of regional hospitals and primary care centers where we introduced triage by a rheumatologist and digital algorithm to facilitate timely cost-effective referrals;
2. Joint compassion: ICHOM IA set implementation to monitor patient-relevant (PROs) and organizational outcomes for shared decision-making. Consequently, national benchmarking was initiated;
3. Joint decision support (Dutch NIH-honored project): Together with patients, caregivers, and technology partners we converted patient-relevant and physician-driven outcome information into valuable services.

RESULTS

The digital algorithm and triage showed a referral reduction of 40% and 70-80% respectively, while PROs did not decline. Additionally, significant cost-effective impact was observed. PRO analyses indicated that what matters most to patients differs from outcomes recommended by international guidelines. The Santeon collaboration lead to transparency and improvement in health and process outcomes, and medical costs. We built an innovative dashboard visualizing ICHOM outcomes along clinical parameters to enable goal-based shared decision-making, remote patient home-monitoring and coaching.

CONCLUSIONS

Joint Value represents a unique (digital) IPU that connects patients, primary care centers and hospitals. By intensive and close collaboration we deliver and improve care that is of additive value for IA patients throughout their lifelong patient journey. This upscalable initiative stimulates patient participation, provides complete and detailed outcome information in- and outside of the consultation room, and contributes to the delivery of a sustainable VBHC system.