Antti Malmivaara
Centre for Health and Social Economics / Scientific Unit, Centre for Health and Social Economics / Scientific Unit, FI-00270 Helsinki, Finland. E-mail: antti.malmivaara@thl.fi
DOI: 10.2340/16501977-2684

Well-designed, evidence-based vision and strategy are fundamental requirements for successful healthcare. This paper reviews previous comprehensive healthcare strategies (Institute of Medicine statement, Value-based healthcare, and Triple aim strategy) published in peer-reviewed scientific journals, and presents an alternative proposal for healthcare vision and Well-designed, evidence-based vision and strategy are fundamental requirements for successful healthcare. This paper reviews previous comprehensive healthcare strategies (Institute of Medicine statement, Value-based healthcare, and Triple aim strategy) published in peer-reviewed scientific journals, and presents an alternative proposal for healthcare vision and strategy. The proposed strategy includes, as prerequisites, competence of staff, healthcare leaders and leaders of health policy, and a well-functioning healthcare system. It is necessary to optimize the financing, reimbursement and incentives, organization, and regulation of the healthcare system. Strategic means to successful healthcare are to improve staff competence, implement current scientific evidence, document clinical and system-related issues, improve quality, and carry out benchmarking with peers. The vision for healthcare is to provide continuous improvement in services, in terms of accessibility, quality, fairness, effectiveness, safety and efficiency, to the patients (customers) and to the population. The new proposal shares many issues with strategies published previously. This paper sets out the prerequisites for the proposed strategy. A common vision, high levels of integrity, and a commitment to providing the best for patients and the population, are of fundamental importance. Competence at all levels of healthcare is a necessity. strategy. The proposed strategy includes, as prerequisites, competence of staff, healthcare leaders and leaders of health policy, and a well-functioning healthcare system. It is necessary to optimize the financing, reimbursement and incentives, organization, and regulation of the healthcare system. Strategic means to successful healthcare are to improve staff competence, implement current scientific evidence, document clinical and system-related issues, improve quality, and carry out benchmarking with peers. The vision for healthcare is to provide continuous improvement in services, in terms of accessibility, quality, fairness, effectiveness, safety and efficiency, to the patients (customers) and to the population. The new proposal shares many issues with strategies published previously. This paper sets out the prerequisites for the proposed strategy. A common vision, high levels of integrity, and a commitment to providing the best for patients and the population, are of fundamental importance. Competence at all levels of healthcare is a necessity.

Three influential frameworks for healthcare strategy have been presented in peer-reviewed medical journals: the Institute of Medicine statement, the Value-based
healthcare, and the Triple aim strategy; all from the United States. The present paper sets out the prerequisites, vision and means for achieving successful health­care. Prerequisites comprise competence of staff at all levels of healthcare and a well-functioning healthcare system. The vision is to continuously improve impacts in 6 categories: accessibility, quality (medical, patient centeredness, processes), equity, effectiveness, safety, and efficiency (cost-effectiveness). The means for pursuing the vision include improving competence, implementing current scientific evidence (e.g. evidence-based medicine), documenting and improving quality of services, and benchmarking with peers. The present strategy adds to previous ones the competence of staff, and competence of leaders at all organizational and health policy levels as a necessity for a successful healthcare strategy.