New Study Reveals 3 Keys to Smarter Health Care Dashboards

What does a kidney transplant really cost—not just to the hospital, but to the patient living through it? For most clinicians, managers, and even patients, the answer has remained surprisingly murky. While health systems worldwide race to implement value-based health care (VBHC), an approach that defines value as outcomes relative to cost, one piece of the puzzle has often been missing: the cost side.

A new qualitative study from Leiden University Medical Center in the Netherlands lifts the curtain on what it takes to put costs front and center in VBHC dashboards. The research reveals the functional, operational, and technical requirements needed to make hospital cost data not only transparent, but actionable.

And the findings carry important lessons for hospitals, policymakers, and anyone who believes better health care should mean better value.

Why This Matters Now

VBHC has become the buzzword in health system reform. Instead of rewarding hospitals for the number of procedures performed, VBHC ties success to the outcomes patients care about most—like survival, recovery, and quality of life. But here’s the catch: you can’t truly measure value without measuring costs.

Until now, dashboards have mostly displayed outcomes, patient safety indicators, and sometimes efficiency measures. Costs were left out, often because data systems were siloed, messy, or considered too sensitive.

The Leiden study shows that ignoring costs risks undermining the very goal of VBHC: delivering more health for every dollar spent.

Voices from the Front Line

To understand what different stakeholders actually need from a cost-integrated dashboard, researchers interviewed 15 people across the transplant center, from doctors and nurses to managers, IT specialists, finance staff, and patients.

Their answers reveal both curiosity and caution:

• Clinicians wanted to know the true costs of the care they deliver. One wondered, “What does a transplantation cost? That is what I would like to know.”
• Nurses looked at everyday supplies, questioning whether bundled kits were really cheaper than picking items individually.
• Managers pushed for benchmarking—comparing costs of similar procedures across hospitals. As one put it, “If our kidney transplantation costs twice as much as in another hospital, I want to know why.”
• Finance staff stressed the need to track reimbursement alongside costs, asking: are care activities financial feeders or bleeders?
• Patients, interestingly, weren’t focused on costs in the immediate aftermath of a transplant. But over time, out-of-pocket expenses—from supplements to lost productivity—became significant burdens.

The Three Big Requirements

From these conversations, the study identified three layers of requirements to make cost dashboards work in practice:

1. Functional Requirements

Dashboards need to do more than just display numbers. Stakeholders agreed on three main functions:

• Identify costs and resources – Who is spending what, and on what?
• Evaluate value of care – Are diagnostics, procedures, and treatments efficient and worth the cost?
• Monitor financial viability – Are care pathways sustainable, or are they draining more resources than they bring in?

2. Operational Requirements

Data must spark action, not gather dust. That means:

• Reviewing dashboards monthly or quarterly in team meetings.
• Bringing together care teams, managers, and a financial expert to interpret data.
• Using dashboards as a springboard for continuous improvement rather than a static report card.

3. Technical Requirements

Without reliable data, even the best dashboard fails. Stakeholders called for:

• A validated costing model that accurately reflects real resource use.
• Integration with existing hospital IT systems to avoid “yet another tool.”
• A user-friendly interface with simple signals (like traffic lights) to highlight problems and progress.

A Patient-Centered Twist

One of the most striking findings came from the patient panel. During the first year after transplant, patients said costs weren’t top of mind, they were simply trying to survive and adjust. But as life stabilized, hidden costs crept in: supplements not covered by insurance, time off work, even informal care burdens on family.

Yet these patient-relevant costs rarely make it into hospital dashboards. The study suggests using existing economic evaluation tools, like productivity or informal care questionnaires, to bridge that gap. Because in VBHC, value isn’t just about what the hospital pays—it’s about what patients and families carry, too.

What’s Next for Value-Based Dashboards

The Leiden study offers practical steps, but also highlights unresolved tensions:

• Feasibility vs. ambition: Should every dashboard review require a financial expert, or should clinicians be trained to interpret costs themselves?
• Method choice: Time-Driven Activity Based Costing (TDABC) is touted as the gold standard but remains resource-intensive. Most Dutch hospitals, including Leiden, still rely on Activity-Based Costing (ABC).
• Organizational silos: Hospitals are often structured vertically by department, while patients flow horizontally across care pathways. Aligning costs across this divide is a major challenge.

Despite these hurdles, the study makes clear: the integration of costs into dashboards isn’t optional. It’s the missing half of the value equation.

Why It Matters for Public Health Professionals

For researchers and policymakers, the lesson is sharp: value-based reforms won’t stick without cost transparency. For clinicians, dashboards could spark hard but necessary conversations about redundant care or costly variations in practice. And for patients, the hope is that the real burdens they face—financial as well as medical—will finally be recognized as part of care value.

As health systems worldwide wrestle with sustainability, dashboards that connect outcomes and costs may be one of the most powerful levers for change.

Join the Conversation

• If your hospital had a cost-integrated dashboard, how would it change decision-making?
• Should patient out-of-pocket costs be tracked alongside hospital costs?
• What’s the right balance between financial detail and usability for busy clinicians?