Person-centred (especially) care

23 Aug

Person-centred care is increasingly the focus of discussion these days, that which incorporates the preferences, circumstances and values of patients. It is also about results related to the life quality of people and clinical variables. This is the guiding theme of the journey we propose today in this summer post. We hope it is inspiring.

Johanna Caro reflected on the challenges faced by the Essencial project and low-value practices, from Quebec (where the international congress, Preventing Over-diagnosis, was held last year).

Johanna Caro reflexionava des del Quebec (on es va fer l’any passat el congrés internacional Preventing Overdiagnosis) sobre els reptes del projecte Essencial i les pràctiques de poc valor.

“Patients are also important decision makers in relation to their needs and in the demand for certain health services. Hence, the project must be accompanied by a communications strategy aimed not only at patients but also at citizens in general”

Cari Almazan was only recently interviewed, in fact, in relation to the Essencial project.

“In usual medical practice, there are known routines that do not offer any benefit to the patient and it is difficult to understand why these occur but it is even more difficult to try and avoid them”

Assumpció González Mestre highlighted the strengths of the patient and expert caregiver programmes (Pacient Expert Catalunya and Cuidador Expert Catalunya, respectively).

“This type of learning programme among equals manages to improve the quality of life of people which find themselves in the environment of a disease in the context of chronicity in Catalonia, be it as patients, as caregivers or both things together”

Gaietà Permanyer – already mentioned several days ago within the context of research and the press, reflected from her experience as a physician on the information which reaches the general population.

“I have witnessed the growth of citizens’ autonomy, now widely acknowledged, and their right to take “informed decisions”. This position, which has come to define the 21st Century as “the patients’ century”, acknowledges their right to know relevant professional data so as to be able to take accurate decisions autonomously”

Felip Miralles i Joan Escarrabill situated us in the process of preparing the XPatient congress which is being held this September and which is based on an innovative vision to foster the empowerment of the patient and caregiver.

“Hi ha moltes estratègies per identificar les necessitats no cobertes dels pacients i dels seus cuidadors”

Finally, Montse Moharra placed value on the importance of language and communication in order to successfully facilitate access to information in a clear and understandable way.

“There is a growing need, therefore, to provide this (medical information) within a comprehensible format which includes the need to ensure that the medical message a patient receives is effective.”

We have a lot of challenges on top of many other challenges, both old and new, in an ever changing world. These challenges add to the limitations but also the opportunities within a health system, to those of the process in disease and those of the entire population.

HTA connections

9 Aug

In our blog at AQuAS, we have spoken about the European EUnetHA project, of the arthroplasty registry of Catalonia, of the paradigm shifts in acute stroke care and of melatonin.

Let us begin with EUnetHA, a European project made up of different institutions working towards joining forces and methodologies to avoid duplicities with the aim of providing, adapting and sharing useful knowledge for health systems. When we speak of HTA, we are basically speaking about assessment.

Emmanuel Giménez highlighted that in a world of constant change a robust system is needed in terms of method which is at the same time agile and which can adapt to the speed of innovations.

“The identification and prioritisation of products to be assessed (the Horizon Scanning system), as well as the balance between innovation and divestment, are also extensively discussed subjects and under continuous debate”

Marta Millaret focused on the aspect of communication and dissemination in a project because although doing is important, explaining and sharing what is being done is equally so.

“Involvement in dissemination means getting the people that work on a project to disseminate both their work and their project at the same time. In this way, everyone stands to gain”

We continue with the Arthroplasty Registry of Catalonia, a tool of the health system with an impact on a large part of the population.

In an interview with Olga Martínez and Xavier Mora, aspects of the suitability and prognosis of arthroplasties were discussed, and in particular, they shed light on the value of registries.

“Arthroplasty registries can help detect models of prosthesis with a malfunction, both in the short and long term, and identify the patients who have received these implants”

Precisely this summer, two reports from the AQuAS have been published thanks to the registries.

We wanted more so we held a second interview with Olga Martínez and Xavier Mora. On this occasion, we put the spotlight on the materials used in making prostheses.

