This document summarizes a presentation on aligning health innovation with service needs and economic opportunity. It discusses how health services have become more complex, knowledge-intensive, and expensive but have also added years and life to years. Health service transformation is driven by reducing budgets, demand for access and quality, technology advances, and chronic disease burden. The preferred model focuses on prevention, chronic illness programs, primary care teams, and centralizing specialist services. It is argued that high-performing health services, vibrant research, and a smart economy are intertwined. Progress is reported on implementing Ireland's Action Plan for Health Research, including developing clinical research facilities and a national biobanking solution.

1. Aligning Innovation with both
Health Service Needs &
Economic Opportunity
Life Sciences International Summit 2010
Croke Park, Dublin
11th November 2010
Jim Breslin,Jim Breslin,
Department of Health & ChildrenDepartment of Health & Children

2. Research, Innovation & HealthResearch, Innovation & Health
- Where have we come from?- Where have we come from?
(Relatively)
-Simple
-Low tech &
- Modest health
outcomes

3. Where have we gotten to?Where have we gotten to?
- Complex & hi-techComplex & hi-tech
- KnowledgeKnowledge
intensiveintensive
-- ExpensiveExpensive
- Powerful inPowerful in
adding bothadding both
years to life &years to life &
life to yearslife to years

4. Health Service TransformationHealth Service Transformation
- Today’s Drivers- Today’s Drivers
 Reducing budgets - Public health spending of €15bn representsReducing budgets - Public health spending of €15bn represents
 27% of public expenditure,27% of public expenditure,
 49% of total tax receipts &49% of total tax receipts &
 133% of Income Tax receipts.133% of Income Tax receipts.
 Public demand for access and qualityPublic demand for access and quality
 TechnologyTechnology
 Biotech, genetics, convergence of products and devices, functional foods,Biotech, genetics, convergence of products and devices, functional foods,
remote diagnostics and healthcare delivery, etcremote diagnostics and healthcare delivery, etc
 Demographics & growing burden of chronic illnessDemographics & growing burden of chronic illness
 Integration between primary & secondary careIntegration between primary & secondary care

5. Health Service TransformationHealth Service Transformation
- Preferred Model- Preferred Model
 Safer, more efficient and more sustainableSafer, more efficient and more sustainable
 Designed around the service userDesigned around the service user
 Focus on chronic illness e.g. Programmes & Care PathwaysFocus on chronic illness e.g. Programmes & Care Pathways
covering Stroke, Heart Failure, Asthma, Diabetes, COPD,covering Stroke, Heart Failure, Asthma, Diabetes, COPD,
Rheumatology & Care of Older PeopleRheumatology & Care of Older People
 Prevention through screening (breast, cervical, bowel cancers,Prevention through screening (breast, cervical, bowel cancers,
etc), lifestyle and other primary and secondary preventativeetc), lifestyle and other primary and secondary preventative
measuresmeasures
 Introduction of multi disciplinary Primary Care TeamsIntroduction of multi disciplinary Primary Care Teams
 Home care packages, community mental health teams and otherHome care packages, community mental health teams and other
community supports to maintain people at homecommunity supports to maintain people at home

6. Health Service TransformationHealth Service Transformation
- Preferred Model- Preferred Model
 Centralisation of certain specialist services e.g. cancer services in 8 designatedCentralisation of certain specialist services e.g. cancer services in 8 designated
centrescentres
 Acute Medicine Programme to address current access & quality issuesAcute Medicine Programme to address current access & quality issues
 Reconfiguration of hospitals based upon networks made up of regionalReconfiguration of hospitals based upon networks made up of regional
centres and local hospitalscentres and local hospitals
 Shift to ambulatory care from inpatient treatmentShift to ambulatory care from inpatient treatment
 Quality – external inspection and licensingQuality – external inspection and licensing
 Health information and technology used for service delivery and performanceHealth information and technology used for service delivery and performance
managementmanagement
 Resource allocation to support preferred modelResource allocation to support preferred model
 ALL OF THE ABOVE ARE ALREADY UNDERWAY BUT NOWALL OF THE ABOVE ARE ALREADY UNDERWAY BUT NOW
NEED TO ACCOMMODATE SPENDING REDUCTIONNEED TO ACCOMMODATE SPENDING REDUCTION
IMPERATIVEIMPERATIVE

