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In most other industries, it\u2019s the customer who consumes the services and engages with the purveyor of services. In health care, not so much. Legacy health care has evolved to honor the insurance carrier as the customer or, in some cases, the fancy surgeon or other driver of revenue as the customer. Listen to the podcast with Marshall Allen for more on that front, but yeah. And here we are.\xa0

Health care should be designed so that patients get the best outcomes at a financially not-toxic price point. Otherwise, what are we doing here besides putting profit over patients?

In this health care podcast, the conversation is about PCVS, otherwise known as creating a \u201cpatient-centered value system,\u201d otherwise known as building a new OS, or operating system, for health care\u2014one that is built around the patient and their experience. The general idea here is to rationalize the patient journey from start to finish: to create a longitudinal flow that guides a patient from here to where they need to be with a minimum of being told you need a follow-up appointment but having no idea with whom or how that\u2019s supposed to happen and when, or getting discharged with no instructions, etc.

So, PCVS \u2026 let\u2019s talk about this, how this works, real quick before we dive in with Dr. DiGioia. In a nutshell, the first step is to really, really carefully trace the patient journey from beginning\u2014really the very, very beginning of the experience, which might start in the parking lot or with the first digital interaction or at the PCP referral\u2014to the very last interaction, which might be after discharge from the SNF (skilled nursing facility) after their last follow-up appointment. It\u2019s figuring out what matters to the patient at each step in that journey and then documenting that flow map.

Then the next step is to compare the current patient journey, the current state, to what the team decides is the ideal patient journey.

Then the last task, which may be obvious, is to implement\u2014for implementation teams to devise and implement action plans to get from here to there.

Here\u2019s an interesting point to ponder: We often talk about fragmentation and interoperability, and when I said these words, your brain immediately snapped to technology fragmentation and interoperability. But bear this in mind: The patient is the only commonality between all the settings of care that are using all those varied technologies. When you rationalize the patient journey, you also, to some extent, create the foundation to integrate technology.

Why a PCVS process, you might ask, if you\u2019re in charge of the P&L and regard patient centeredness as a nice to have if there\u2019s extra cash lying around? Here\u2019s why: If you\u2019re going to successfully roll out a prospective bundle, for example, to employers, you better have gone through a PCVS process. Other things, too, but being intimately aware of the patient journey and where patients fall through the cracks or get disgruntled can easily spell the difference between bundle success and failure.

This is probably also true for really almost any sort of risk-based/capitation arrangement. It\u2019s probably also true for great customer satisfaction scores. It\u2019s probably also going to become increasingly true when competing against some of these virtual-first operations that may have been built from the ground up to be sticky and engaging for patients, as well as guide them through a longitudinal journey.

For more on the WIIFM (the \u201cwhat\u2019s in it for me?\u201d) if you are a provider organization and are thinking about patient-centered care, listen to one of our most popular episodes over here at Relentless Health Value\u2014the one with Joe Selby, MD, from PCORI\u2014on this topic.

In this health care podcast, I\u2019m talking with Tony DiGioia, MD, about PCVS (patient-centered value systems). Dr. DiGioia is a practicing orthopedic surgeon at the Bone and Joint Center over at UPMC Magee-Womens Hospital and also the medical director of the UPMC Innovation Center. Dr. DiGioia wrote a book aptly titled The Patient Centered Value System.\xa0

One thing I thought of as I listened to this conversation again in preparation for releasing the episode: Dr. Shantanu Nundy has written that on the front lines of health care, clinicians and other frontline workers know what to do for their patients. They know what\u2019s the matter and what matters to the patient and, really, what they need.

Dr. Nundy talks about how, to efficiently transform health care, one thing that we need to do is \u201cdecentralize\u201d control or shift power in terms of decision-making authority and resources back to the front lines and to patients.

