Health research at andalusia region

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Andalusia has a population of over 9 million people, making it Spain's most populated region. It has established a pioneering public health system called the Andalusian Public Health System (APHS) that is organized under a single organization with over 100,000 professionals working across 41 hospitals and 1,459 primary care centers. The APHS has close ties to the region's 10 public universities and works with the regional government to invest in cutting-edge medical research facilities and infrastructure.

Salud y medicina Noticias y política

Andalusia,
investing in health,
investing in people.

Andalusia
9 Million
Inhabitants

Andalusia,
investing in health,
investing in people.

The most populated Region of Spain

Spain’s second largest Region,
a surface area of 87,268 km2

Larger than countries like Belgium,
Denmark or Switzerland

Andalusia
Strategically Located

Andalusia,
investing in health,
investing in people.

Excellent transportation system

Meeting point of two continents

Modern and large
airports and harbours

ANDALUSIAN
PUBLIC UNIVERSITY GOVERNMENT
HEALTH COMMITMENT
SYSTEM

Andalusia,
investing in health,
investing in people.

APHS
Organization
UNIVERSITY GOVERNMENT
COMMITMENT

Single Organization
Under a common managament system
Full Autonomy for Health Policy since 1984
41 Hospitals
150 Specialized Care Centres
1,459 Primary Care Centres

Andalusia,
investing in health,
investing in people.

APHS
Organization
UNIVERSITY GOVERNMENT
Professionals COMMITMENT

102,000 Professionals
Healthcare, Research and Teaching Role
60% are graduates
Recruitment, Training and Return Programs
(NIH and MSU)

Andalusia,
investing in health,
investing in people.

APHS
Organization
UNIVERSITY GOVERNMENT
Professionals COMMITMENT
Patients

9 Million Patients
Contributing to improve citizen health
Important developments in terms of:
Prevention, Diagnosis and Treatment

Andalusia,
investing in health,
investing in people.

ANDALUSIAN UNIVERSITY
PUBLIC GOVERNMENT
Universities
HEALTH COMMITMENT
SYSTEM

10 Public Universities

Andalusia,
investing in health,
investing in people.

ANDALUSIAN UNIVERSITY
PUBLIC GOVERNMENT
Universities
HEALTH COMMITMENT
Students
SYSTEM

1,700 Graduates per
year in Health Science
+100 PhD and 700 Masters
Postgraduates per year
More than 500 research groups

Andalusia,
investing in health,
investing in people.

ANDALUSIAN UNIVERSITY
PUBLIC GOVERNMENT
Universities
HEALTH COMMITMENT
Students
SYSTEM
Link

Direct link between
Hospitals and Universities
All our Hospitals are University Hospitals
Regional Agreement

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY
HEALTH
SYSTEM

Pioneering Legal
Framework
hESc research
Cellular Reprogramming
Genetic Analysis

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY Strategy
HEALTH
SYSTEM

Andalusian Initiative
for Advanced Therapies
Andalusian Program for Cell Therapy and Regenerative Medicine
Andalusian Program for Clinical Genetics and Genomic Medicine
Andalusian Program for Nanomedicine

Promoting collaborative research and traslating knowledge into clinical practice

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY Strategy
HEALTH Investment
SYSTEM

RTDi Investment

Since 2004, €112 millon to improve Research
Cutting-edge equipmet

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY Strategy
HEALTH Investment
SYSTEM Infrastructures

Infrastructures
3 Thematic Research Centres
2 Health Research Institutes
12 GMPs Rooms
10 Biobanks
2 Networking Research Centres

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY Strategy
HEALTH Investment
SYSTEM Infrastructures

Andalusia,
investing in health,
investing in people.

Andalusian Biobanking system

Central node of the Spanish Stem Cell Bank

Andalusian Human DNA Bank Network with nodes in most of the hospitals

Andalusian Cord Blood Bank 5th biggest cord blood bank in the world

Andalusian Tumor Bank Network with 10 nodes within the main hospitals

Andalusian Tissue Bank Network with 5 nodes

Andalusia,
investing in health,
investing in people.

