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Abstract Rationale and methodology A survey of patients was carried out between January and June 2019, to better understand how patients interpret value in relation to radiology as a means to refining the concept of Value-Based Radiology (VBR) in Europe, ensure radiology’s value is properly weighted in Value-Based Health Care (VBH) metrics, and maximise the value of radiological services to patients. The survey was disseminated via various heads of radiology departments, ESR officers, patient organisations, and ESR website and social media channels. Results Responses were received from 400 patients from 22 countries. Whilst most expressed general satisfaction with the radiological services they received, certain aspects of the radiological services they received left room for improvement. Thirty-six percent of respondents reported that they were not satisfied with the information provided about the risks and benefits of procedures, and thirty-three percent reported not being satisfied with the availability of radiologists for consultation, potentially suggesting that some patients lack sufficient information to participate fully in treatment decisions. Patients were often unaware of what information they were entitled to receive. Over eighty percent of respondents were unfamiliar with the concepts of Value-Based Radiology and/or Value-Based Health Care. Conclusion In addition to procedural correctness (correct diagnosis, appropriate procedures performed), patients highly value information and communication with their radiologist (information provided about procedures, explanation of results, personal consultation). Lack of communication was found to be a cause of dissatisfaction in many cases. This could suggest a means of improving patient outcomes as measured by Value-Based Health Care metrics.

Abstract Background The Value-Based Healthcare (VBH) concept is designed to improve individual healthcare outcomes without increasing expenditure, and is increasingly being used to determine resourcing of and reimbursement for medical services. Radiology is a major contributor to patient and societal healthcare at many levels. Despite this, some VBH models do not acknowledge radiology’s central role; this may have future negative consequences for resource allocation. Methods, findings and interpretation This multi-society paper, representing the views of Radiology Societies in Europe, the USA, Canada, Australia, and New Zealand, describes the place of radiology in VBH models and the healthcare value contributions of radiology. Potential steps to objectify and quantify the value contributed by radiology to healthcare are outlined.

Background: The Value-Based Healthcare (VBH) concept is designed to improve individual healthcare outcomes without increasing expenditure, and is increasingly being used to determine resourcing of and reimbursement for medical services. Radiology is a major contributor to patient and societal healthcare at many levels. Despite this, some VBH models do not acknowledge radiology's central role; this may have future negative consequences for resource allocation. Methods, findings and interpretation: This multi-society paper, representing the views of Radiology Societies in Europe, the USA, Canada, Australia, and New Zealand, describes the place of radiology in VBH models and the healthcare value contributions of radiology. Potential steps to objectify and quantify the value contributed by radiology to healthcare are outlined. [ABSTRACT FROM AUTHOR]

Abstract The European Society of Radiology (ESR) established a Working Group on Value-Based Imaging (VBI WG) in August 2016 in response to developments in European healthcare systems in general, and the trend within radiology to move from volume- to value-based practice in particular. The value-based healthcare (VBH) concept defines “value” as health outcomes achieved for patients relative to the costs of achieving them. Within this framework, value measurements start at the beginning of therapy; the whole diagnostic process is disregarded, and is considered only if it is the cause of errors or complications. Making the case for a new, multidisciplinary organisation of healthcare delivery centred on the patient, this paper establishes the diagnosis of disease as a first outcome in the interrelated activities of the healthcare chain. Metrics are proposed for measuring the quality of radiologists’ diagnoses and the various ways in which radiologists provide value to patients, other medical specialists and healthcare systems at large. The ESR strongly believes value-based radiology (VBR) is a necessary complement to existing VBH concepts. The Society is determined to establish a holistic VBR programme to help European radiologists deal with changes in the evolution from volume- to value-based evaluation of radiological activities. Main Messages • Value-based healthcare defines value as patient’s outcome over costs. • The VBH framework disregards the diagnosis as an outcome. • VBH considers diagnosis only if wrong or a cause of complications. • A correct diagnosis is the first outcome that matters to patients. • Metrics to measure radiologists’ impacts on patient outcomes are key. • The value provided by radiology is multifaceted, going beyond exam volumes.

The International Forum, established by the European Society of Radiology (ESR), aims to discuss important topics in the field of radiology with radiological partner societies from outside Europe. Value-based healthcare is currently a hot topic around the world and has been addressed in many papers. The ESR chose the topic "value-based radiology" for the ESR International Forum at ECR 2018 to discuss the trend within radiology to move from volume-based to value-based practice. The value-based healthcare (VBH) concept defined "value" as health outcomes achieved for patients relative to the costs of achieving them (European Society of Radiology (ESR) 2017, Insights Imaging 8: 566). Value should increase the health outcome and decrease the cost of delivering the outcomes. Radiology is simply counted as a cost and therefore, it is important that the radiologists themselves have an active role in the transition to be recognised as clinicians taking care of the patients. [ABSTRACT FROM AUTHOR]

The European Society of Radiology (ESR) established a Working Group on Value-Based Imaging (VBI WG) in August 2016 in response to developments in European healthcare systems in general, and the trend within radiology to move from volume- to value-based practice in particular. The value-based healthcare (VBH) concept defines 'value' as health outcomes achieved for patients relative to the costs of achieving them. Within this framework, value measurements start at the beginning of therapy; the whole diagnostic process is disregarded, and is considered only if it is the cause of errors or complications. Making the case for a new, multidisciplinary organisation of healthcare delivery centred on the patient, this paper establishes the diagnosis of disease as a first outcome in the interrelated activities of the healthcare chain. Metrics are proposed for measuring the quality of radiologists' diagnoses and the various ways in which radiologists provide value to patients, other medical specialists and healthcare systems at large. The ESR strongly believes value-based radiology (VBR) is a necessary complement to existing VBH concepts. The Society is determined to establish a holistic VBR programme to help European radiologists deal with changes in the evolution from volume- to value-based evaluation of radiological activities. Main Messages • Value-based healthcare defines value as patient's outcome over costs. • The VBH framework disregards the diagnosis as an outcome. • VBH considers diagnosis only if wrong or a cause of complications. • A correct diagnosis is the first outcome that matters to patients. • Metrics to measure radiologists' impacts on patient outcomes are key. • The value provided by radiology is multifaceted, going beyond exam volumes. [ABSTRACT FROM AUTHOR]

Rationale and Methodology: A survey of patients was carried out between January and June 2019, to better understand how patients interpret value in relation to radiology as a means to refining the concept of Value-Based Radiology (VBR) in Europe, ensure radiology's value is properly weighted in Value-Based Health Care (VBH) metrics, and maximise the value of radiological services to patients. The survey was disseminated via various heads of radiology departments, ESR officers, patient organisations, and ESR website and social media channels., Results: Responses were received from 400 patients from 22 countries. Whilst most expressed general satisfaction with the radiological services they received, certain aspects of the radiological services they received left room for improvement. Thirty-six percent of respondents reported that they were not satisfied with the information provided about the risks and benefits of procedures, and thirty-three percent reported not being satisfied with the availability of radiologists for consultation, potentially suggesting that some patients lack sufficient information to participate fully in treatment decisions. Patients were often unaware of what information they were entitled to receive. Over eighty percent of respondents were unfamiliar with the concepts of Value-Based Radiology and/or Value-Based Health Care., Conclusion: In addition to procedural correctness (correct diagnosis, appropriate procedures performed), patients highly value information and communication with their radiologist (information provided about procedures, explanation of results, personal consultation). Lack of communication was found to be a cause of dissatisfaction in many cases. This could suggest a means of improving patient outcomes as measured by Value-Based Health Care metrics.