Health Care Clínic Corporation Hospital Clínic University of

Health Care Clínic Corporation Hospital Clínic University of Barcelona

Hospital Organization 1996 Institut of Thorax Institute Diseases of Thorax Diseases Institut of Institute of Nephrology & Urology Institut of Institute Metabolic Digestive & of Digestive & Metabolic Diseases Medical Direction Emergencies-Operating Rooms Anesthesia-UASP-Pharmacy Institut of Institute of Gynecology Institute. Internal Medicine of Gynecology Institute of Obstetrics & Internal Medicine & Dermatology Obstetrics & Ophtalmology Neonatology & Dermatology Neonatology Center of Biomedical Diagnosis Center for Biomedical Diagnosis Institut of Institute of Neurosciences Institut of Institute of Hematology & Oncology Institut of Institute of Medical & Surgical Specialities Center of Diagnosis by the Image Center for Imaging Diagnosis

Increasing the efficiency of hospital organization Process Units Reference physician Instituts Wards ICU Day Care Diagnostic Units

RESPONSABILITIES OF PROCESS UNITS Ø Updated clinical guidelines and pathways Ø To assure high quality clinical database management Ø Identifiy clinical outputs to be measured based on the best practices Ø Transversal follow-up of patient’s disease through different episodes and different healthcare levels Ø Research and innovation on diseases included Ø Education for health professionals and patients

Fragmentedvs Territorial Healthcare Hospital healthcare systems Community Care HOSPITAL Process Units Behaviour and attitudes of health professionals. Transplant Familiy physician coordinated Lack of education for professionals promoting efficient work. Nurse CHF Territorial Lack of citizen’s education on a rational use of healthcare Social Healthcare worker systems. COPD Home care The payment systems that in many cases do not encourage Dementia coordinated work.

THE BASELINE SITUATION IN BARCELONA: Territory and Providers BARCELONA ESQUERRA • EAPs CAPSE EAP Gesclínic EAP Les Hortes 550. 000 inhabitants • EAPs ICS 18 Primary Care Centers (5 different healthcare trusts) • 4 Hospitals • 1 main Social-health center • 3 Mental Health Providers • Catalonia Medical Emergency Service 5 D EAPs Vallplasa Hospital Clínic 5 E Hospital Sagrat Cor 4 C 5 C 5 B 4 B 5 A 4 A 2 E 3 E 3 G 2 C 2 B 3 D 2 D 2 A 3 B Clínica Plató CAP II Manso (ICS) CAP II Numància (ICS) 3 A 3 C

Territorial Health Care Comission Barcelona Esquerra Institutions representative Permanent Comission Operational Committees IT Pediatric care Mental health Pharmacy Home Care Social Care Process 4 Specialized Care Process 3 Emergencies Process 2 Health Transport Implementation & follow-up Redesign Process 1 Technical Management Team

Adaptation of health services to chronic patients (shared care arrangements across the system) Hospital Consultant Emergency team Case Manager Primary Care Mobile teams Home Patient Relatives & Care givers Primary Care Team

Benchmarking among the top hospitals in Spain Institut of Thorax Diseases Complexity Mean stay Institut of Nephrology Ambulatory surgery & Urology Mortality Institut of Gynecology Morbidity Obstetrics & Neonatology Readmissions Institut of Digestive & Metabolic Diseases 1, 1625 Institut of Neurosciences Since 2001 Hospital Clinic has been ranked among the Medical Direction Institut of four Hematology 1, 2000 Rooms best hospitals in Spain Emergencies-Operating regarding health outcomes, & Oncology Anesthesia-UASP-Pharmacy efficiency, and productivity. 0, 8877 0, 7770 Institut of 0, 9789 Internal Medicine & Dermatology Center of Biomedical Diagnosis 0, 9824 Institut of Medical & Surgical Specialities Center of Diagnosis by the Image

Ranking of aggregate specialties Reputation Index Hospital Clínic, Barcelona Hospital Vall d’Hebron, Barcelona Hospital La Paz, Madrid Hospital Doce de Octubre, Madrid Clínica Universitaria, Navarra Hospital Sant Pau, Barcelona Hospital Ramón y Cajal, Madrid Hospital La Fe, Valencia Hospital Gregorio Marañón, Madrid Hospital de Bellvitge, L’Hospitalet Hospital Puerta de Hierro, Madrid Hospital Marqués de Valdecilla, Santander 107, 9 83, 5 71, 4 67, 9 46, 1 39, 0 35, 4 Nº Special. 11/13 12/13 8/13 5/13 7/13 31, 4 26, 2 20, 9 15, 6 9, 0 7/13 3/13 6/13 4/13 2/13

The top 10 hospitals selected for physicians to be trained in Spain (2001 -2011) 1. Hospital Clínic, Barcelona 2. Hospital Gregorio Marañon, Madrid 3. Hospital la Paz, Madrid 4. Hospital 12 de Octubre, Madrid 5. Hospital La Fe, Valencia 6. Hospital Valle de Hebron, Barcelona 7. Hospital Virgen del Rocío, Sevilla Fuente: 8. Hospital de Cruces, Baracaldo 9. Hospital de Bellvitge, L’Hospitalet 10. Hospital Miguel Servet, Zaragoza 16/03/2011

Research & Innovation

RESEARCH: Integrating high quality clinical research with high level basic research. Generalitat de Cataluña (Catalonia Governement) Clínic Hospital Barcelona University of Barcelona Biomedical Research Institute of Barcelona belonging to High Counsel of Scientific Research (Central Government) (IIBB-CSIC) Associate Centre Members of IDIBAPS Consortium Support : Clínic Foundation

Research Centers

Research Support Services Microscopy Unit (SCT-UB). Image Analysis Unit (HC). Neurological Tissue Bank (SCT-UB). Unit for Optical Recording of Cell Signals. Radioisotope Service (UB). Cell Culture Unit (HC). Animal House (UB). DNA Unit (HC). Genomics Unit (IDIBAPS). Tumour Bank (HC). Proteomics Unit (IDIBAPS). Evaluation, Support and Prevention Unit (HC). Bioinformatics Unit (IDIBAPS). Cytomics Unit (IDIBAPS). Flow Cytometry Service and Cell Sorting. Nanobiotechnology Unit (IDIBAPS). Library of Medicine (UB). IDIBAPS Store (IDIBAPS).

