2014-11-17-奥纬咨询-Operationalizing_Wellness_10页_350kb

Summary of OPERATIONALISING WELLNESS Report

Rationale for Change

The report emphasizes the urgent need to shift healthcare and social care systems from reactive ("sickness and repair") to proactive approaches, focusing on prevention, personalization, and integration for better population health outcomes in England. This is driven by the recognition that current systems are fragmented and siloed, failing to meet individual quality needs, and must adopt systemic changes to enhance wellness.

Key Concepts

• Patient Activation: A four-level scale (L1 to L4) measures individual engagement in health behaviors, with higher levels linked to improved health outcomes and cost savings. Activation is better than socio-demographics at predicting health, and economic incentives exist for improvement.
• WEMWBS Metric: The Warwick-Edinburgh Mental Well-being Scale is proposed as a supra-sectoral tool to measure wellness, capturing psychosocial and physical aspects. It promotes collaboration across sectors, reducing reliance on traditional reactive care.

Prerequisites for Wellness Metrics

Wellness metrics must:

• Shift from disease-focused to whole-person, holistic assessments (salutogenesis).
• Incentivize prevention, reduce multi-morbidity, and extend life quality (add life to years).
• Involve individuals in setting goals and be relevant across care sectors.
• Be supported by unified themes and payments linked to outcomes, avoiding disruption to current activity-based metrics.

Implementation Strategies

• System Changes: Transition to integrated, patient-centric care focused on wellness, using technology, revised payment systems, and contractual levers to increase patient engagement across activation levels.
• Supportive Infrastructure: Includes personal health information tools, digital data capture (e.g., mobile apps), and incentives like performance-based payments for primary and secondary care.
• Stepped Approach: Phased implementation starting with data capture, incentives through mechanisms like CQUIN, and pilot projects in specific populations to learn through doing.

Immediate Next Steps

• Capture baseline WEMWBS data by integrating it into existing patient surveys or digital platforms, complemented by metrics like emergency bed usage.
• Develop incentives (e.g., through CQUIN or PMS contracts) to focus providers on wellness metrics, applied incrementally across the system.
• Pilot wellness metrics in key populations, such as major cities, to test and refine approaches.

Vision

A future where supra-sectoral wellness metrics (e.g., WEMWBS) account for up to 10% of payments, fostering integrated care with education, local government, and justice sectors. This will promote individual activation, reduce disengagement, and create sustainable, proactive systems in health and social care.