The new Andalusian Biobank (in progress)

One of the biggest in Europe: millions of samples linked to clinical information

Aimed at researchers

Organized as a Network with a coordination node and hospital nodes

Connected by Biobanking information System: an only database

Wide portfolio of services: distributed within the nodes

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY Strategy
HEALTH Investment
SYSTEM Infrastructures
Alliances

Alliances
INSTITUTIONAL
BIOTECH COMPANIES

Andalusia,
investing in health,
investing in people.

GOVERNMENT
COMMITMENT
ANDALUSIAN
Legal Framework
PUBLIC UNIVERSITY Strategy
HEALTH Investment
SYSTEM Infrastructure
Alliances

INSTITUTIONAL BIOTECH COMPANIES

Andalusia,
investing in health,
investing in people.

ANDALUSIAN
ANDALUSIAN SYSTEM FOR
PUBLIC UNIVERSITY GOVERNMENT
HEALTH
HEALTH COMMITMENT
SYSTEM RESEARCH AND
INNOVATION

Andalusia, investing in health,
investing in people.

Andalusia,
investing in health,
investing in people.

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Jose Luis Rocha Castilla

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Resumen de las estrategias de calidad en salud y resultados en Andalucia

Jose Luis Rocha Castilla

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Jose Luis Rocha Castilla

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Jose Luis Rocha Castilla

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Jose Luis Rocha Castilla

This presentation summarizes the achievemente of electronic prescription in Andalusia and its contribution to improve therapeutic adherence in patients with chronic conditions. The Public Healthcare Service of Andalusia has developed a long-term strategy about e-health called "Diraya". All the citizens of Andalusia have a single electronic health record, available at primary care centres, hospitals, pharmacy offices or emergency units. The system has a prescription module. Last year 121 million of electronic prescriptions were done in Andalusia. The system allows to saving costs in many ways: avoiding mistakes and duplications, facilitating the use of international non proprietary name (INN), reducing the number of consultations in primary care, and many other. Accumulated, every 100 euros invested, the system recovers 212 euros. This module and its decision support system may allow to identify patients with potential non-compliance behaviour by checking the treatment prescribed for a single drug and the withdrawal of boxes of this drug at the pharmacy offices. This approach should be complemented by other actions and tools, such as mems apps designed for smartphones and tablets; patient education, phone surveillance, and others.

Electronic prescription and therapeutic adherence

Jose Luis Rocha Castilla

Ponencia sobre la perspectiva de Andalucia sobre la sostenibilidad del SNS presentada en el Congreso de SOMUCA en Cartagena. Muestra los excelentes resultados en salud y eficiencia del SNS antes de la crisis financiera, respaldados por estudios internacionales. Detalla las estrategias de Andalucia en la última década para mejorar la calidad y la eficiencia del sistema público y las profundas reformas introducidas en el SSPA que demuestran que un sistema publico puede mejorar la calidad y ganar en eficiencia manteniendo la provisión pública y los valores de universalidad equidad y gratuidad incrementando el compromiso profesional. Gestión Clínica, ya implantada en el 100% de los centros andaluces; reingenieria de procesos para los problemas de salud más importantes y frecuentes y un modelo de gestión de competencias para incidir en la excelencia profesional gracias a la formación como elemento estratégico y el desarrollo profesional en el marco de las necesidades del Sistema de Salud. Y con dos elementos transversales, una línea de acreditación de la calidad y el uso masivo de TIC. Con muy buenos resultados en los principales drivers de gasto del SNS: hospitalización, con la tasa más baja del conjunto del SNS, y farmacia, con una reducción relativa de gasto por habitante con respecto al promedio nacional. En contraste con el incremento del coste producido en Holanda al privatizar el conjunto del Sistema sanitario en 2006, o con el impacto negativo sobre la mortalidad en los paises del este que privatizaron masivamente su asistencia sanitaria durante la crisis que atravesaron en los 90. Concluye mostrando referencias en la literatura que avalan que son más eficientes los modelos públicos, universales, financiados por impuestos, basados en atención primaria, con el Medico de famila como gatekeeper, con capitación, profesionales asalariados, provisión pública preferente y descentralizada. Razones que justifican la defensa de un modelo como el SNS cuando se apuesta por la mejora continua del mismo en complicidad con los profesionales y con el apoyo de la ciudadanía. Se muestra que el 5% de los pacientes suponen el 50% del coste. Para un sistema privado, expulsar a este pequeño grupo del sistema supone un ahorro enorme. Desde la perspectiva de un sistema público, este es el segmento de población que hay que atender preferentemente y buscar fórmulas para hacerlo de forma más eficiente.

