SUSAN MCKEE
Executive Director, Value Based Healthcare Implementation, Dental Health Services Victoria
“Only one in four eligible people accessed public dental services in 2015–16, with another 6% of eligible people waiting for care.”
A
s the lead public oral health agency in Victoria, Dental Health Services Victoria is transitioning to a model of care that reflects the principles of
Introducing value-based healthcare in the oral health sector A new approach to improve oral health outcomes.
Our clinicians had become disillusioned by the lack of impact they were having in improving health outcomes, especially given most dental disease is preventable. At the
value-based healthcare. By co-designing a new
same time, our consumers felt frustrated
system in partnership with our consumers and
with the difficulty in accessing patient-
staff, we are driving better health outcomes
centred care, and felt that no one was
and experiences for patients.
listening to them.
We are thrilled that our work towards
We also discovered huge variations in the
The new model focused on five key areas: • achieving the best health outcomes at the lowest cost • creating a patient-centred system organised around what patients need • ensuring the right services are being provided by the right person at the right locations • integrating care across separate facilities
introducing value based oral healthcare
services provided across the public dental
has been recognised internationally, and
sector. The variation in topical fluoride
we look forward to continuing to share our
treatments was 14-fold from lowest to
The model comprised eight key elements
experiences with the health community and
highest, while variation in the provision of
(see diagram) with consumer engagement
learning from other innovations in this space.
root canal treatments was also 14-fold.
and co-design being at the centre of the
We wanted and knew we could do better.
THE NEED FOR CHANGE
• measuring outcomes and costs for every patient.
model.
There are an estimated 2.46 million people
A NEW MODEL OF CARE
THE FUTURE STATE
eligible to receive public dental services in
In February 2017, we started developing
A trial of the new model began in October
Victoria (41% of the population). Only one in
a model for value-based oral healthcare.
2018 at RDHM with a focus on achieving:
four eligible people accessed public dental
We hosted a series of workshops with
services in 2015–16, with another 6% of
academics and researchers, clinicians,
consumers arrive at the clinic, they receive
eligible people waiting for care.
senior management and consumers. We
comprehensive information so they know
worked with them to map out the current
what to expect and where to go. Their care is
Victoria have more disease and fewer teeth
state of emergency and general care at
coordinated and efficient, respectful of their
than the general population and are less
the Royal Dental Hospital of Melbourne
culture and language, and they have control
likely to access services than the general
(RDHM). We then mapped out the ideal state
over what happens to them.
population. And when they do access care,
(what it would look like with no financial or
it is not always focused on achieving better
operational restraints) followed by a more
spend time being educated on how they can
health outcomes.
realistic future state.
best improve their oral health. All information
People who access public dental care in
12
The Health Advocate • DECEMBER 2018
Improved consumer access: Before
Comprehensive assessment: Consumers
