234 Chapter 8 CONCLUSION This thesis aimed to identify the added value of the implementation of VBHC, as defined within the Dutch healthcare context, in routine clinical care for patients with an inherited bleeding disorder. The results of this thesis are inconclusive about the added value of the implementation of VBHC for patients with inherited bleeding disorders. The collection of outcome information could improve shared decision making as long as this information is discussed during the consultation. However, the lack of practice variation in the care for patients with inherited bleeding disorders and overall difficulties in determining if difference in patient outcomes reflects true differences in quality of care, decrease the potential value of collecting outcome information to stimulate continuous learning and quality improvement. Additional research should therefore be performed to further investigate the added value of the implementation of VBHC for patients with an inherited bleeding disorder. This research could focus on how and if the routine collection of outcome information can improve shared decision making, continuous learning and quality improvement, but also on how and if it can contribute to improved patient empowerment, outcomes, experiences, and perceived quality of care.
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