Sostenibilidad del SNS. Perspectiva de Andalucia

Jose Luis Rocha Castilla

Reflexión sobre la evolución de la calidad de la atención sanitaria en Andalucía en la última década, el impacto de la crisis económica y como inciden las medidas de ahorro sobre la calidad asistencial y la importancia de un abordaje adecuado de la cronicidad para dar respuesta al desafio de mejorar la asistencia a un coste menor. Contiene una fotografia en homenaje a Enrique Alonso, que recibió el primer premio de Calidad en Andalucia. Los datos básicos de calidad sanitaria de Andalucia han mejorado significativamente en Andalucia en esta decada, tanto en terminos absolutos como relativos con el promedio nacional. Así la satisfacción, la esperanza de vida en buena salud. Todo ello con el menor coste por habitante del conjunto de España, gracias a la baja tasa de hospitalización, comparable a la de Canadá, a la mejora del gasto farmacéutico y al esfuerzo diferencial en atención primaria, donde Andalucia se situa como la Comunidad que más invierte en términos relativos. Eso no significa un impacto negativo en servicios hospitalarios; de hecho se observa como en una actividad emblemática como los trasplantes, Andalucia ha superado el promedio nacional cuando partia de cifras mucho menores. Igualmente la incorporación de algunas técnicas de diagnóstico genético o cirugía fetal, se ha producido en el SSPA incluso varios años antes que en otros Centros punteros de nuestro país. El impacto de la crisis y su prolongada duración no deben hacernos olvidar los logros alcanzados ni reinterpretar de forma negativa nuestro modelo de atención. Por ejemplo, a pesar de algunas visiones pesimistas sobre la situación de la Atención Primaria, un estudio europeo nos situa entre los 3 sistemas del continente con una AP mas fuerte, junto a Dinamarca y el Reino Unido. Además, es el momento de reforzar nuestro esfuerzo en salud, puesto que conocemos el impacto de las crisis sobre la salud, y es devastador, especialmente cuando se desmantela el tejido social de soporte como sucedió en algunos países del este tras la caida del telón de acero. Ya hay datos en españa que apuntan a un incremento de suicidios. Un grave problema es que la previsión del Gobierno de la Nación para 2015 refleja un gasto en sanidad del 5.1% del PIB, una cifra que hace inviable un sistema de proteción universal. Por otra parte, las medidas del RDL 16/2012 suponen de hecho un retroceso sobre la universalidad en las tres dimensiones de la OMS: población cubierta, cartera incluida y coste en el punto de atención. Las políticas de calidad contribuyen a una mejora de la eficiencia, pero es fundamental evaluar sistematicamente es aspecto economico de las medidas implantadas. La crisis ha obligado a numerosas medidas, Es interesante que las actuaciones de mejora de la calidad son eficientes, pero actuan a largo plazo, Por contra muchas de las medidas de restriccion presupuestaria ahorran a corto plazo pero empeoran la calidad. La cronicidad emerge como clave: el 5%

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Jose Luis Rocha Castilla

Estrategias de cronicidad en andalucia

Jose Luis Rocha Castilla

Desarrollo profesional en el Sistema Sanitario Publico de Andalucia

Jose Luis Rocha Castilla

Atencion Primaria en Salud en Andalucia

Jose Luis Rocha Castilla

Electronic prescription and patient safety

Jose Luis Rocha Castilla

Uso seguro de opioides en pacientes en situacion terminal

Jose Luis Rocha Castilla

Documento informativo para pacientes, cuidadoras y familiares sobre los cuidados paliativos. Que son, para que sirven, donde se proporcionan, que se debe saber, que derechos se tiene y como ejercerlos. Se describe la sedacion paliativa, la declaracion de voluntad vital anticipada, el tratamiento del dolor, el apoyo a la familia y otros aspectos de esta situacion. Se relacionan los recursos disponibles en Andalucia y donde obtener informacion adicional