7. The Role for Health Research:The Role for Health Research:
The InterconnectionsThe Interconnections
Quality health services, a vibrant health research system andQuality health services, a vibrant health research system and
social and economic prosperity are not separate butsocial and economic prosperity are not separate but
inextricably intertwined.inextricably intertwined.
High Performing
Health Services
Vibrant Health
Research System
Smart
Economy

8. Health & Wealth – Evidence for theHealth & Wealth – Evidence for the
Virtuous CircleVirtuous Circle
19871987 20072007
““Wealthier”Wealthier”
 UnemployedUnemployed 17%17% 4.6%4.6%
 Long Term Unemp.Long Term Unemp. 10%10% 1.3%1.3%
 EmployedEmployed 1.1m1.1m 2.1m2.1m
 MigrationMigration -23k-23k +67k+67k
 Govt Deficit/Nat IncomeGovt Deficit/Nat Income 9%9% 0.3%0.3%
 Govt Debt/Nat IncomeGovt Debt/Nat Income 118%118% 25% (14% net)25% (14% net)
““Healthier”Healthier”
 Life ExpectancyLife Expectancy M 70 yrsM 70 yrs M 76.8M 76.8
F 75.6yrsF 75.6yrs F81.6 (1 yr > EU)F81.6 (1 yr > EU)
 Circulatory death rateCirculatory death rate 464464 209 (EU 246)209 (EU 246)
 Infant mortalityInfant mortality 7.97.9 3.2 (EU 4.5)3.2 (EU 4.5)
 DaycasesDaycases 88k88k 567k567k
 Av. Length of StayAv. Length of Stay 7.3 days7.3 days 6.2 (EU 6.7)6.2 (EU 6.7)
 Public spend per capitaPublic spend per capita $664$664 2,121 (OECD $1,684)2,121 (OECD $1,684)

9. Using Health Research to PromoteUsing Health Research to Promote
Both Health & WealthBoth Health & Wealth
 Strong health researchStrong health research systemsystem needed toneeded to
support:support:
 Transformation of health service delivery and patientTransformation of health service delivery and patient
outcomesoutcomes
 Economic agenda in developing new products andEconomic agenda in developing new products and
servicesservices

10. Health Research PathwayHealth Research Pathway
Translation &
Application
-Clinical & patient
oriented research
-Population Health Sciences
-Health Services Research
Basic
Biomedical
Research
Transformation
Health outcomes and
system performance
Commercialisation
New technologies

11. The Health Outcomes GapThe Health Outcomes Gap
Coordination of Treatments
and Services
Implementation Gap
Scientific Knowledge Gap
EXISTING HEALTH OUTCOMES
Potential Health Outcomes

12. The Health Outcomes GapThe Health Outcomes Gap
Service Coordination
Implementation Gap
Knowledge Gap
EXISTING HEALTH OUTCOMES
Potential Health Outcomes
Alzheimer’Alzheimer’
ss
treatmentstreatments
ThrombolysisThrombolysis
delays in strokedelays in stroke
treatmenttreatment
Late dischargeLate discharge
summaries forsummaries for
GPsGPs

13. Action Plan for Health ResearchAction Plan for Health Research
(2009)(2009)
The Health ResearchThe Health Research
Group published theGroup published the
Action Plan in order toAction Plan in order to
be accountable, tobe accountable, to
generate support andgenerate support and
to build partnershipsto build partnerships
amongst diverseamongst diverse
stakeholders withstakeholders with
passion for research &passion for research &
innovation.innovation.