Hospital Clinic leads the Spanish ranking in terms of scientific impact Top ten hospitals in Spain Hospital Documents citations C/D H. Clinic de Barcelona 4. 250 53. 074 12, 49 H. Vall d’Hebron , Barcelona 2. 208 26. 395 11, 95 H. Santa Creu i Sant Pau, Barcelona 1. 818 18. 939 10, 42 H. Ramón y Cajal Madrid 1. 726 15. 632 9, 06 H. 12 de Octubre , Madrid 1. 713 17. 166 10, 02 H. La Paz , Madrid 1. 678 10. 861 6, 47 H. De Bellvitge , Barcelona 1. 362 13. 699 10, 06 H. Del Mar , Barcelona 1. 305 20. 627 15, 81 H. La Fe , Valencia 1. 194 10. 418 8, 73 H. Gregorio Marañon , Madrid 1. 170 9. 607 8, 21 Hospital Clínic is ranked among the first 25 best hospitals in the world regarding scientific production. Méndez-Vásquez R, Suñén E, Cervelló R, Camí J. Mapa bibliométrico de España 1996 -2004: Biomedicina y Ciencias de la Salud. Med Clin (Barc) 2008; 130: 246 -53.

HOSPITAL CLINIC - CLINICAL TRIALS HCB is the leading Hospital in Spain in Clinical Trials 1. USA, 2. Germany, 3. France, 4. Canada, 5. UK 6. Spain 7. Italy Clinical Trials reviewed by Hospital Clinic IRB

Technology Transfer & Biz Development Unit (2007 -June 2013) Activity Indicators Ideas Assessment Protection Negotiation (VC, industry) Tech Transfer / Spin-off Translational Research Focus 389 Ideas 54 Active Patent Families 10 Registered Software 163 Agreements: Including MTA, licenses, alliances & collaborations 4 Spin-offs innovacio@clinic. ub. es | +34 93 227 9165 18

ROADMAP We should develop the potential to be at the forefront of healthcare delivery innovation by embracing the evolution of medicine and technology System Medicine The 4 P’s of Medicine: Predictive Personalized Preventive Participatory 2020 Personal ized Health Services Evolved Integrated Care Services 2011 Use of technology

Fira de Barcelona May 21 th -22 th , 2014 Organizer: The City of Barcelona. Chair: Dr. JM Piqué, Managing Director Hospital Clínic

QS World University Rankings 2011 - Faculty Rankings Life Sciences & Medicine EUROPE 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Cambridge Oxford Imperial College Karolinska Edimburgh King’s College Zurich Technol Heildelberg Manchester South Wales Copenhagen Uppsala Glasgow Zurich Leuven Berlin-Humboldt (-) world ranking (2) (3) (11) (22) (23) (25) (30) (38) (43) (48) (52) (55) (56) (61) (62) (65) 17. Helsinki 18. Amsterdam 19. Utrecht 20. Berlin-Freie 21. Barcelona 22. Leiden 23. Lund 24. Marie Curie 25. Dublin-Trinity 26. Dundee 27. Shefield 28. Nottingham 29. Erasmus 30. London School 31. Freiburg 32. Aarus (66) (69) (71) (72) (74) (76) (77) (79) (80) (85) (89) (91) (92) (93) (94) (95) 32. Birmingham 33. Basel 34. Strasbourgh 35. Leeds 36. Göttingen 37. Vienna 38. Ecole Paris 39. Liverpool 40. Geneva 41. Stockholm 42. Munich 43. Ghent 44. Oslo 45. Maastricht 46. Madrid-Complut 47. Milano (96) (98) (99) (101) (103) (104) (106) (107) (110) (111) (113) (118) (119) (123) (124) (125)

Challenges in health care How to generate and to incorporate new knowledge and technologies in practice health care How to increase the efficiency of health service delivery

Working Lines in Innovation Research : turning resources into knowledge through scientific talent (with the support of management); Innovation : turning knowledge into health and social impact and resource generation through organizational talent. Project & Business Development Health Technology Assessment Technology Integration and Health care Efficiency

Projects & Business Development Projects with industry 2011 R&D HCB : Projects initiated by hospital Alliances : Projects initiated by industry Start – up companies Medical Devices 2009 Telemedicine 2007 /2010 Immunology 2010 Neuroscience 2009

Integrated care at HCB 2000 2002 2004 2006 2008 2010 2012

Long tradition in leading Chronic care/telemedicine projects in the EU 2000 -03 • Embryonic ICT platform • Clinical validation of limited model 2004 -06 • Conceptual platform • Market analysis / deployment strategy 2007 • Integrated Care Unit is created 2008 -12 • Effective deployment: Facing co-morbidity, articulation health / social care. Sustainable business models. • Reliability of ICT platform 2010 • Creation of the spin-off 2010 -13 • Large scale-deployment / regional level