AQuAS Blog

Collaboration between professionals and citizens, a key factor for health data visible and useful

16 Jul

Cristina Ribas, President of the Catalan Association of Scientific Communication (ACCC). Professor of Journalism in Internet. Universitat Pompeu Fabra

AQuAS and ACCC recently organized a data visualization workshop for health technicians and science journalists. The outcome of this session resulted stimulating and enriching for both profiles. Undoubtedly, sharing knowledge between disciplines encourages innovation and professional growth.

The workshop, taught by Eva Dominguez and Paula Guisado, showed visualization examples applied, mainly to journalism, but other institutions, are increasingly moving in the same direction. And it’s that the public rarely knows how to interpret and treat available data unless it’s accompanied by graphics and interactive tools. The Catalan Health System Observatory, for example, makes an extra effort to gather all network data from Catalan institutions in a single portal and, as Anna Garcia Altés explains, they are investigating how to use visualization tools with the purpose of providing a better service . Continue reading →

European Health Management Association (EHMA) Conference 2015: Special interest group session on best practice in management

9 Jul

Montse Moharra, OIGS AQuAS

The EHMA Annual Conference took place this year in Breda (The Netherlands). The main theme was on Evidence-Based Management which is inspired by the use of evidence in the decision making process of healthcare professionals assuming that the systematic use of the best available evidence in management decision making will improve healthcare provision. This year’s programme included several oral presentations within the Special Interest Group (SIG) session on best practice in management. The aim was to make participants familiar with different problem-solving approaches taken up in different European countries.

The Observatory of Innovation in Healthcare Management in Catalonia presented the three best practices selected from innovative experiences during this SIG session: Continue reading →

Measuring the impact of research: an ongoing challenge

2 Jul

Maite Solans, ISOR Group

Society has high expectations from research and wishes to know what are its benefits: social, decision-making, health, economic, etc., and in order to respond to these expectations, it’s important to assess its impact. An important aspect to consider when we want to evaluate the impact of research would be to choose our starting point: a project or an impact?

Let’s consider the first option. Our starting point is a research project. Now we want to find out whether it has led to a specific health benefit. In most cases, this cannot be found out immediately, on the contrary, we’ll have to spend enough time waiting for the effects to take place. As time passes, we then find that this project will contribute in some way or another to a greater number of impacts and also that other research projects have their own impact. If our starting point is a specific impact, the opposite will occur: that is, it will be difficult to connect an impact with a specific project and as time passes, many other research projects will have contributed to our specific impact. Continue reading →

Telemedicine: 18 ways to prevent excess pilots

25 Jun

Tino Martí, Health economist

Telemedicine services, like any other high value technological innovations tend to work well in controlled environments, such as a laboratory, where the most decisive variables are preset. These experiments are called ‘pilots’ and lead up to the spread of innovation. Pilots often present Hawthorne effect features, such as the result bias displayed when the observed is conscious of being observed and adopts the best behaviour accordingly. Under the spotlight, everything works well, but when the project expands, it often fails. The phenomenon is so common that the health authorities have abused the pilots as a means of implementation and currently there’s a lot of talk on pilotitis.

But what makes a project to exceed the pilot phase and become habitual? And what are the features of the projects that reach a large scale implementation? With these questions in mind and relying on the European Commission’s support, the Momentum project was launched in 2012. Its aim was to develop a guide to the successful implementation of telemedicine in Europe and last week they published the provisional list of 18 critical success factors identified by analyzing cases of success in telemedicine, understood as the relationship between professionals and patients who are not in the same place. These factors cover the following blocks: Continue reading →

Can unnecessary hospitalizations be avoided?

18 Jun

Jordi Varela, Editor of the blog “Advances in Clinical Management“

It is said that the best savings in health is in avoidable hospitalisation that doesn’t occur, especially since the use of a hospital bed is the most expensive health resource of all the health offers, but also because if one person, let’s imagine an elderly one with several chronic conditions, can avoid being admitted in hospital, his/her health will suffer less compromising situations. For this reason, all health systems are very active in trying to launch all kinds of measures to reduce the admission of chronic and frail patients.

Dr. Sara Purdy, family physician and Senior Consultant at the University of Bristol, published under the auspices of the King’s Fund, in late 2010, an analysis of what actions reduce the unnecessary hospital admissions and which ones do not. The work of Dr. Purdy is focused only on organisational actions such as home hospitalisation or case management, and, in contrast, does not include strictly clinical factors such as the impact of a new drug for asthma conditions.

