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TO-Reach - Transfer of Organisational innovations for Resilient, Effective,
equitable, Accessible, sustainable and Comprehensive Health services and
systems
Dr. Stefano Vella, Istituto Superiore di Sanitá, Italy
1. The context
Three Decades of Dynamic Change in Health Systems 1980s 2010s
• Changes in information technologies (electronic medical record, e-health capacities, tablet-based patient management, centralized Big Data)
• Changes in citizen expectations (choice of provider, equal and rapid access, privacy)
• Changes in patient expectations (participation in decision-making, second opinions, international quality standards, patient rights)
• Changes in payment systems (public and private): case-based payment, penalties for poor outcomes (re-admission, re-treatment), volume based contracting
• Changes in provider configuration (consolidating hospitals and services, integrating health and social care)
3Richard B. Saltman Emory University
Health systems differ widely but face common challenges
oDifferences in finance, organisation, outcomes
oPart of (and subject to) wider political, cultural, economic environment
oChallenges relate too Rising costs / need for cost containment
o Demographic changes
o Technological advances
o Increasing public expectations
oCommon goalso Ensuring accessible health care of high quality that is responsive,
equitable, affordable and financially sustainable
The changing health systems landscape: preparing for the “perfect storm”
Scarcity of resources
Chronic diseases, multimorbidity
Growing expectations of patients/citizens
Expensive
breakthrough medicines
and biomedical devices
Demographic change and population ageing
HealthSystems
The commonest chronic conditions are costing the EU countries more than 1 trillion Euros per year, which is expected to increase to 6 trillion Euros by the
middle of the century.
2. The action
• Health care and services research is the multidisciplinary field of
scientific investigation that studies how social factors, financing
systems, organizational structures and processes, health
technologies, and personal behaviors affect access to health care,
the quality and cost of health care, and ultimately our health and
well-being.
• The main goals of health services research are to identify the most
effective ways to organize, manage, finance, and deliver high
quality care to citizens
Why Health Systems and Services Research is needed ?
Our goal is to identify the European Health Care common challenges and organizational needs, and to propose
possible solutions to improve health system performance and to identify the most effective ways to organize, manage, finance, and deliver high quality care to our
citizens
TO REACH
European countries explore similar solutions to improve service delivery for citizens:
how to better learn from such initiatives in other countries, using Europe as a natural laboratory?
TO REACH
European countries explore similar solutions to improve service delivery for citizens:
how to better learn from such initiatives in other countries, using Europe as a natural laboratory?
1. Identify Strategic Priorities
Identify future challenges and priorities (roadmapping)
Main objectives
2. Building Research Infrastructure
TO REACH: objectives and tasks
Provide knowledge synthesis and analytical framework
(meta-questions)
Main tasks
Prepare a common and sustainable platform by research funding bodies
(strengthening the network)
Enhance cooperation and linkage with other funders
networks (embedding the network)
PERT diagram of the TO REACH Project
TO-REACH: stakeholder involvement
Project partners
PAC
Scientific AdvisoryCommittiee
PolicyAdvisory Committiee
Fellow interna-tionalinitiatives
Alliances of regional or local authorities
Sector or provider associations
International bodies
Fellow funding bodies including charities
Citizen and patient plus caregiver organisations
Media & General public
Politiciansand policy makers
Scientific community
Payer and insurerorganisations
3. The future
1. Identify Strategic Priorities
Identify future challenges and priorities (roadmapping)
Main objectives
2. Building Research Infrastructure
TO REACH: objectives, tasks, outcomes
Provide knowledge synthesis and analytical framework
(meta-questions)
Main tasks
Prepare a common and sustainable platform by research funding bodies
(strengthening the network)
Enhance cooperation and linkage with other funders
networks (embedding the network)
Strategic Research Agenda
Outcomes
Our Strategic Research Agenda will pave the way to future European Joint Research Initiatives supported by Member
States to tackle the challenges ahead of us.
