HealthManagement, Volume 18 - Issue 4, 2018


As a leading center in the treatment of cardiac arrhythmias, Oslo University Hospital, in Norway is acutely aware of the increasing number of lives that are being impacted by atrial fibrillation.

Dr. Erik Kongsgård, Head of Electrophysiology at the hospital, shared, “we are the only public center in the south of Norway, with approximately 2.8 million citizens – a huge region. We’ve had to take on more patients this year, and next year it will increase. Resources are limited. If we can’t stay within budget, we’ll get less next year. To increase the number of patients we treat, we need to work smarter.”

Afib is the new millennium epidemic – affecting 11 million in Europe. It places a critical burden on healthcare systems as it more than doubles a patient’s risk of stroke and mortality. Yet, only 4% of eligible patients undergo ablation treatment. Oslo University Hospital were committed to do something about this and had a clear goal – to treat more patients, safely, and improve outcomes.

“At six months, our hospital waiting list is too long, as is procedure downtime. I’ve travelled across Europe to other centers and it’s the same wherever you go. For us it’s 60-90 minutes downtime, in other centers its 90-150. Everyone is struggling.”

Rather than hand over the reins of their electrophysiology laboratory to a vendor with an ‘off-the shelf’ solution, they wanted a true partner with whom they could create their own solution. Dr. Kongsgård describes, “We wanted to partner with a large and experienced company, with a global network, meaning quick input on solutions. We had to explore how we could systematically standardize protocols and find a smart way to have multiple afib patients in one lab – efficiently and safely.”

Johnson & Johnson understands that every hospital is unique. Thus, it prides itself on listening first. This was how the CareAdvantage, value-based approach was born. ‘Solving Starts with Listening’ remains central to the process of understanding, supporting and solving challenges collaboratively with hospitals through innovative, bespoke and co-created solutions.

“If I have a problem, I know I can come to Johnson & Johnson to provide a solution – so we got in contact. We were lucky. It was the right moment for our partnership.”

“There are different barriers between professions in a hospital and sometimes we’re not good at listening.” “The process with Johnson & Johnson has opened our minds to listen, not only talk. So, we involved the whole department in the process and, through follow-up and assessment, they can see we’ve achieved something good by making changes that improve productivity and safety.”

Johnson & Johnson and Oslo University Hospital signed the Biosense Webster ADVANTAGESM Partnership in April 2018 with an objective to increase the total number of patients treated in the electrophysiology lab, including an additional 80% of afib patients treated annually. The key program objectives included:

  • Ensuring patients are well-informed pre-operatively, with improved assessments to reduce the number of patients dropping out on the day of procedures
  • Reducing down-time of the electrophysiology lab and changeover-times
  • Standardizing the afib ablation procedure to reduce the current inter-procedure variability and improve safety and outcomes

Describing changes already seen, Dr. Kongsgård said, “Downtime is shorter, and doctors’ awareness of new standardization processes has improved, meaning the afib ablation procedure is more standardized than before. It’s a major achievement. Patient follow-up, which was previously not that good, has also improved.”

Johnson & Johnson’s CareAdvantage value based approach has been able to offer Oslo University Hospital a custom designed pathway capability for comprehensive afib management, delivering value at every point along the care pathway – ultimately expanding access to heal more hearts.

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