Guia para pacientes sobre cuidados paliativos

Jose Luis Rocha Castilla

Guía de ayuda a los profesionales sobre la practica de sedacion paliativa en enfermos terminales en el contexto de los cuidados paliativos. Elaborada por un grupo multidisciplinar de expertos, aborda tanto aspectos eticos como científico-técnicos y de practica clinica, para facilitar la toma de decisiones y el abordaje de una practica de excelencia clinica como es la sedacion paliativa terminal

Sedacion paliativa terminal

Jose Luis Rocha Castilla

Documento pensado para ayudar a los pacientes que han sido diagnosticados de ernfermedad renal cronica avanzada, para que conozcan las alternativas de tratamiento y sus ventajas e inconvenientes. Esta estructurado para ayudar a tomar una decision sobre la modalidad de tratamiento que mas se adapte a sus preferencias y expectativas. Basada en la evidencia científica disponible y elaborada en lenguaje sencillo. Elaborado por la Agencia de Evaluacion de Tecnologias Sanitarias de Andalucia en el marco de colaboración previsto en el Plan de Calidad del SNS elaborado por el Ministerio de Sanidad, Politica Social e Igualdad al amparo del convenio de colaboración entre el Instituto de Salud Carlos III, del Ministerio de Ciencia e Innovación y la Fundación progreso y Salud de Andalucia

Ayuda a la toma decisiones del paciente con ERC

Jose Luis Rocha Castilla

Independent report on a successful experience of e-prescrining in Andalusia region, Spain. This tool is currently available for all the 8.5 million people living in Andalusia, running in all the 3,500 pharmacies across the region, linking the EHR data with the pharmacist's computers, and saving 15 to 20% of the GP's time. The total amount of net benefits at 2010 exceeds € 60 Million. It is a case of the EHR Impact study commisioned by the DG INFSO and Media of the European Commision

Ehri case 5 receta xxi Andalucia

Jose Luis Rocha Castilla

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Gestión Clínica: Fundamentos y experiencias

Construção e utilização do Modelo de Gestão por Competências no Sistema da Sa...

Copago en servicios sanitarios

Resumen de las estrategias de calidad en salud y resultados en Andalucia

Taller herramientas cronicidad espacio sociosanitario andalucia

Sostenibilidad del SNS y modelo de prestacion de servicios: Andalucia

Guia para hacer la voluntad vital anticipada

Planificación anticipada de decisiones en el Sistema Sanitario Público de And...

Electronic prescription and therapeutic adherence

Sostenibilidad del SNS. Perspectiva de Andalucia

Calidad, cronicidad y crisis. Conferencia clausura SADECA 2012

Estrategias de cronicidad en andalucia

Desarrollo profesional en el Sistema Sanitario Publico de Andalucia

Atencion Primaria en Salud en Andalucia

Electronic prescription and patient safety

Uso seguro de opioides en pacientes en situacion terminal

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Sedacion paliativa terminal

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Ehri case 5 receta xxi Andalucia

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Health research at andalusia region

1. Andalusia, investing in health, investing in people.

2. Andalusia 9 Million Inhabitants Andalusia, investing in health, investing in people.

3. The most populated Region of Spain Spain’s second largest Region, a surface area of 87,268 km2 Larger than countries like Belgium, Denmark or Switzerland

4. Andalusia Strategically Located Andalusia, investing in health, investing in people.

5. Excellent transportation system Meeting point of two continents Modern and large airports and harbours

6. ANDALUSIAN PUBLIC UNIVERSITY GOVERNMENT HEALTH COMMITMENT SYSTEM Andalusia, investing in health, investing in people.

7. APHS Organization UNIVERSITY GOVERNMENT COMMITMENT Single Organization Under a common managament system Full Autonomy for Health Policy since 1984 41 Hospitals 150 Specialized Care Centres 1,459 Primary Care Centres Andalusia, investing in health, investing in people.

