This document discusses e-innovation in healthcare procurement through translational research projects at Hospital Sant Pau in Barcelona. It provides examples of current and planned projects including a dysphagia tele-rehabilitation program. It advocates for a request for research to results methodology using living labs to test innovations with citizens before implementation. The document concludes by describing the role of the Sant Pau Knowledge Center and accountable care organizations in driving innovation through multidisciplinary collaboration between researchers, medical professionals, businesses and users.

1. e-Innovation procurement
Hospital Sant Pau - UPC Barcelona Tech
Experience

2. Josep Picas
Hospital Sant Pau. CIO

3. • Significant and sustainable improvements in the
quality and efficiency of health and social care
can be obtained trough the procurement of
R&D services that can lead to solutions and
technologies that do not yet exist and that will
outperform the solutions available on market
Accelerating the Development of the eHealth Market in Europe
eHealth Taskforce report 2007
European Commission
Information Society and Media

4. Agenda
• First project. e-dis Dysphagia Tele-Rehabilitation
• Projects in development and assessment.
• Last challenge: e-blood Living Lab.
• Conclusion: R2R methodology for e-Innovation.
• Where & How: SP-KC & ACO

5. e-dis. Disphagia Tele-Rehabilitation

6. Why exercise with ?
It exits evidence that swallow
musculature increase strength/tone
with non-swallow excercises and
increased strength/tone translates into
improved function.
• Clark H: Therapeutic exercise in dysphagia management: philosophies, practices, and challenges. Perspectives on swallowing and
swallowing disorders. Newsletter for the Dysphagia Special Interest Division of the American Speech-Language-Hearing
Association 14(2):24–27, 2005
• Logemann J: The role of exercise programs for dysphagia patients. Dysphagia 20(2):139–140, 2005.
• Robbins J et al. The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc. 2005;53(9):1483-9.
• Burkhead LM et al. Strength-Training Exercise in Dysphagia Rehabilitation: Principles,Procedures, and Directions for Future
Research. Dysphagia 2007; 22: 251–65.
6

7. How much costs a dysphagic pt?
Presential Distance treatment
• Videofluoroscopy: 381,25 € • Videofluoroscopy: 381,25 €
• Dysphagia clinical evaluation • Dysphagia clinical evaluation
and treatment: 146,80€ x pt and treatment:
• Transportation if needed x 15 • 19,57€ (2 inhospital
days. visits).
• 1 therapist / 2 pts: 63,61€
• Total cost: 83,18€ x pt
• Transportation if needed x
2 days.
• Computer: 304,99€
• Modem + internet connection: 30€/month
7

8. Projects in development & assessment.
Patient
Therapist

9. Projects in development & assessment.

10. Last challenge: e-blood Living Lab
Simulator for theoretical assessments.
Blood Donor
Blood Bank
Patient

11. Conclusion.
R2R methodology for e-Innovation.
Health System and authorities
Users of Hospital
Services Multidisciplinary
Primary Research
Care Medical / Business / Technology
Market

12. Knowledge Center
as a driver of innovation at
Sant Pau University Hospital

13. • Platform of Innovation - Mision
Sant Pau - Knowledge Center (SP-KC)
Center of Biotechnological Knowledge and Industrialists Demonstrator for
Innovation in Public Health
• To improve patient care by facilitating collaboration among patients, scientists,
engineers/technologists and clinicians
• To catalyze the discovery, development and implementation of innovative technologies
• Emphasizing minimally invasive approaches, e-health and primary care
Funded: 1.3 M Euros:
NATIONAL PLAN OF SCIENTIFIC RESEARCH, DEVELOPMENT AND
TECHNOLOGICAL INNOVATION (2008-2011)

14. The need and the opportunity – Sant
Pau’s Knowledge Centre (SP-KC)
• A „Multi-tasking Simulation Environment‟
• an area that could simulate one or more real-
world health-related settings, allowing rigorous • Citizens
testing and rapid improvement of eHealth
innovations before they are introduced into real
environments
• equipped with high-capacity graphic
Simulation
workstations with supercomputing and server
capabilities, data gathering equipment • A „Demonstrator Area‟
(cameras, video network processors, etc.), • Space for the
high-quality printing devices, complete demonstration of
hardware for the simulation of various modular ‘e-Health the products
environments, testing and observation rooms, generated in the
• Laboratory laboratory itself or
and work stations.
transferred to
industry or other
researchers who
• Demonstrator wish to convene its
products and its
customers /
audiences in an
environment of
health validation

15. ACO: Accountable Care Organizations
A.P. H.
Primary
Care HOSPITAL
Center
PATIENT CENTERED
“MEDICAL HOME”
SURGICAL DIAGNOSTIC
PROCEDURES PROCEDURES
Supporting
Clinical
Leadership ? EMERGENCY
SERVICES +
CRITICAL
CARE

16. Accountable care organizations
Accountable care organizations: A new idea for managing Medicare
The goal of ACOs is to encourage physicians and hospitals to
integrate care by holding them jointly responsible for Medicare
quality and costs.
By Jane Cys, amednews correspondent. Posted Aug. 31, 2009
The ACO also would need a designated administrator and a formal
organization that could serve as a point of contact, work with
payers, monitor performance and collect any shared savings. The
physicians, hospital and other ACO members would need to agree
on how to divide any earned bonuses.
Dartmouth Institute for Health Policy and Clinical Practice and the Engelberg Center for
Health Care Reform at Brookings Institution

18. Summary
• e-Innovation procurement
• Traslational Research
• Living labs platforms (Tech + Ideas + Business
Models + Citizens)
• R2R methodology for e-Innovation.
• Approach to a sustainable model of funding

19. Thank you !!
Josep M Picas
Sant Pau Hospital. CIO
jmpicas@santpau.cat
Josep M Monguet
UPC- I2 Cat. Professor
monguet.upc@gmail.com
Jaume Kulisevsky
Sant Pau Hospital Research Institute. Director
jkulisevsky@santpau.cat
www.santpau.cat