“The new European legislation passed in 2016, regarding implants used in health, aims to increase the supervision of the industry by implementing stricter norms and regulations including the obligation of clinical assessment, while at the same time fostering innovation in this field”

Moving on to another subject. Knowledge advances, which has implications in medical practice. An example is this text by Sònia Abilleira which shows a paradigm shift forcing one to rethink organised systems of care for people with acute stroke.

“This recentralising tendency in carrying out endovascular treatment contrasts with the decentralisation which was done in its day to ensure an adequate access to thrombolytic therapy which by nature needs to be administered in the first 4,5 hours after the onset of symptoms”

To finish this journey, a 100% current topic: melatonin. Joan MV Pons shared his thoughts after an assessment report.

“New physiological actions of this hormone are discovered every day which means that it almost acquires the quality of a “miraculous molecule” due to its ubiquity and the number of activities in which it takes part (antioxidant, neuro-protector, anti-cancerous, immunomodulation, etc..).”

What do these initiatives, all so different from each other, have in common? The answer is assessment. Wherever, with the will to identify, analyse and use knowledge of better quality using the best methodology available while considering the context in all its complexity. This is no mean feat!

Gender issues: here and now

2 Aug

 

 

 

 

One of the editorial lines of the AQuAS blog is on gender. In recent years, we have had the collaborations of Mercè Piqueras shedding light on the silenced contributions of some women in science with the example of Nettie Maria Stevens (Who discovered the Y chromosome?), of Esther Vizcaino with a call for the involvement of all of society (men and women) in subjects of equality, of Paula Adam with the initiative to include gender in research impact assessment and of Dolores Ruiz-Muñoz bringing to light what happens with women (in biomedical research) and the famous glass ceiling.

What else have we published on gender? Since last summer we have put the emphasis on a more practical approach (apparently) from a health profession perspective and on a more theoretical approach (apparently) within a conceptual framework and related to public policies.

The first approach emerges from several concerns and events in the media which alerted us and we found it interesting to do a group exercise with Núria Rodriguez-Valiente, Marc Fortes and Mercè Salvat that generated an inspiring conversation about nursing and gender. The result was a very enriching text which is an invitation to question multiple elements of daily life based on a very specific case.

El primer enfocament sorgeix de diverses inquietuds i esdeveniments en mitjans de comunicació que ens van alertar i vam trobar interessant fer un exercici en grup amb Núria Rodríguez-Valiente, Marc Fortes i Mercè Salvat que va generar una conversa inspiradora sobre infermeria i gènere. El resultat va ser un text molt ric, que és una invitació al qüestionament de múltiples elements de la vida quotidiana, a partir d’un cas molt concret.

“Why the term caregiving is associated with women in our society, why this care does not have nor has had social recognition when opinion is favourable in the processes of health-illness, how the men who have chosen this profession experience it and finally, how it would be possible to “deconstruct” this social and cultural construct”

The second approach emerges from the sum of different initiatives having a clearly informative purpose. Iria Caamiña laid down the basics about gender from the perspective of public policies in the context of health. It is a dense and solid text which shows the ground that has been covered (available, public, within reach of everybody) and which stated that although the journey has begun, there is still a long way to go.

“The media systematically show us examples of the persistence of discriminatory situations for women such as the gender wage gap, the lack of women in managerial positions and the violence towards women, among other things. These situations are a result of our social construct which is still based on an androcentric model where man is placed at the centre, as a reference of values and of the view of the world while at the same time subordinating women and rendering them  invisible”

All these different and complementary perspectives, despite still needing to be explored further and considered, all form part of our daily lives in society. What is more, they affect us and explain where we come from, who we are, where we are and where we want to go.

The concept of “gender mainstreaming” means incorporating the perspective of gender in all policies and actions by a government, an entity or an institution; in a health system and in assessment too.

We recommend reading this document by the catalan Health Department:

The impact of research in retrospect

26 Jul

It was last autumn, with cooler temperatures than this mid summer’s, that we published some interesting reflections by Ramon Gomis on biomedical research in Catalonia  mentioning the CAPRIS programme (Advisory Board in Research and Innovation Policy) and the ICREA programme (Catalan Institute of Research and Advanced Studies).