The point that I\u2019m making is that the PCVS might be the OS that health care needs for \u201cdecentralization\u201d to happen at a system level and in a way that everyone works together toward a common, aligned goal\u2014as opposed to clinicians and patients all doing their own thing, making their own assessments about what is needed at any given moment at potentially cross-purposes to one another, re-creating all kinds of wheels that are going all kinds of different directions.

Anthony (Tony) DiGioia, MD, is an entrepreneur, engineer, and practicing orthopedic surgeon, and a pioneer in care delivery transformation. \u201cDr. D\u201d developed the Patient Centered Value System (PCVS), a personalized, replicable approach to care that improves clinical outcomes and experiences while reducing costs.

His book, The Patient Centered Value System: Transforming Healthcare Through Co-Design, helps you understand what matters most to patients, map the current state of care in your organization, identify what can be improved, and build teams that co-design sustainable change. Using \u201cWhat Matters to You?\u201d surveys and shadowing to keep patients and families at the core of care, the PCVS serves as the care delivery model for Dr. D\u2019s current award-winning practice at the Bone and Joint Center at UPMC Magee-Womens Hospital.\xa0

Dr. D most recently used the PCVS to develop the Center for Bone and Joint Health, flipping the script of routine health care visits by putting patients in the driver\u2019s seat. In this relationship-based program, patients team up with providers to engage in their own care and personalize a plan based on their needs and priorities. But the PCVS is not just for orthopedics. It is increasingly being adopted nationally and internationally and has been applied to over 65 clinical conditions.

Dr. D is medical director of the Magee Bone and Joint Center as well as the UPMC Innovation Center and a Fellow of the American Academy of Orthopaedic Surgeons and the American College of Surgeons. He is a faculty member for the Institute of Healthcare Improvement and an adjunct faculty member in the Department of Biomedical Engineering and the Robotics Institute at Carnegie Mellon University. Dr. D founded the not-for-profit AMD3 Foundation, which leads the Operation Walk Pittsburgh medical mission effort.

06:19 What is the Patient-Centered Value System, and why should it be the operating system for all health systems moving forward?
07:47 \u201cIt\u2019s the infrastructure to allow us to redesign care delivery.\u201d
09:00 \u201cThese artificial silos that we have in health care have to be crossed and broken down.\u201d
10:03 \u201cThe patient is the common denominator. We have to follow the patient.\u201d
10:33 Why does the disjointed patient experience affect a patient\u2019s trust in their care delivery?
12:00 What are the steps to creating a patient-centric system?
12:30 \u201cThe challenge is to view all care through the eyes of patients and families.\u201d
13:19 \u201cOur end users are patients and families. Period.\u201d
16:36 What\u2019s the difference between asking patients, \u201cWhat is the matter with you?\u201d and \u201cWhat matters to you?\u201d
19:56 How are nonclinician staff included in a patient-centric value system?
25:40 \u201cWe can give them the tools, wherever they\u2019re coming from.\u201d
29:33 \u201cThe bottom line is, these are engagement tools and technologies that we do need to start looking at to help redesign care delivery.\u201d

@drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

What is the Patient-Centered Value System, and why should it be the operating system for all health systems moving forward? @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cIt\u2019s the infrastructure to allow us to redesign care delivery.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cThese artificial silos that we have in health care have to be crossed and broken down.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cThe patient is the common denominator. We have to follow the patient.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

Why does the disjointed patient experience affect a patient\u2019s trust in their care delivery? @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

What are the steps to creating a patient-centric system? @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cThe challenge is to view all care through the eyes of patients and families.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cOur end users are patients and families. Period.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

What\u2019s the difference between asking patients, \u201cWhat is the matter with you?\u201d and \u201cWhat matters to you?\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

How are nonclinician staff included in a patient-centric value system? @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cWe can give them the tools, wherever they\u2019re coming from.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity

\u201cThe bottom line is, these are engagement tools and technologies that we do need to start looking at to help redesign care delivery.\u201d @drtonydigioia of @UPMC discusses #PCVS on our #healthcarepodcast. #healthcare #podcast #digitalhealth #patientcentric #patientcentricity