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Hans Middelhoven: HARMONICS – Improving Stroke Care Outcomes in Spain and Portugal

Hans Middelhoven/LinkedIn

Apr 8, 2026, 16:16

Hans Middelhoven: HARMONICS – Improving Stroke Care Outcomes in Spain and Portugal

Hans Middelhoven, Health Business Leader at Roche, shared on LinkedIn:

”The HARMONICS project demonstrates how measuring patient outcomes alongside clinical results fosters a more holistic, patient-centered model of stroke care, moving away from volume-based approaches.”

Objective of the Project

To improve clinical and patient-reported outcomes in stroke survivors while reducing mortality and recurrence rates, fostering a more patient-centered recovery process.

VBHC Elements in Action

Patient-relevant medical outcomes: Regular tracking of NIHSS and modified Rankin Scale scores to assess clinical outcomes.
Patient involvement: Measuring self-perceived recovery rates to integrate patient perspectives into care improvement.
Medical condition: Focus on acute and post-acute stroke management.
Patient initial condition, stratification, and segmentation: Stratifying patients based on clinical severity at discharge.
Integrated Practice Units (IPUs): Collaborative teams ensuring continuity of care across different recovery phases.
Learning cycles: Leveraging outcome data to refine and adapt care strategies for improved results over time.

Key Outcomes

1-year post-stroke mortality rate of 9.3% and stroke recurrence rate of 7.3%.
Median National Institutes of Health Stroke Scale (NIHSS) score at discharge: 1 (IQR: 0.0–2.0), demonstrating strong clinical recovery.
Median Modified Ranking Scale (mRS) score at 3 months: 1 (IQR: 0.0–3.0), indicating functional independence in many patients.
Despite favorable metrics, ~30% of patients reported poor self-perceived recovery, spotlighting opportunities for better psychological and quality-of-life support.

Stakeholders Involved

Stroke patients.
Hospitals and stroke rehabilitation centers.
Multidisciplinary clinical teams (neurologists, physiatrists, primary care physicians, social workers, occupational therapists and advanced practice stroke nurses).
Data specialists analyzing outcome metrics for continuous improvements.

Commentary

This project shows how measuring both clinical outcomes and patient-reported metrics can create a completer picture of care quality.

By focusing on what truly matters to patients, it is shown that VBHC is not just about reducing costs, it’s about enhancing outcomes that matter to patients.

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