These questions marked the start of a powerful reflection by Núria Radó about nursing research where the aspects of participation and impact of research were combined (multifactorial), and where the aspect of involvement came into play. All of this in the context of SARIS (The Health Research and Innovation Assessment System) and PERIS (Strategic Plan for Research and Innovation in Health 2016-2020).

Doing research and publishing on this research are actions which often go hand in hand, be it in scientific contexts (articles, communications at congresses) or in informative contexts (the traditional media  or  social networks).

In this study we saw an analysis of the critical tone of news about medical innovations published in the daily written press. These are the generous reflections by Gaietà Permanyer on the reservations of a doctor when publishing in newspapers or books of a non-professional nature, of the concepts of patient autonomy, of informed decisions and health literacy, and of how everything fits together, to ideally arrive at balanced information in non-specialist media.

We continue highlighting publications. However, we are now focusing on scientific publications and the impact that can be derived from two very different but inspiring subjects:

On the one hand we saw the phenomenon known as “the sleeping beauties of science” thanks to Joan MV Pons and the case of a discovery (published) by Francis Mojica (25 years ago) which has been key in the development of the CRISPR genome editing technique..

“Sleeping Beauties is also said of those scientific articles which seem to go by unacknowledged until someone comes to their late rescue and gives them the recognition they deserve”

On the other hand, two days before the start of spring, we had the collaboration of Ernest Abadal from Newcastle who explained the altmetrics and the strengths and weaknesses of systems (traditional and not so traditional) in the assessment of the quality of a scientific publication.

“From 2010, people started talking about altmetrics, a set of indicators (for example, how often an article is shared, its re-dissemination, the comments it has generated, mentions (likes), etc…) that measure the presence of a publication in social and academic networks, which complement citation indexes considerably”

The aspect of involvement also comes up here:

“From a researcher’s perspective, it is clear that at present publishing an article in a journal is not enough and one needs to be fully involved in its dissemination in social networks and also in academic networks so as to give visibility to the contents published”

We end this journey on the assessment and impact of research with Ion Arrizabalaga with the challenge of measuring involvement in this context.

“Participation of the actors in research is a key element in research to transform and generate impact in society”

If you would like to read more about participation and research, we recommend reading these two documents published at AQuAS:

How we adapt medical language to improve communication with patients

12 Jul
Montse Moharra

What is special about the recommendations for patients and the Essencial project, one of the projects of the Agency for Health Quality and Assessment of Catalonia (AQuAS)?

There is a greater and greater demand to have access to clear and more readily understandable information in health by patients. There is a growing need, therefore, to provide this within a comprehensible format which includes the need to ensure that the medical message a patient receives is effective. This will in turn facilitate the conversation between both parts and will improve a patient’s understanding of their diseases, treatment options or possible side effects and will most likely also have an impact on empowering patients to be more actively involved in taking decisions related to their treatment.

 

The use of medical terminology is one of the factors, among others, which impedes an effective communication between professionals in health and patients. This could be due to a low level of understanding in health which we call “literacy” or perhaps as a result of the complexity of the specialised medical terminology itself which stems from a wide range of clinical specialities. These use specific terminology and we often find terms used in other fields of expertise such as pharmacy or biology.

It is most likely too that one of the reasons why medical information is not successfully transmitted is due to the amount of terminology found in a text which may not easily be understandable to the patient. Moreover, with the progress of medicine itself new terminology is constantly being introduced – some is modified and some terms are discarded. Therefore, the variation in terminology and the use of overlong sentences, the density of unexplained terminology, the use of acronyms, symbols or abbreviations are some of the barriers that complicate understanding.

The Essencial project, which has been drawing up recommendations to avoid unnecessary clinical practices for five years, started to adapt information for patients in 2014 and at present there are a total of twenty-two recommendations for patients available in Catalan and Spanish. These are a clear example of how medical terminology is adapted so that clinical recommendations can better be understood by patients and reach them effectively. For this reason, a process is followed to adapt the language to make a text easier to read and this also applies to its content, format and graphic images thus ensuring that documents for patients meet minimum reading requirements. The communication group of the Patient Advisory Council that designed the format of the documents and regularly validates the content also participates in this process.