14. What will the Action Plan for HealthWhat will the Action Plan for Health
Research Achieve?Research Achieve?
1.1. Framework for co-ordination & accountability acrossFramework for co-ordination & accountability across
diverse stakeholders.diverse stakeholders.
2.2. National priorities for health research.National priorities for health research.
3.3. Enabling research infrastructure; in particular clinicalEnabling research infrastructure; in particular clinical
research facilities in our main academic hospitals &research facilities in our main academic hospitals &
scalable informatics and bio-banking solutions.scalable informatics and bio-banking solutions.
4.4. More clinical trials networks, internationally linked.More clinical trials networks, internationally linked.
5.5. Focus on commercialisation & industry partnerships.Focus on commercialisation & industry partnerships.
6.6. Streamlined and predictable regulatory environment.Streamlined and predictable regulatory environment.

15. What will the Action Plan Achieve?What will the Action Plan Achieve?
7.7. More clinicians & health care professionals doingMore clinicians & health care professionals doing
high quality patient focused research.high quality patient focused research.
8.8. Rebalancing activity towards patient relatedRebalancing activity towards patient related
outcomes.outcomes.
9.9. Increased capacity for population health and healthIncreased capacity for population health and health
services research.services research.
10.10. Transformation of care pathways informed byTransformation of care pathways informed by
(locally adapted) international research evidence.(locally adapted) international research evidence.
11.11. Mechanisms to monitor and evaluate investment,Mechanisms to monitor and evaluate investment,
across both health and economic dimensions.across both health and economic dimensions.

16. Action Plan – Year 1Action Plan – Year 1
ProgressProgress

17. Investing in Clinical
Research Facilities
Benefits to industry:Benefits to industry:
- Access to Clinical Specialists and Networks- Access to Clinical Specialists and Networks
- Access to Patient Cohorts- Access to Patient Cohorts
- Research Nurse Support- Research Nurse Support
- Biostatistics & Informatics Support- Biostatistics & Informatics Support
- Regulatory Support- Regulatory Support
- Bio specimen Storage and Processing- Bio specimen Storage and Processing
- Linkage with International Researchers &- Linkage with International Researchers &
Funding ProgrammesFunding Programmes

18. Other Highlights of Year 1 ProgressOther Highlights of Year 1 Progress
 InfrastructureInfrastructure
 Growing & Networking Clinical Research FacilitiesGrowing & Networking Clinical Research Facilities
 National bio-banking solutionNational bio-banking solution
 Centre of Excellence for Successful Ageing approvedCentre of Excellence for Successful Ageing approved
 GovernanceGovernance
 Revamp of Research Ethics Committee StructuresRevamp of Research Ethics Committee Structures
 HSE research governance brought under Quality & ClinicalHSE research governance brought under Quality & Clinical
Care Directorate & aligned with Clinical Care ProgrammesCare Directorate & aligned with Clinical Care Programmes
 Commercial LinkagesCommercial Linkages
 HSE Quality & Clinical Care partnering with EnterpriseHSE Quality & Clinical Care partnering with Enterprise
agencies on Innovationagencies on Innovation

19. Year 1 Progress Contd.Year 1 Progress Contd.
 Clinical Trials - Cardiovascular and Stroke NetworkClinical Trials - Cardiovascular and Stroke Network
under developmentunder development
 FundingFunding
 HRB awards have been aligned more towards patient andHRB awards have been aligned more towards patient and
health service benefitshealth service benefits
 New HRB/SFI Translational Research AwardsNew HRB/SFI Translational Research Awards
 SFI/HRB/Wellcome Trust Biomedical Research PartnershipSFI/HRB/Wellcome Trust Biomedical Research Partnership
 International – Tripling in latest FP7 funding awards toInternational – Tripling in latest FP7 funding awards to
€17.4. Strong Irish participation in Joint Programming in€17.4. Strong Irish participation in Joint Programming in
Neuro-degenerative and Food areas.Neuro-degenerative and Food areas.

20. Thank YouThank You