Value-based healthcare delivery in the digital era

Introduction Mental disorders are a major cause of disability in Europe [1] . However, organizational structures and information systems are focused on delivery of care, rather than providing value [2] . In the digital era, we have the capacity to change priorities through the analysis of heterogeneous databases that could support patients’ and professionals’ decisions. Objectives to analyse the contradictions between the design and the theoretical structure of mental health services and the possibilities to evaluate the actual value of the delivered care. Aims To reflect on changing the trend using a different conceptualization of objectives and evaluating methods. Methods We used a tool provided to clinicians by the Madrid's Regional Health Service SERMAS (‘ConsultaWeb’) combining primary care, pharmacy and hospital data ( n  = 395,073 patients for the catchment area), and a set of hospital-based data (patients attended by psychiatrists at the ER, n  = 13,877, and patients admitted to the Psychiatric Inpatient unit n  = 3318), to explore some of the present professional information resources. Results Currently used healthcare databases only describe the diagnostic or therapeutic categories of patients and might be used to detect abnormal behaviours. However, they are neither able to show the functional status of patients nor designed to predict their clinical course. Conclusions A clearer definition of value in patient outcomes is needed. This might help to organize the healthcare delivery and to create a new information system that would allow to asses health outcomes.