The ultimate aim, therefore, is to make medical language more accessible to patients so that the message is effective bearing in mind the linguistic, cognitive and cultural barriers that may impede the information from being understood adequately.

Post written by Montse Moharra.

“Me sube la melatonina”

28 Jun
Joan MV Pons

Well, let’s say that in Juan Luis Guerra’s merengue song (1990), it was bilirubin that was on the rise:

Me sube la bilirrubina
¡Ay! Me sube la bilirrubina
Cuando te miro y no me miras
¡Ay! Cuando te miro y no me miras
Y no lo quita la aspirina
¡No! Ni un suero con penicilina
Es un amor que contamina
¡Ay! Me sube la bilirrubina

It is evident that it is something difficult to treat, but who cares, it could also have been serotonin, dopamine or noradrenaline. After all, love alters everything and things would rhyme just the same. Whatever the case, if there is one thing that should best be avoided, it is a rise in bilirubin, because one can end up jaundiced or, as they said in the past, with an excess of bile.

What is true is that melatonin starts increasing in all of us when it begins to get dark, before going to sleep, following a circadian rhythm set by our hypothalamic biological clock. The pineal gland, where Descartes thought there was a connection between the mind and the body, where he placed the soul, segregates this hormone that induces sleep and thus, works better when restful sleep eludes us, that is, when there is a delay in the onset of sleep.

New physiological actions of this hormone are discovered every day which means that it almost acquires the quality of a “miraculous molecule” due to its ubiquity and the number of activities in which it takes part (antioxidant, neuro-protector, anti-cancerous, immunomodulation, etc..).

Melatonin, which is mostly obtained synthetically, is marketed as a drug (prolonged-release tablets of 2 mg) and as a nutritional or dietary supplement (doses of less than 2 mg). This difference, we are talking about 0.02 mg, is in itself a little surprising and even more so bearing in mind that there is only one drug with melatonin but on the other hand, there are numerous supplements that contain melatonin (on its own or in combination with other products). The requirements, in one case or another, are very different. While there are countries in which melatonin is marketed on its own or as dietary supplements, in others it is only found as a drug which requires a doctor’s prescription, and in Europe both situations exist. In Spain, a medical prescription is needed but it is not a publicly funded drug and as a supplement, as mentioned before, there is a wide range of products.

As a drug, it is authorised by the European Medicines Agency (EMA) in people aged 55 or over and in treating primary insomnia for a limited period of time. The EMA considers that melatonin is effective albeit with a small effect size in a small fraction of the population but with a more favourable safety profile than other hypnotic drugs.

It is known that as one gets older the secretion of this hormone decreases and yet all clinical practice guidelines or recommendations in the approach to insomnia primarily advise sleep hygiene measures followed psychological interventions. Nevertheless, the data of pharmacological consumption shows an increase in prescriptions of hypnotic drugs and sedatives, especially those derived or related to benzodiazepines.

The EMA has asked for more studies on melatonin at a paediatric level despite the fact that there is data which seems favourable in children with an attention-deficit hyperactivity disorder or with autistic spectrum disorder where sleep hygiene and psychological interventions have failed.

The report “Exogenous melatonin in the treatment of sleep disorders: efficacy and safety” drawn up by the AQuAS talks of these and other related subjects, mentioning the wide range of para-pharmaceutical products that contain melatonin.

 

As a dietary supplement or a drug, there are unequal demands by regulatory agencies in Europe (food safety, drugs) in terms of its authorisation for marketing. It is a known fact that the variability in the quality of a product, its formulation, dosage and combinations in supplements and so on, in part explain the heterogeneity between studies observed in some meta-analyses, also contained in the report.

Post written by Joan MV Pons.

Taking another step forward: Can we measure the participation in research of the agents of the system?

21 Jun
Ion Arrizabalaga

In recent years, the idea that the participation of the actors in research is a key element in research to transform and generate impact in society has been insisted on repeatedly. For those who are still a little unsure of this statement, studies in the assessment of the impact of research demonstrate the idea. They emphasise the participation of professionals, patients and the remainder of the actors of the system throughout the entire process of research during which the effectiveness of research in reaching society is improved.

