‘Value-based Healthcare’ was originally proposed by Michael Porter and defined by the equation of outcomes achieved divided by cost. Value can only be achieved through recognising the importance of shared Values (including defining what is important to patients and their carers) and Valued Partnerships. For example, to  deliver high-value care  elderly patients and their caregivers were asked, “What is most important to you?”

They defined  “time spent at home,” and care was designed to achieve that patient-defined goal in.

That outcome — spending time at home, instead of in the hospital — became the system measure of success.

Focusing on a single, clearly understood goal — defined by patients and embraced by all involved in their care — created powerful clarity of purpose across a complex range of providers and organizations.

The experience shows the potential for a patient-defined outcome to drive the collaboration needed to integrate care. (Sayer, Mullins and Blundell NEJM 2015)