Continue reading →

How does participation become effective? Successes, benefits and risks

11 Jun

Marta Millaret, Communication and Documentation Unit, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)

To continue the analysis of the participation of citizens in health policies, a careful and wise consideration of who participates, for what reasons and from which location, is required. Let’s go a little further: The 2012 report from the Belgian Health Care Knowledge Centre and the report from the Australian Commission on Safety and Quality in Healthcare, 2010, deal with these issues. An article published in “The Milbank Quarterly” magazine and another one published in the “Health Policy” journal also shed light and shadows on the issue. Let’s see it in terms of successes, benefits and risks.

(Image courtesy of nonicknamephoto at FreeDigitalPhotos.net) Continue reading →

Participation: squaring the circle of heterogeneity

4 Jun

Marta Millaret, Communication and Documentation Unit, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)

Beyond the cliché that says that participation is the important thing, the actual times suggest a thorough discussion of the issues, the controversies and the challenges that new participatory models with the promise of participation on the horizon, is on the table in many different areas, not only health.

What’s involved in participation?

It was 1969, when, Arnstein presented eight levels of participation, from low to high in the article “A ladder of citizen participation”.

foto

Reference: Vancouver Community Network Continue reading →

BiblioPRO: A resource for measuring health outcomes reported by patients

28 May

Jordi Alonso is the director of Epidemiology and Public Health, IMIM-Hospital del Mar Institut d’Investigacions Mèdiques of Barcelona. He was the president of AQuAS’ Scientific Committee (2006-2012)

The PRO-Patient Reported Outcomes allow us to actively incorporate the patient perspective in clinical decision making. PRO are measurements of health as perceived by patients and the population, including (not exclusively) symptoms, functions, the perception of health, the quality of life when related to the health services and the satisfaction with the treatments. Its incorporation into clinical and epidemiological research is consolidated. However, despite the evidence of potential benefits [Valderas JM, Alonso J & Guyatt GH, 2008], PRO is very little used in clinical practice. Real time measurements of patients’ welfare, functionality and preferences have a very significant potential to inform health care system and contribute to effective benchmarking. Since about five years ago, the National Health Service in England has promoted the routine use of PROs in certain pathologies with an additional purpose: to allow comparisons between healthcare providers, with the hope that the information provided would increase both productivity by avoiding unnecessary treatments, as well as quality, through the redesign of services or patient choice [Black N, 2013]. Continue reading →

Catalonia shows its potential teamwork with the REVASCAT clinical trial in mechanical thrombectomy in grave ischemic stroke

21 May

Sònia Abilleira Castells, neurologist. Plan for Cerebral Vascular Disease

A clinical trial conducted entirely in Catalonia with the participation of four tertiary stroke hospitals and the support of the master plan for cerebral vascular disease, showed that treatment with catheters in the acute phases of severe ischemic stroke is crucial for good clinical outcomes.

Ischemic stroke causes around 8,500 annual hospitalizations in Catalonia. An estimated 70% of patients are either dead or are in a situation of dependency within 5-years of the stroke. Until now, the only treatment available to us was a drug administered intravenously in the first 4.5 hours of the stroke achieving lysis or a rupture of the thrombus which for a percentage of the patients increased the likelihood of survival without significant neurological sequels. This treatment, known as intravenous thrombolysis has a very low efficiency when the thrombus is located on a main artery of the brain which happens in 25% of cases, translating clinically into more severe strokes. Continue reading →

Research and health policy: “to blog or not to blog”

7 May

Tino Martí, Health economist

That is the question. The strength of the link between research and health policy looks different depending on the perspective. Health service researchers expect that their work has more impact in politicians’ decisions while the politicians expect to be informed about the most effective way to ease the configuration of health policies based on scientific evidence. This is a difficult transition bridge whose surface is eminently communicative.

The “Web first” section of the influential Health Affairs, this month features a paper on the use of social media and the researchers’ perceptions and it’s worth reviewing (Grande D et al, 2014). During the Academy Health Annual Research Meeting, 215 researchers were interviewed using a mix of techniques (cases, assessment of broadcasting’ effectiveness and open qualitative questions). In the cases’ section, three ways of communicating research results to policy makers were presented: traditional media, social media and direct contact with decision makers: The social media includes the blogosphere and different social networks, particularly Twitter. Continue reading →