Hence, the AQuAS, in collaboration with the Fundación Bancaria “a Caixa”, considered it necessary for the systems of assessment to be involved too if we want research to have a greater impact. With this objective, and a great contribution from Maite Solans and Paula Adam, the first monographic on Responsible Research of the SARIS (Assessment System of Research in Health) was presented. As a result of reviewing the existing international literature, 47 indicators were identified that measure the activities and participation of the actors in research institutions.

The indicators identified cover a large part of the research ‘process’, and they have been grouped in six aspects  – training, governance, resources, activity, dissemination, and primary results. This allows us to see how the different actors in the system can be involved during the entire process of research (planning, execution and translation).

Figure 1. Aspects in the process of research

However, we need to be cautious! On the one hand, the proposed indicators can be useful to stimulate and open up the reflection on how to monitor the activities carried out in research institutions in relation to the participation of the actors of the system. On the other hand, it must be pointed out that an indicator must be used responsibly by taking into consideration their context, incentives and the distortions that a measure can provoke. Experts in measures and indicators in science know very well that the research fabric and the research system change their behaviour according to what is being measured, ‘you get what you measure’, said Cyril Frank, chairman of the panel on the impact of research in health of the Canadian Academy of Health Sciences (CAHS).

Referring to participation in research, the question of measure is even more complex because it is still in its infancy. As Derek Stewart said, director of Patient Involvement of Nottingham Biomedical Research Centre and speaker at the SARIS session where this monographic was presented:

One of the greatest challenges of measures is that ‘inputs’ are often measured – the number of people that participate, the number of groups that have been called or who have been talked to or the number of studies in which patients participate. It is about carrying out actions that add value, that help provide knowledge for solutions for patients”

Derek Stewart’s reflections during the preparation of his conference can be found on his blog ‘Making a difference’.

Indicators should help to answer specific questions based on each situation and need, and this is why it is essential to assess their relevance and feasibility within their context. The concept of relevance refers to the proximity of an indicator to a need and specific question that we pose; for example, what is the real value of the participation which an indicator measures? The concept of feasibility refers to how easily available and affordable data is when constructing an indicator.

As can be seen in Figure 1, among the indicators found in the literature there is a large number that are relevant, which was to be expected because they are recommended by very prestigious entities. Nevertheless, their feasibility in our environment is low in the majority of cases which means that although we have identified several indicators with limitations, none are fully recommendable.

Figure 3. Feasibility vs Relevance of the 47 indicators

Therefore, bearing in mind the context of research in Catalonia, at AQuAS we have catalogued the indicators as follows:

  • 27 indicators as not recommendable for use
  • 20 indicators with limitations
  • No indicator as being fully recommendable

Our findings allowed us to learn a valuable lesson: before defining indicators or measuring the participation in research, we must first explore what is done in our environment and so by first analysing what is feasible we can then decide what the most relevant actions are.

The success of assessment systems depends on the acceptance of their processes and results among those in charge of taking decisions and the research communities which are being assessed. The challenge, thus, is to understand what is done in practice in our environment based on the guide which the indicators in the international literature have provided us with.

Let us continue!

Post written by Ion Arrizabalaga.

(Post published jointly in the AQuAS blog and the blog of CaixaCiència)

mHealth assessment at HIMSS Europe 2018: success stories and new challenges

15 Jun
Elisa Poses Ferrer

Last 27, 28 and 29 of May, Sitges hosted the annual congress of Healthcare Information and Management Systems Society (HIMSS) Europe & Health 2.0, an event centred on digital health and innovation in telemedicine. The congress received hundreds of professionals from around the world who shared their experiences in mHealth and people’s health, integrated care, value added strategies, big data, data analysis and real world data.

The characteristic feature of the congress was the focus of activities and presentations on the action and participation of all stakeholders involved in the health sector. It was also about facilitating the creation of strategic networking, about research and about the funding of projects.

AQuAS had a noteworthy participation with a presentation by Toni Dedeu at the “ETC Map of Excellence” session within the framework of the European Telemedicine Conference.

The adoption of the 2.0 solutions among health professionals from a disruptive perspective was also a lively debate which is still ongoing after the congress. How do we involve professionals?

