Value-based healthcare – what it means for Thailand
Thailand’s population is ageing rapidly with almost half of its electorate above 50 years old by 2025. Healthcare costs are rising and it is not tenable in the long-run to keep building hospitals. One possible consideration for the country is the shift towards value-based healthcare (VBHC), which is about improving healthcare outcomes at lower cost. It focuses on what patients value and allocates resources according to the health outcomes delivered by the system, rather the traditional model of a volume or visit-based healthcare system.
While VBHC sounds promising, the reality is that it is challenging to achieve as transforming a health system that is truly patient-centred and outcome based requires a lot of work. According to an article by the World Economic Forum, the transformation to a value-based health system requires:
- Sufficient technical expertise about VBHC to design and implement its core features.
- Leaders committed to trying ideas and willing to accept the risks involved.
- Cooperation among different organisations working together to improve outcomes for patients.
The same article offers four key lessons for a successful switch to VBHC. Firstly, it is to focus on outcomes that matter to patients, rather than merely focusing on processes or costs. In the context of Thailand, this could mean bringing care to people especially in rural areas in which healthcare is not easily accessible. In that regard, Thailand has begun development of its telemedicine programme at 32 hospitals located in rural areas in eight provinces since March this year. Telemedicine services will be offered by the initial 32 hospitals as soon as by the fourth quarter of 2019.
Another key lesson for a successful switch to VBHC is to engage partners from across the whole health system. In order to achieve meaningful system-wide change, transformation efforts have to include organisations from across the entire system, including the private sector. The unique advantage that Thailand has is its advanced development of the private healthcare sector, given the country’s reputation as a regional medical tourism hub. However, the challenge lies in how government institutions such as the Ministry of Public Health (MOPH) can meaningfully engage the private healthcare sector in moving towards VBHC.
Next, stakeholders need to acknowledge that systems change is going to be hard, and they need to adopt a long-term perspective rather than looking only for “quick wins” or easy answers. eHealth is one of the tools that could be used towards achieving VBHC, and the MOPH has a long-term strategy to drive the growth and development of eHealth from 2017-2026. At its core, the aim is to develop a capable and interoperable health information system as well as digital health technologies to bring about value and improved standards of care.
The last lesson is to take a problem-driven approach. In healthcare, it is often easy to ‘cut and paste’ solutions from other health systems but sometimes the answers or successful models may lie within. Telemedicine policies, for example, are still being studied in Thailand and the government is looking into more investments and getting the timing right to provide on-demand digital care to locals, expats and tourists, according to an article by Healthcare Asia.
With the theme of “Empowering Value Creation”, the upcoming HIMSS AsiaPac19 conference will be held in Bangkok, Thailand from October 7 to October 10 2019, featuring five main tracks:
(i) Sustainability and growth
(ii) Patient experience
(iii) Unlocking the value of AI
(iv) Value-based care
(v) Health 2.0