The Value of Diagnostics

Next Masterclass: Value of Diagnostics- Industry, April , 2013.  Download the brochure and apply now.

“Diagnostics is the missing link for a sustainable healthcare system, providing immediate opportunities to reduce costs and to deliver higher quality of care.” – The Decision Group

Introduction – Diagnostics out of the basement
The Decision Group Framework
The 5 Decision Group Steps
Implications for different stakeholders
How can we help your organization?
Events & Masterclasses
Acknowledgement
More Information

Introduction – Diagnostics out of the basement

Did you know that in The Netherlands:

• Diagnostics influences as much as 60-70% of healthcare decision making
• Expenditure on diagnostics is even less than 6% of the total health expenditure

Today, too often diagnostics is regarded as a non value adding healthcare activity or as black box. Policymakers and managers tend to see treatment and diagnostics as one, however there is a huge difference. Treatment cures people. Diagnostics improves clinical decision making, which has an impact on treatments. This fundamental shift in thinking causes an increasing number of organizations to struggle with the central question; how to assess the value of diagnostics.

Together with the cardiology department and the laboratory, The Decision Group performed  a study on diagnostics; and developed a framework to asses the value. The basis for our study is the academic network, our research method and our expertis. :

1. Academic international network of leading universities a.o. Harvard Business School of Prof. Porter.
2. Research method: Interviews, two executive sessions with 30 participants of all stakeholders, an academic council, peer-reviewed literature, whitepaper publications & reports, news and developments and three retrospective cases.
3. Expertise on: Clinical Management, Value Based Healthcare and Health Costing, our long term research program, and our strategy focus and experience.

After 3 successful retrospective studies we are performing 5 prospective studies at the moment, with high value expectations. 

2. The Decision Group Framework for Diagnostics

The first decision framework for diagnostics will help you and your organization to assess the value of different types of diagnostics and provides a much more efficient mechanism to take reimbursement, investment and portfolio decisions. The framework provides immediate opportunities to deliver higher quality healthcare and to significantly reduce costs. A common set of decision criteria helps to make choices for usage of diagnostics and the value it can deliver. For the first time patients, medical boards, hospital boards, labs, industry, health insurers and policy makers can use one common point of view of the value of diagnostics.

Immediate opportunities to implement:

• An alternative diagnostic procedure  for Wegener’s disease can save up to 200 persons of the of dialysis and possible kidney transplant and at the same time reduces costs with €30 mln per year*.
• An alternative test for Acute Myocardial Infarction can save up to 800 lives per year and at the same time reduces costs with €30 mln per year*.

*Immediate opportunities to implement, retrospective validated, according to two Dutch hospitals which used the new framework of The Decision Group and Isala Klinieken

3. The 5 Decision Group Steps

to unleash your potential of diagnostics:

1. Understand the value of diagnostics
2. Measure the value of diagnostics dissimilar as the value of treatment
3. Invest in better diagnostics and evaluate “me too” products
4. Break down organizational barriers
5. Use health economics on reimbursement decisions when needed

4. Implications for different stakeholders

• Care & Cure:
  • Better diagnostic portfolio investment decisions. Focus diagnostics as value/productivity enhancement center instead of cost center.
  • Better decision making on improved care delivery by diagnostics.
• Patients:
  • Benefit from real added value innovation of diagnostics.
  • Better decision making non-medical value of diagnostics.
• Insurers:
  • Right diagnostics, prune diagnostics.
  • Making long term decisions on cost of ownership, rather than costs; a transparent reimbursement discussion.
  • Manage over-diagnosis and dealing with result measures and risk adjustment methods.
• Industry:
  • Ability to develop broader range of diagnostics.
  • Faster acceptance.
  • Aligning medical society demands and patient value with product development – focus on co-creation of value.
  • Optimize current portfolio by identifying potential and ensuring that products are embedded in the right care delivery process.
• Investors:
  • New knowledge available on the value of diagnostics for investment decisions for biotech start-ups.
• Government:
  • Making outcome based reimbursement decisions and utilize the role and value of diagnostics in the healthcare system.

5.   How can we help your organization?

To unleash the potential of diagnostics. A partial overview:

Diagnostics Portfolio Analysis: An analysis on the (complete) portfolio to support decision making on: under vs. over diagnosis; completeness of the portfolio, over the entire value chain; profitable diagnostics; diagnostics on the right decision level and risk controlling diagnostics. 

The Purchase Tool: A comparative and predictive analysis on the new diagnostic versus the gold standard diagnostic. An analysis on the value-adding activities and their value for the patients

Potential Value Tool: Analyze the potential of a new diagnostic in the early stage of development, in order to help make investment decisions.

Benchmark Profiling Tool: What is the impact of a diagnostics tool in the final outcome of the patient? Which diagnostics are used where in the process of care delivery, and how does this relate to the volume and kind of treatment? 

Value Assessing Tool: Where in the care delivery value chain can the most value be achieved?  Or in which medical condition is the effect of diagnostics the largest?

Other Tailored Projects: e.g. In-house Masterclasses on the Value of Diagnostics, or other Value Based Healthcare principles.  

6. Events & Masterclasses

On June 5^th, 2012 by The Decision Group and Isala Klinieken Laboratories and the department Cardiology organized  the first event to share our vision on diagnostics. The session was very successful and the study results, new framework, method and implications were discussed.

The quotes of the audience give a good impression of the event:

• The event was very usefull and inspiring. It gave me a new vision on how to interpret costs and value. - Medical specialist
• The Decision Framework is innovative and can result in product improvement. The Value of Diagnostics is the ‘new thinking’  - Director of Life Sciences company
• The Decision Group succeeded to open a new discussion on diagnostics, via a differen point of view and a practical approach’  - Head Clinical Chemistry

A large variety of stakeholder groups were present at the event. An overview of the stakeholders:

A part of the presentation which is used on the event can be downloaded here. In case you would like to know the methodology we can organize in-house masterclasses. Please contact for the Masterclasses Value of Diagnostics Karen Whitburn (k.whitburn@thedecisiongroup.nl)

Next event

• January 30, 2013: Masterclass Value of Diagnostics

On this website we will announce new events in the future with respect to diagnostics.

7. Acknowledgement

The Decision Group would like to acknowledge the invaluable assistance of our partners at The George Washington University, Harvard Business School, the six members of our international academic advisory council, the people involved with the special research cases and the 30 experts of our executive sessions. The experts were representatives of all (healthcare) stakeholders; industry, care&cure, government, insurers and patients. This study is a co-production between The Decision Group and Isala Klinieken. Created by:  ir. Maarten Koomans, Prof. dr. Fred van Eenennaam, Kim Bruheim, Msc., Ir. Roald van Leeuwen and Frank Westerhof, Msc – The Decision Group. Co-written by Jaap Stuut, MBA,  Dr. Bert Dikkeschei and Dr. Robert Slingeland – Isala Klinieken.

8. More information

Special stakeholder flyers of our study the Value of Diagnostics can be downloaded.

• Value of Diagnostics – Care & Cure
• Value of Diagnostics – Goverment, Insures and Patients
• Value of Diagnostics – Industry and Investors

Please feel free to forward these flyers to a colleague or friend. For more information, please contact Kim Bruheim, Msc.: k.bruheim@thedecisiongroup.nl