To continue. In the field of assessment, the conference “Assessing Telemedicine Solutions” was focused on examples of European eHealth in which the assessment of technology was a key piece in the implementation of digital strategies in health.

On the one hand, representatives of the Odense University Hospital of Denmark outlined an innovative strategy to reduce hospital stays of premature new-born babies and to improve their weight gain and family experiences by using video conferences and digital support in the management of data.

On the other hand, the company Kaia Health presented a mobile application aimed at people with chronic obstructive pulmonary disease, monitoring both adherence to medication and the degree of day to day sedentary lifestyle. The factors for success most discussed during the session were, on the one hand, the collection of continuous and systematic feedback of patients, family members and professionals and on the other, the continuous and cyclical improvement technology.

As challenges, the conference speakers highlighted the assessment of economic impact and the impact on health as well as the design of strategies to guarantee the use of mobile technologies and applications by patients.

This confirms that it is becoming increasingly necessary to have a European framework of assessment in mHealth that provides an assessment framework of impact and a roadmap to improve the satisfaction of users beyond mere technological validation and certification of quality.

AQuAS has been developing a theoretical model of mHealth assessment, published in the JMIR mHealth and eHealth journal and at present it is in a second phase with the aim of transforming this theoretical framework into a practical model.

An exercise in consensus will soon be done by using the Health Consensus tool to agree on indicators of assessment and several focus groups to get to know of the qualitative assessment of patients, professionals and other parties involved in eHealth technologies.

It is estimated that this framework of assessment will be ready at the end of the year to respond to the present day needs of assessing the impact on users and their satisfaction of new health technologies.

The next European HiMSS congress, programmed for the 7 and 18 October, 2018, in Potsdam, Germany, will in fact be dedicated to discussing the social and economic impact of health technologies.

The annual congress (equivalent to that held in Sitges) will take place next year in Finland. You can take note in your diaries: Helsinki, 11-13 June, 2019, HIMSS Europe 2019 & Health 2.0 2019.

Post written by Elisa Poses Ferrer.

Specialised health training and indicators to measure the quality of teaching

7 Jun
Alicia Avila

To work as a specialist in the health system -in any speciality in medicine, pharmacy, psychology, nursing or other- not only do you need to have a university degree but also the corresponding specialist qualification. To get it you need to pass the selective test traditionally known as the MIR in Spain (national specialisation examination) for specialist doctors, PIR for psychologists, FIR for hospital pharmacists, to give some examples and which has been done annually for more than 30 years. The training of specialists in the Health System is done in public and private health centres and teaching venues, previously accredited, to which professionals have access once they have passed the selection process, in rigorous order of registration.

The allocation of chosen places for this year recently finalised and the residents took up their places at the end of May. The specialist health press has made use of all kinds of headlines, commenting on the results of autonomous communities, the most sought after specialties by residents or the best positioned centres. Nevertheless, not all the comments that have been published, sometimes too hastily, contain an accurate and rigorous analysis. The ability of centres to attract teaching staff in Catalonia has not regressed nor changed much in recent years; the hospitals and teaching centres most sought after in Family and Community Care by new residents are still the same at a state level.

Why is it important to be an attractive teaching centre for residents? Obviously, because all centres aspire to have the students with the best marks, not only for the prestige that this has or for the base of knowledge they have shown to have, but also because of the possibility of retaining them and contracting them at the end of their residency. The lower the mark in the MIR, the greater the chances are of abandoning a speciality and in practice a significant number of foreign residents are seen as having greater difficulties for future employment.

To promote the intrinsic and perceived quality in specialised training given to residents, the Department of Health of the Generalitat de Catalunya has implemented a Management Plan of Teaching Quality and within this, a set of structural, procedural and results indicators related to the places offered, which have been published in a report since last year at the Central de Resultats (Results Centre, Catalan Health System Observatory) under the auspices of the AQuAS.

Furthermore, a survey of satisfaction is carried out with all residents in Catalonia which has had an effective participation of 76% this year and which offers complementary information to that of the Plan of Quality. Both instruments, beyond the fact of generating transparency and information regarding a healthy specialist training, make it possible to benchmark different centres with the aim of achieving greater competitivity and improved teaching in Catalonia.

