PsoPlus: An Integrated Practice Unit for Psoriasis

Abstract

There is a need to revise current healthcare organization due to the ever-rising costs and variation in quality of delivered care. Over the past decades there have been several strategic frameworks attempting to tackle this problem. Value-based healthcare (VBHC) is one those frameworks which has gained increasing popularity the last years. The framework is formulated on the premise that the healthcare sector should deliver integrated care, using integrated practice units (IPUs), and strive to maximize the value created. Value in this context is defined as the health outcomes achieved per costs made. We have designed a lean IPU called PsoPlus in which psoriasis patients are managed by a multidisciplinary team which has all the expertise and skill to manage psoriasis and its associated conditions. In addition, we have developed and implemented guidelines for the management of psoriasis associated comorbidities enabling us to deliver integrated care in the Belgian healthcare setting. Finally, we have designed a supporting information technology platform, called PsoSmart, that brings data from patients and healthcare providers together and provides actionable insights for clinical decision making. The created value is documented and captured using a value-based outcome set. Cost assessments at the individual patient level are also performed. To conclude, we describe here a comprehensive IPU setting for psoriasis which incorporates the VBHC principles. This IPU goes further and delivers a higher level of integrated care than other multidisciplinary psoriasis clinics. Monitoring outcomes and costs provides us with further insights to optimize psoriasis care. In addition, a software program designed to enhance psoriasis care is being developed further, however, advances in healthcare technology are needed.

Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management – a 1-year prospective clinical study to evaluate feasibility and value creation

“…The IRIS trial will be a prospective clinical trial in which patients attending the PsoPlus for the first time will be followed during a period of 1 year. The PsoPlus IPU has been described in detail previously 25. The focus will lie on patients with no prior experience with PsoPlus.…”

“…Data on clinical outcomes, such as skin clearance, in the VOS will be collected during follow-up visits at our clinic. Outcomes which are assessed via a questionnaire will be collected using a specialised patient platform (PsoQuest) in which patients have to fill in the questionnaires 3 weeks prior to the consultation 25. In addition, for this study, the EuroQol 5 Dimensions 5 Level questionnaire will need to be filled in.…”

“…Patient costs are calculated by multiplying the time spent for each step in the care process with the costs per time unit of that resource. The starting point for the measurement of costs is the development of process maps throughout the whole IPU 25. The process maps are an aerial representation of all the key activities, which are performed and their location for the patients requiring treatment.…”

“…An IPU is an organisational entity that connects multiple specialisms and functions around a medical condition, with a distinct organisational structure, and with a coherent set of agreements/contracts 24. We have set up such an IPU for psoriasis called PsoPlus at the Ghent University Hospital, Belgium 25…”

“…24 We have set up such an IPU for psoriasis called PsoPlus at the Ghent University Hospital, Belgium. 25 …”