Enabling Value-Based Health Care in Low-Resource Settings Through Innovations in Health Information Technology

Abstract

Value-based health care (VBHC) is a critical approach that ties physicians’ incentives to patient outcomes. Several high-income countries proved that VBHC improves overall patient outcomes without raising costs. However, lower- and middle-income countries (LMICs) are left behind due to barriers such as immature health financing systems and the lack of health information technology (HIT) infrastructure to collect information on costs and patient outcomes. The most practical starting point for LMICs is to develop a HIT system that collects reliable data on cost and patient outcomes to guide the transformation towards VBHC. This doctoral project demonstrates that a cloud-based electronic health record (EHR) is a feasible solution to collect data points required for VBHC, even in low-resource settings. Embedding components of VBHC into the EHR also reveals positive effects that extend beyond capturing data, such as inspiring teamwork between caregivers, encouraging positive doctor-patient relationships, and promoting excellent patient satisfaction. The outcome of this doctoral project helps to prove that HIT can be an enabler for VBHC in low resource settings. Hence, VBHC should be advocated as a key to improving outcomes and value to patients in LMICs just as it is in high-income countries, and providers should focus on HIT as a starting point to collect reliable data on cost and patient outcomes to start the journey towards VBHC.