Ultimately, guaranteeing profiles of excellence of specialist health professionals is the permanent aspiration of the Health Authority via a learning process based on supervised and mentored practice to attain the necessary professional skills to offer a safe and high quality practice. In this way, the health system will be capable of training better specialists to meet the needs of the population in health.

Post written by Alícia Avila, Assistant Director-General of Professional Planning and Development. Health Department.

Antisuperbugs: 3 million euros for technological innovation in the prevention of resistance of microorganisms to antibiotics

31 May

The healthcare market is one of the areas with the greatest purchasing impact in the public and private sector in Spain with a business turnover of 71 billion euros annually. It is a very complex market where the formulas used for purchasing both consumer goods and drugs, and services depend on the centres themselves. However, they also depend on the local regulations of suppliers, autonomous regions as well as state and community legislation.

This complexity does not only make it impossible for companies to make their products or services available to procurers but it is also often the interested parties in the purchasing that see the inclusion of these produces in their centre and their accessibility to their staff as a truly impossible mission.

And this is a whole lot more difficult when it comes to incorporating new technologies that meet the real needs of professionals.

In a panorama where investment in research and development is at its lowest point in recent decades, having a pre-commercial public procurement project subsidised by the European Union with 3 million euros is a big opportunity for companies that can offer their R+D services to create innovation which responds to the real needs of professionals.

An innovative public procurement project is an approach to innovation based on demand, where a group of procurers combine their resources to share risk in a joint R+D effort in the industry to provide solutions to needs which are not being met by the market. In the case of our project, it would be an ICT solution aimed at the early detection of microorganisms resistant to antibiotics (superbugs) in a healthcare environment, the Antisuperbugs project, coordinated by Jean Patrick Mathieu of the Agency for Health Quality and Assessment of Catalonia (AQuAS).

Antisuperbugs team (from left to right): Kristina Fogel, Sara Bedin, Maren Geissler, Dag Ilver, Benian Ghebremedhin, Jean Patrick Mathieu, Enric Limon, Gonçalo de Carvalho, Gemma Cabré, Esther Arévalo

The consortium coordinated by the AQuAS, an expert institution in the definition and execution of public procurement projects in innovation in Spain, consists of 6 contracting authorities (the Catalan Institute of Oncology IDIBELL (ES), Hospital Mútua of Terrassa (ES), Sheffield Teaching Hospitals NHS Foundation Trust (UK), Helios Kliniken (DE), Universitaetsklinikum Aachen (DE) and Autonomous Province of Trento (IT)), and two expert institutions in their area of research at RISE ACREO (SE) and Sara Bedin (IT).

Enric Limon of the VINCat Programme (Surveillance of Infections) of the CatSalut, principal researcher of the project, sees having a detector of microorganisms resistant to antibiotics as a business opportunity for a company.  In the United States, Asian and European Union markets, solutions are being sought that will make it possible to have a rapid detection system that activates early detection mechanisms. The resistance of certain microorganisms to antibiotics is creating a situation of alarm across the world to which the World Health Organisation (WHO) itself has drawn attention, estimating a figure of 50 million deaths in the years to come if adequate measures are not taken. The successful tendering companies will not only have access to funding but also receive the support of hundreds of professionals from six European institutions at the highest level in research and a potential market in a first phase of hundreds of hospitals and healthcare centres interested in purchasing a solution that they themselves have helped create.

Gonçalo de Carvalho, expert biologist in resistances at the Catalan Institute of Oncology, explains the need for this project to consider the possibility of creating new modules that when applied to the technologies themselves enable new detections to be made which makes purchasing them even more attractive to health institutions by adapting them to their own needs.

The tender which will be opened to companies in the next few months forms part of the Pre-Commercial Public Procurement programmes funded within the European Commission’s H2020 framework of reference. All the information regarding the Antisuperbugs project and the tendering options are available on the website of the project.

Interested companies can access the questionnaire of the open call of the market.

There is also the option for companies to offer their availability by putting in a tender as a consortium.

Post written by Jean Patrick Mathieu, Enric Limon and Gonçalo de Carvalho.