Tavola rotonda Dalla varietà dei bisogni all integrazione degli interventi: il ruolo delle Istituzioni. Maddalena Illario

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1 Workshop «SALUTE E INVECCHIAMENTO ATTIVO NEL LAZIO: POLITICHE E INTERVENTI IN EUROPA, E RUOLO DELLA SORVEGLIANZA DI POPOLAZIONE PER LA GOVERNANCE DEL SISTEMA». Tavola rotonda Dalla varietà dei bisogni all integrazione degli interventi: il ruolo delle Istituzioni. L invecchiamento Sano ed Attivo secondo la Partnership Europea per l Innovazione nell esperienza Campana Maddalena Illario ASL Roma D 6 Febbraio 2014 Coordinatore EIP-AHA Campania Reference Site Coordinatore Tavolo Tecnico R&S, AOU Federico II DISMET, Università Federico II

2 Opportunities for INNOVATION L OPPORTUNITA EUROPEA: INNOVATION UNION A Europe 2020 initiative: EIP-AHA European Partnership on Active & Healthy Aging Innovation Union, key initiatives The Innovation Union contains over thirty action points including groundbreaking proposals like the European Innovation Partnerships. For example, the pilot Partnership on active and healthy ageing aims to add an average of two years of healthy life for everyone in Europe Maximising regional and social benefits To avoid an "innovation divide" between the strongest innovating regions and the others, the Commission will assist Member States to use better the remaining part of the 86 billion of structural funds programmed for for research and innovation projects.

3 INTERNATIONALIZATION Is the process of planning and implementing products and services so that they can easily be adapted to specific local languages and cultures, a process called localization. The internationalization process is sometimes called translation or localization enablement. ENABLEMENT includes: User interfaces (ICT-hardware, help pages, online menus, softwares- cultural, administrative, organizational, language); Develop products that can support international character sets Creating print or Web site graphic images so that their text labels can be translated inexpensively Using written examples that have global meaning For software, ensuring data space so that messages can be translated from languages with single-byte character codes (such as English) into languages requiring multiple-byte character codes (such as Japanese Kanji). LOCALIZATION is the process of adapting a product or service to a particular language, culture, and desired local "look-and-feel." Ideally, a product or service is developed so that localization is relatively easy to achieve - for example, by creating technical illustrations for manuals in which the text can easily be changed to another language and allowing some expansion room for this purpose. This enabling process is termed INTERNATIONALIZATION. An internationalized product or service is therefore easier to localize. The process of first enabling a product to be localized and then localizing it for different national audiences is sometimes known as GLOBALIZATION. In localizing a product, in addition to idiomatic language translation, such details as time zones, money, national holidays, local color sensitivities, product or service names, gender roles, and geographic examples must all be considered A successfully localized service or product is one that appears to have been developed within the local culture.

4 INTERNAZIONALIZZAZIONE SANITARIA IL CONTESTO - The White Paper: Together for Health - Health Programme PSN - PSR Ageing population The population aged 65 and over in the WHO European Region Is projected to rise to 224 million by SOCIETAL CHALLENGES Health inequalities in Europe (SOCIAL DETERMINANTS OF HEALTH) Equity of access and treatment New models in healthcare delivery Social solidarity

5 When opportunities Knocks Open the door An ageing population, health inequalities and the social determinants of health present significant challenges to healthcare systems that go beyond medical problems. Ensuring a MULTILEVEL AND HOLISTIC RESPONSE BY GOVERNMENTS will be important in tackling these challenges Consideration of quality in healthcare requires examination of the different dimensions of quality, the impact of rationing devices, professional organization and new models of healthcare delivery Healthcare costs have steadily increased in recent years, although this is not necessarily driven by increased need. Cost-effectiveness, value for money considerations, pharmaceutical pricing, new technologies and diversity of provision are all important elements in exploring how to reduce health costs While states remain the main actors in healthcare policy in Europe, EU policies and law can influence healthcare delivery, particularly when considered in terms of the inter-relation between health and other sectors. While internal market rules ensuring the free movement of people and services can challenge domestic health sectors, there are also tangible benefits and opportunities of collaborating at EU level, not least the potential for coordinated policy Future in Health Care Health is more than a medical problem 2. Maintaining high-quality healthcare 3. Maintaining access to healthcare 4. Managing the costs of healthcare

6 - INSUFFICIENTE ALLINEAMENTO DEGLI OBIETTIVI E DELLA PROGRAMMAZIONE TRA AMBITO RICERCA (IRCCS, UNIVERSITA, Centri di Ricerca etc) ED AMBITO SANITA - DISALLINEAMENTO, ASSENZA DI COORDINAMENTO E DI COLLEGAMENTI EFFICACI TRA I DIVERSI LIVELLI DI PROGETTAZIONE E PROGRAMMAZIONE, CON IMPATTO NEGATIVO SULL UTILIZZO SISTEMATICO DELLE INNOVAZIONI E SUL LORO TRASFERIMENTO AL SETTORE PRODUTTIVO DEBOLEZZA DELLE AZIONI DI SISTEMA E PERDITA DI OPPORTUNITA DI FINANZIAMENTI EU

