The aim is to understand the meaning of value in the provision of health services within the public health system (publicly financed) in Spain by the different stakeholders in the process, from policy makers to aged individuals who are users of the public and social service systems.
Stakeholders & Beneficiaries
The interaction between professional health providers and chronic patients is of great value in order to improve quality of life of patients and the evolution of their illness. At the same time, health policy makers and health managers affect this process with their understanding of the relationship between health providers and patients and their allocation of the scarce resources in the public health system.
Digital Transformation Process
This project is not about digital transformation process.
Results, Outcomes & Impacts
Value created in the provision of health services to chronic patients is much more than curing individuals. The main goal is to improve quality of life of the elderly taking into account both physical and mental capacities. Quoting one of our health managers, “it is about filling the years with life and not filling the life with years” Value is created in all stages (co-design, co-production, co-construction and co-innovation) and by all stakeholders. In fact , the stage at which co-creation is more important mostly depends on the type of service. However, the most important interaction is that of public service staff and patients. Quoting another of our health managers, “about 70% of the quality of life of the elderly has to do with their lifestyles (diet and habits), which are much more important than genetics. Therefore it is very important that the elderly takes a leading role in the provision of public service provision through prevention, and through the patient empowerment”.
Challenges & Bottlenecks
Each stakeholder performs differently in the co-creation of value. Health policy makers allocate the resources and decide which services are the priority for their health policies. Their interaction and communication with health managers but also with the society in general will make them more sensitive to their needs. Chronic patients find that the Community is not engaged with them, and in a sense, they feel a bit abandoned. This is important as the Community may affect the direction of health policies. There is room for increasing the importance of the role of patients in the provision of health services. Even if in the last decades, there has been a continuous process of taking more and more into account the patient, in what has been named as a patient centred health system, they still feel that they are not sufficiently asked about their needs and levels of satisfaction.
Transferability & Replicability
Even if this case study was performed with a special focus on Parkinson patients, with the collaboration of Asociación Parkinson Madrid (an association of Parkinson patients in Madrid), most of the lessons are applicable, with limitations, to the co-creation of value in the interaction of the different stakeholders in the organisation and provision of care for patients with other chronic conditions.
The interaction between health professionals, providing health services and patients is a success in the creation of value, which is not only to cure patients (many times unfeasible solution for chronic conditions) but to improve the quality of life of patients. They, through a better engagement in the process of health provision, may understand better their condition and improve their quality of life through their lifestyle and habits, delaying the progression of the disease.
The interaction of the different stakeholders is key in all stages, from realizing the need of a change or innovation to the design of the service provision, or to the actual production and construction of the health service provision. The clearest interaction is that of health professionals with chronic patients. However, health policy makers and the Community, are somewhat disengaged with the real needs of patients.