Dossier n. 243/2014 [Abstract] The 2007-2013 Research Programs between Emilia-Romagna Region and its Universities

This document describes the experience of the Programma di ricerca Regione-Università (PrRU), an experimental research program launched in 2007 and coordinated by the Regional Agency for Health and Social Care of Emilia-Romagna.

The PrRU is part of a broader strategy that the Regional Government adopted to support and encourage research within its Health Service, according to the Regional Law
n. 29/2004 (Dossier Agenzia sanitaria e sociale, 2009).

The initiative is targeted to University hospitals of Emilia-Romagna, Rizzoli Orthopedic Institute and Bellaria and Baggiovara hospitals (since 2011 Bellaria hospital is recognized as a care and research institute of national relevance for neurosciences). Although Bellaria and Baggiovara are not University hospitals, they were included in the Program because identified as collaboration sites between the Regional Health Service and University. The PrRU is addressed to these institutional players as cornerstones for achieving the integration and collaboration between Health Service and Academia.

An additional aim of PrRU is to promote research also in Local health trusts. When responding to calls launched by the Program, University hospitals and research hospitals may actually - and in some calls (i.e. calls of the Clinical governance Area) have to - involve Local health trusts as research units.

The main purposes of the Program include the promotion of University hospitals’ role in research networking, the involvement of all Local health trusts and clinicians, the growth of centers of excellence and professional networks, the development of scientific innovations and new models of organization, management and professional training related to Health Service.

A Steering Committee is designed as decision-making body of the Program. It is composed by 11 members, representing Universities (4), University hospitals (4), Local health trusts, Regional Health Authority and Agency for Health and Social Care of Emilia-Romagna. Scientific Secretariat of the Program is run by the Agency for Health and Social Care.

The first edition of the Program, launched in 2007, was completed in 2009. The second edition was started in 2010 and ended in December 2012. For each edition, the Regional Authority has allocated 30 million Euros. According with an increased level of requirements, the process of project selection was capable to identify a lower number of studies. This allowed to support a third edition in 2013: a year-long edition supported with a 5 million Euros budget.

The activities of the Program are designed to:

• promote the most promising lines of research, i.e. research able to respond to knowledge needs of the Health Service;
• deepen the knowledge of emerging technologies;
• verify the degree of dissemination and adoption of technologies and their implications for the organization of the Health Service.

The Program pursues the objectives of research and innovation by organizing its activities into 3 main areas.

Innovative research - Area 1 of the PrRU is dedicated to innovative research (theory enhancing) meant to produce new knowledge on potentially relevant technologies and interventions for the Regional Health Service of Emilia-Romagna.

From the second edition of the Program (2010-2012), two important novelties in Area 1 were introduced:

• the funding is no longer provided to single projects but to strategic integrated programs on biomedical research and health care;
• the Steering Committee launched a special call for young researchers: the “Alessandro Liberati young researchers call”.

Research for clinical governance - Area 2 is devoted to assessing the clinical and organizational impact - in terms of comparative effectiveness and appropriateness - of specific health interventions and technologies (change promotion).

Research on human resource training and development of research networks - Area 3 was created to experiment training interventions aimed at increasing research expertise in Regional Health Service professionals and to facilitate the development of research networks.

With the exception of Area 3 - whose project proposals were evaluated directly by the Steering Committee - the scientific evaluation of research projects related to Area 1 and 2 was made according to standard criteria used in international contexts through peer review evaluations.

All projects have gone through a selection process carried out by expert evaluators (reviewers). The two first edition of the Program involved 342 reviewers coming from outside Emilia-Romagna; 57% of them were foreigners.

A peculiarity of the selection process was the organization of workshop meetings with project proponents (principal investigators) and reviewers in a very early stage of conceptualization of the proposals, with the aim of supporting proponents in identifying targets with more accuracy and appropriate methodologies. The sharing of information received by the reviewers allowed Health trusts to focus on proposals with a greater chance of producing useful data for the Regional Health Service. In a second step of the evaluation process a formal assessment of projects quality (performed within a study session) permitted to select the projects and/or programs to be funded.

During the two editions of the Program (2007-2012) 122 projects were funded:

• 52 projects in the “Innovative research” area, committing € 37,912,376. Of these projects, 15 were dedicated to young researchers for an amount of € 3,114,443;
• 47 projects in the “Research for clinical governance” area, committing € 13,603,832;
• 23 in the “Research on human resource training and development of research networks” area, committing € 2,333,313.

An amount of € 774,064 (1.4% of total budget) was needed to cover the Program management costs.

The funded research activities, have so far produced a total of 373 papers published in peer reviewed journals. The monitoring program seeks to measure the output of the this program according bibliometric measurements but also in terms of impact on regional health assistances such as new guidelines, recommendations.

The Program has developed ad hoc communication tools - a newsletter and a dedicated website (LaNiUslettER - available at http://laniusletter.it/) - to spread information and scientific outputs of the Program, and to offer insights on biomedical and health research.