7 PARTE INTEGRANTE DEL CONTESTO DI RIFERIMENTO: LE REGIONI IN PIANO DI RIENTRO La spinta di innovazione all interno di una REGIONE IN PIANO DI RIENTRO. Deve essere soddisfatta all interno di vincoli normativi ed economici. Primo vincolo: divieto di spese non obbligatorie. Secondo vincolo: blocco del turnover. Conseguente scarsità delle risorse disponibili: economiche molto ridotte, e risorse umane sottodimensionate. IL BLOCCO DEL TURNOVER PREGIUDICA SCALE-UP DELLE GOOD PRACTICES E LA LORO MESSA A SISTEMA

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9 Horizon 2020 STRUMENTO FINANZIARIO per implementare l UNIONE DELL INNOVAZIONE ed assicurare la COMPETITIVITA EUROPEA. In vigore dal 2014 al 2020 con un budget di 80 miliardi. STRUMENTI DI IMPLEMENTAZIONE: Accordi di Cooperazione Scientifica e Tecnologica per definire ed implementare le tabelle di marcia I dialoghi politici stabiliti a livello regionale. PRIORITA

10 Programmazione EU IMPLEMENTAZIONE ED ADOZIONE SU LARGA SCALA DI GOOD PRACTICES: da isolate a «MAINSTREAM» Riforma dei Sistemi Sanitari nell ottica della sostenibilità per mantenere i livelli qualitativi raggiunti. Utilizzo dei supporti ICT. La salute come driver di sviluppo: perché settore ad elevato tasso di innovazione «Silver Economy»: il cambiamento demografico come opportunità di sviluppo socioeconomico. Dietro l aging si nasconde una dinamica di crescita! Generare dati di monitoraggio relativi al ritorno economico dell innovazione (costi evitati, ricadute sugli outcome di salute etc) France invests in the "silver economy" The national strategy includes regional deployments and applications: a first initiative was launched at Ivry-sur-seine (eastern Paris) last 1st July with the creation of the "Silver Valley". Promoted by the cluster SOLIAGE, the project aims at creating a specific silver sector in the eastern area of Paris. The site already hosts important stakeholders like the Pôle Allongement de la vie de l'hôpital Charles Foix, research teams from the University Pierre et Marie Curie and from the Institut de la vision, as well as entreprises. Fabien Verdier Economy, Rights and Policy of the Age Advisor, France

11 STRUCTURAL FUNDS: EU common strategic framework for regional development

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13 32 RS approvati dalla Commissione EU CON PROCEDURA PEER REVIEW: 5 RS ITALIANI

14 COMMITMENT A1 COMMITMENT A3 Commitment B3: Campania nel cuore (HeArtBit). An integrated, web-based network to improve the management of the high risk of fragile elderly patients. COMMITMENT B3 CAMPANIA REFERENCE SITE Campania Reference Site: INNOCARE. Bridging Health Care Innovation to Europe. Commitment A1: An integrated Adherence Monitoring System regarding patients with chronic conditions (AMS). Commitment A3: An integrated model of care, cure and prevention for fraility osteoporosis and its complications (OSTEOCARE).

15 COMMITMENTS presentati dalla CAMPANIA alla SECONDA CALL Titolo EURO MEDITERRANEAN REGISTRY OF OSTEOPOROSIS Assessment of the impact of climate change on senior citizens Awareness of Risk of Cardiovascular events in High Risk populations Getting Optimise Ageing Life-quality Strategies for the development of new healthy foods for the management of frailty and ageing. FUNCTIONAL FOODS AND MICROBIAL COMPONENTS ABLE TO IMPROVE THE WELLBEING IN OLDER PEOPLE. Accounting and Information Management System Acronimo EMEROS ClimAge ARCHR GOAL NEW AGE FOODS FFoAM-WeOP AIMS New molecular determinants and pathogenic mechanisms in age-related diseases Easy Aging Strategic Industrial Innovations Biomedical Enterprises Leading Over Various Elderly Diseases campania nel cuore MOLAGE EASII BELOVED HeArtBit

16 CAMPANIA REFERENCE SITE ACTIVITIES ASSESSMENT ASL NA 1 Centro: Sara Diamare ECONOMIC DATA GENERATION AOU Federico II- Adelaide Ippolito COMMITMENTS & FUTURE COMMITMENTS Nunzia Montuori DISMET ACTION PLAN A1 ACTION PLAN A2 ACTION PLAN A3 ACTION PLAN B3 ACTION PLAN D4 CIRFF- Enrica Menditto Imprens Pomelia- Alberto Maria della Ratta AOU Federico II- R&S- Maddalena Illario Unisa- Guido Iaccarino ASL NA 3- Katia Giova FUTURE COMMITMENTS «IMMUNONUTRITION»: ALLERGIE ALIMENTARI, CELIACHIA, OBESITA, SINDROME METABOLICA Roberto Berni Canani TRAINING AOU Federico II- R&S- Maddalena Illario Ufficio Formazione- Grazia Isabella Continisio DISSEMINATION AOU Federico II- R&S- Maddalena Illario TWINNING AOU Federico II- R&S- Maddalena Illario NETWORKING Unisa- Pietro Campiglia

