Biosistemak participates in the presentation of the integrated value-based care pathway for people with heart failure
The initiative is the result of two years of collaborative work with Osakidetza’s Care Integration and Chronicity Service.
On 27 November, Biosistemak participated in the presentation of Osakidetza’s value-based integrated care pathway for patients with heart failure at Cruces University Hospital, the result of two years of collaborative work with the Chronic Care Integration Service (SIAC).
The Institute has provided key methodological support throughout the process of designing the pathway and its deployment plan, developing a robust methodology for adapting circuits and resources, defining evaluation frameworks, integrating technical and technological requirements, and creating awareness and training plans for professionals. All this with the aim of building a comprehensive and coordinated care model that improves health outcomes and quality of life for people with heart failure and is sustainable over time.
Value-based pathway with three perspectives
This value-based corporate roadmap covers the entire life cycle of patients with heart failure, from suspected diagnosis to hospitalisation and discharge, including primary care and outpatient consultations. Its design brings together three complementary perspectives:
- For patients: it organises interventions and responsibilities to reduce morbidity and mortality, ensure continuous care, and promote shared responsibility for self-care.
- For professionals: it strengthens coordination, defines clear actions, offers decision support tools and reduces clinical variability.
- For society: it improves population health, quality of care, scientific knowledge and the sustainability of the system.
Objectives of the conference
During the conference, our researcher Yhasmine Hamu highlighted the multidisciplinary work carried out over more than two years with professionals from family and community medicine, hospital care, nursing, pharmacy and management, among others, which has also focused on responding to the real needs of patients and incorporating the perspective of sex and gender.
In addition to presenting the pathway and its objectives, the session showcased innovative solutions for the care of people with heart failure, corporate tools and the perspective of patients and professionals as a fundamental pillar. The roadmap standardises care within the Osakidetza network, optimises circuits, facilitates communication between levels and establishes indicators for periodic evaluation and continuous improvement, responding to the challenge of this highly prevalent pathology that generates frequent hospitalisations in the Basque Country.
This initiative is part of the JACARDI Joint Action, which aims to reduce the burden of cardiovascular disease and diabetes in the EU through good practices and transnational pilot projects ranging from health literacy and prevention to improving care pathways. Biosistemak represents the Basque Country as an Affiliated Entity in the project, co-leads communication and dissemination tasks, collaborates on methodological frameworks for the implementation of European pilot projects, co-leads the health literacy area of 24 pilot projects, and leads the deployment of this heart failure pathway together with the mapping of European needs.