8. APHS Organization UNIVERSITY GOVERNMENT Professionals COMMITMENT 102,000 Professionals Healthcare, Research and Teaching Role 60% are graduates Recruitment, Training and Return Programs (NIH and MSU) Andalusia, investing in health, investing in people.

9. APHS Organization UNIVERSITY GOVERNMENT Professionals COMMITMENT Patients 9 Million Patients Contributing to improve citizen health Important developments in terms of: Prevention, Diagnosis and Treatment Andalusia, investing in health, investing in people.

10. ANDALUSIAN UNIVERSITY PUBLIC GOVERNMENT Universities HEALTH COMMITMENT SYSTEM 10 Public Universities Andalusia, investing in health, investing in people.

11. ANDALUSIAN UNIVERSITY PUBLIC GOVERNMENT Universities HEALTH COMMITMENT Students SYSTEM 1,700 Graduates per year in Health Science +100 PhD and 700 Masters Postgraduates per year More than 500 research groups Andalusia, investing in health, investing in people.

12. ANDALUSIAN UNIVERSITY PUBLIC GOVERNMENT Universities HEALTH COMMITMENT Students SYSTEM Link Direct link between Hospitals and Universities All our Hospitals are University Hospitals Regional Agreement Andalusia, investing in health, investing in people.

13. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY HEALTH SYSTEM Pioneering Legal Framework hESc research Cellular Reprogramming Genetic Analysis Andalusia, investing in health, investing in people.

14. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY Strategy HEALTH SYSTEM Andalusian Initiative for Advanced Therapies Andalusian Program for Cell Therapy and Regenerative Medicine Andalusian Program for Clinical Genetics and Genomic Medicine Andalusian Program for Nanomedicine Promoting collaborative research and traslating knowledge into clinical practice Andalusia, investing in health, investing in people.

15. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY Strategy HEALTH Investment SYSTEM RTDi Investment Since 2004, €112 millon to improve Research Cutting-edge equipmet Andalusia, investing in health, investing in people.

16. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY Strategy HEALTH Investment SYSTEM Infrastructures Infrastructures 3 Thematic Research Centres 2 Health Research Institutes 12 GMPs Rooms 10 Biobanks 2 Networking Research Centres Andalusia, investing in health, investing in people.

17. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY Strategy HEALTH Investment SYSTEM Infrastructures Andalusia, investing in health, investing in people.

18.

19.

20.

21.

22.

23. Andalusian Biobanking system Central node of the Spanish Stem Cell Bank Andalusian Human DNA Bank Network with nodes in most of the hospitals Andalusian Cord Blood Bank 5th biggest cord blood bank in the world Andalusian Tumor Bank Network with 10 nodes within the main hospitals Andalusian Tissue Bank Network with 5 nodes Andalusia, investing in health, investing in people.

24. The new Andalusian Biobank (in progress) One of the biggest in Europe: millions of samples linked to clinical information Aimed at researchers Organized as a Network with a coordination node and hospital nodes Connected by Biobanking information System: an only database Wide portfolio of services: distributed within the nodes Andalusia, investing in health, investing in people.

25. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY Strategy HEALTH Investment SYSTEM Infrastructures Alliances Alliances INSTITUTIONAL BIOTECH COMPANIES Andalusia, investing in health, investing in people.

26. GOVERNMENT COMMITMENT ANDALUSIAN Legal Framework PUBLIC UNIVERSITY Strategy HEALTH Investment SYSTEM Infrastructure Alliances INSTITUTIONAL BIOTECH COMPANIES Andalusia, investing in health, investing in people.

27. Andalusia, investing in health, investing in people.

28. ANDALUSIAN PUBLIC UNIVERSITY GOVERNMENT HEALTH COMMITMENT SYSTEM Andalusia, investing in health, investing in people.

29. ANDALUSIAN ANDALUSIAN SYSTEM FOR PUBLIC UNIVERSITY GOVERNMENT HEALTH HEALTH COMMITMENT SYSTEM RESEARCH AND INNOVATION Andalusia, investing in health, investing in people. Andalusia, investing in health, investing in people.

Health research at andalusia region

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