17 Campania Reference Site: INNOCARE. Bridging Health Care Innovation to Europe CALL I Commitment A1: An integrated Adherence Monitoring System regarding patients with chronic conditions (AMS). E. Menditto, CIRFF Commitment A3: An integrated model of care, cure and prevention for fraility osteoporosis and its complications: (OSTEOCARE). M. Illario-C. Di Somma, A. Colao, Unina Commitment B3: Campania nel cuore: HeArtBit. G. Iaccarino, Unisa CALL II Strategies for the development of new healthy foods for the management of frailty and ageing : NEW AGE FOODS (A. Reale, ISA-CNR) Getting Optimise Ageing Life-quality: GOAL (Z. Simonova, L. Russo, D. Tramontano, M. Di Girolamo) Functional foods and microbial components able to improve the wellbeing in older people: FFoAM-WeOP (M. Succi, Unimol) New molecular determinants and pathogenic mechanisms in age-related diseases: MOLAGE (Montuori, Illario, Iaccarino, Kisslinger) Biomedical Enterprises Leading Over Various Elderly Diseases: BELOVED (G. Lamberti, Unisa) Assessment of the impact of climate change on senior citizens: ClimAge (E. Menditto, Pasquale Schiano, Italian Aerospace Research Center-CIRA) EURO MEDITERRANEAN REGISTRY OF OSTEOPOROSIS: EMEROS (Prisco Priscitelli, ISBEM ISTITUTO SCIENTIFICO BIOMEDICO EURO MEDITERRANEO) Easy Aging Strategic Industrial Innovations: EASII (A. Della Ratta, Imprens Pomelia; Katia Giova, ASL NA-3) Accounting and Information Management System: AIMS (L. Natale, Dipartimento Salute e Risorse Naturali, Regione Campania) ORGANIZATION A3 SUB-GROUPS: frailty in general; cognitive decline; physical activity; care-givers; nutrition; functional decline TASKS TASK COORDINATORS

18 WHAT S NEXT From BOTTLENECKS To MAINSTREAM What is expected from the individual commitments and collaborative work. In 2014 the EIP will have to demonstrate tangible results taking stock of what has been achieved. The main focus of EIP work in 2014 will be on the individual commitments (progress in implementing actions) and the collaborative work Work under Action Group will be conducted in 2 TRACKS: an INDIVIDUAL COMMITMENT TRACK drawing on the commitments that A3 EIP partners submitted on the occasion of the 1st and 2nd invitation for commitment a second track initiated recently on COMMON WORK drawing on the willingness and interest shown by some of the A3 partners to conduct collaborative work in addition to the individual commitments. Quality of work and individual commitments Synergies across AG Incorporation of new members to the AG is restricted and only allowed following the formal procedures in place for all the EIP.

19 USEFUL TOOLS: Joining EU networks

20 ALLEANZE STRATEGICHE Per il Reference Site Campania rispetto all EIP-AHA: - Il supporto Regionale: Lara Natale, Mariateresa Giuliano Dipartimento Salute e Risorse Naturali - Il Progetto Mattone Internazionale - La Commissione EU - l Università - Il Ministero della Salute TWINNING e NETWORKING CON ALTRE REGIONI (EU ed ITA) VALORIZZAZIONE DELLE ECCELLENZE REGIONALI CREAZIONE E POTENZIAMENTO DELLE COLLABORAZIONI SSR/UNIVERSITA ALLINEAMENTO DELLE PRIORITA FACILITANDO CIRCOLAZIONE DELLE INFORMAZIONI

21 PROGETTO MATTONE INTERNAZIONALE - WORKSHOP - "I fondi strutturali nella programmazione : quale spazio per la salute Roma, 21 febbraio 2014 il sotto-progetto del PMI "programma di formazione interregionale per l'utilizzo dei Fondi del Quadro stategico comune nel settore sanitario" che intende realizzare attività di coordinamento, informazione e formazione sull'utilizzo dei fondi strutturali in sanità rivolte al personale amministrativo e sanitario del Ministero della salute, delle Regioni italiane nonchè delle Aziende Sanitarie e Ospedaliere. STRUTTURA DI COORDINAMENTO TIPO NHS-24

22 PERSSILAA s CORE STRUCTURE AIM: effective screening & prevention of FRAILTY/pre-FRAILTY SHIFT from reactive disease management to screening, triage and anticipatory care PERSSILAA service protocols TRAINING MODULES BUSINESS MODELS FOUND/ENDOCARE PLATFORMS

23 PERSSILAA in Campania

24 Campania Key-players Federico II University Hospital Endocrinology Section of the Department of Clinical Medicine and Surgery & Endocare Network Health Campus Caritas network Caritas Charity Mission: - Welcoming and Listening - Retrieve and distribute aid - Social Commitment - Opening to the territory Health Campus Mission: Carry out a constant dissemination and promotion of prevention through health and educational initiatives. Two major objectives: specialist visits and services to prevent and detect health risks dissemination of a culture of prevention that encourages changes in lifestyle