HVHC was founded in 2010 and identified nine high volume, high cost, high variation conditions to focus on, with the goal of improving care and outcomes and lowering cost.

Read the full story at Dartmouth-Hitchcock news.

Five leading health systems, including The Dartmouth Institute for Health Policy and Clinical Practice (TDI) and Dartmouth-Hitchcock Medical Center, are changing aspects of how they perform total knee replacements, as a result of data they collected that showed variations in length of stay, length of operating room time, and in-hospital complications.

TDI and Dartmouth-Hitchcock are two of the founding members of the High Value Healthcare Collaborative (HVHC). In a paper released by Health Affairs, the HVHC outlined the first results from their study of nearly 11,000 total knee replacements performed across the five health systems. Comparison data showed “considerable” differences among the institutions in procedures and outcomes, the authors report.

The paper, featured as a Health Affairs "Innovation Profile", and titled “A Collaborative of Leading Health Systems Finds Wide Variations in Total Knee Replacement Delivery And Takes Steps to Improve Value,” was authored by Ivan Tomek, a professor at TDI, and includes co-authors Karl Koenig, assistant professor of orthopedic surgery at the Geisel School of Medicine; James Westrich, senior statistical research analyst at TDI; William Weeks, associate professor of psychiatry and of community and family medicine at the Geisel School and member of the office of professional education and outreach at TDI; and James N. Weinstein, the president and chief executive officer of Dartmouth-Hitchcock Health System and the Peggy Y. Thomson Professor in the Evaluative Clinical Sciences.

The intention of the HVHC is to identify best practices and subsequently move them out to other health care institutions so that all providers and patients can benefit from this work. The collaborative was founded in 2010 and identified nine high volume, high cost, high variation conditions to focus on, with the goal of improving care and outcomes, reducing variation, and lowering costs.