| 4. In which ways is the initiative creative and innovative?
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As mentioned above, the Biomedical Research Workflow Management System has been implemented since 2005. The main achievements arising from the project development have been the following:
-Starting from 200 proposals in 2005, in 2013 the system was able to manage more than 4,000 proposals.
-Consequently, the researchers connected to the system increased yearly, until the current number of 13,000 users.
-All the information is available online, both for the reviewers (NIH) activities and for the management of the communication between MoH and research community, through a Customer Relationship Management (CRM) tool.
More in details:
Year: 2005
Key developments:
The Research Workflow Management System started from the initiative of the 7 Italian Excellence Cancer Institutes.
Main activities:
Design and implementation of the first prototype, aimed to manage common research activities funded by the MoH Current research budget (publications, clinical trials, ....).
Year: 2006
Key developments:
Extension of the workflow system to the 35 Institutes belonging to the National network.
Main activities:
Software functionalities improvement (researchers directory, scientific research impact factor, …) and technological infrastructural assessment - database, connectivity, ...).
Year: 2007
Key developments:
The workflow system has been extended to cope with all the MoH yearly funded research activities, both current and finalized.
Main activities:
Training activities and the enabling of a specialized call center service have been planned to support researchers and reviewers.
Year: 2008
Key developments:
The system was adopted for the management of the first call for proposal submitted by young researchers.
Year: 2009 - 2010
Key developments:
Design and development of the on-line evaluation module by external reviewers (reviewers directory, curricula, …) in partnership with the National Institutes of Health (NIH) and Italian Scientist and Scholars of North America Foundation (ISNAFF).
Main activities:
Complete digitalization of the research funding workflow (proposal submission, evaluation, administrative monitoring, results exploitation).
Year: 2011 - 2012
Key developments:
Improvement of administrative and scientific monitoring of the projects with the introduction of the electronic folder.
Main activities:
Design and implementation of a new release (Workflow 2.0) for the upgrade to new technological standards.
Year: 2013 - 2014
Key developments:
The Workflow management system has been integrated to a Customer Relationship Management (CRM) tool.
Main activities:
All the proposals information and the communications among the research stakeholders have been made available online.
Starting from the year 2010 the Workflow system has substituted all the different means of communication previously used, in a single flow entailing a unique identification of the contact persons, that were included in a specific database referring to all the Institutional subject defined by law (about 100 institutions, as divided: 48 healthcare centers - IRCCS, 10 veterinary institutes - IZS, 21 Regions and Autonomous Provinces, the National Institute for Insurance against Accidents at Work – INAIL, the National Agency for regional health services - AGENAS, and the Italian National Health Institute - ISS).
Furthermore such system, put in place by the MoH at a national level, has been already taken into use by some Regions for their internal management.
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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The Biomedical Research Workflow Management System was designed by General Direction for Scientific Research and Health Innovation (at the time Directorate General for Health and Biomedical Research) with the Supervision of National Health Bodies and Institutions of the Italian Ministry of Health in partnership with Consorzio di Bioingegneria e Informatica Medica (CBIM).
CBIM is a no-profit research institution, founded in 1992 by the University of Pavia and some Scientific Biomedical Research Institutes, with the aim of promoting ICT based innovative services in the Healthcare area. CBIM since its foundation worked in the design and management of several Italian large scale Hospital Information Systems.
CBIM, in addition to design, also managed the implementation and management of the information system in all its aspects: software development, database management, training, operational support.
Since 2009, the Biomedical Research Workflow Management System has been delivered in cooperation with Consortium GARR that represents Italian Research & Education Network. It plans and operates the national high-speed telecommunication network for University and Scientific Research.
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| 6. How was the strategy implemented and what resources were mobilized?
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The initiative was implemented and funded exclusively through resources belonging to the General Direction for Scientific Research and Health Innovation.
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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1.Implementation of the Biomedical Research Database in terms of Institutes, Researchers, Publications, Clinical Trials, Research lines and topics, Proposals. Since 2005 more than 15,000 Researchers, 80,000 Publications, 12,000 Proposals, have been included.
2.According to the National regulation, beneficiaries of the MoH finalized funding are about 100 Institutional subjects (48 healthcare centers - IRCCS, 10 veterinary institutes - IZS, 21 Regions and Autonomous Provinces, the National Institute for Insurance against Accidents at Work – INAIL, the National Agency for regional health services - AGENAS, and the Italian National Health Institute - ISS). The introduction of the Biomedical Research Workflow Management System allowed more than 10,000 subjects to access the research network, thereby increasing the transparency of funding and procurement procedures.
3.Implementation of the International Reviewers Directory, based on specific expertise, in order to guarantee the correct correlation between reviewers and proposals. In addition, the MoH enabled a system functionality for on-line monitoring of evaluation process and results. Through this system of "open" peer review, all research stakeholders are able to verify the evaluation results in a completely transparent model, thus increasing the quality of the biomedical research.
Through the complete accessibility to the judgments expressed by the international scientific reviewers and the possibility of resubmitting a modified application in the following years, the quality of the submitted projects has improved, with a great increase of the Italian research competitiveness at a global level.
4.The workflow system implementation makes available both governance information (number of projects funded for institution, project results, impact ...) and the electronic folder of any specific project (startup date, upgrade status, scientific and administrative reports...). The networking among researchers, Institutions and MoH could guarantee a knowledge sharing at different levels thereby increasing the benchmark and quality of the biomedical research.
5.In addition, the ICT tools allow an easy communication across Public Administration actors and private stakeholders (more than 7.000 messages per year posted in the system).
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| 8. What were the most successful outputs and why was the initiative effective?
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The Biomedical Research Workflow Management System has been implemented with the Agile methodology that provides opportunities to assess the direction throughout the development lifecycle. By focusing on the repetition of abbreviated work cycles the agile methodology is described as “iterative” and “incremental.”
In an agile paradigm, every aspect of development (requirements, design, …) was continually revisited. The team, composed of MoH personnel and CBIM engineers and developer, has re-evaluated the direction of the project every month.
This “inspect-and-adapt” approach to development greatly reduced development costs and time of activation of the services because the team’s work cycle was limited to a month; stakeholders had recurring opportunities to calibrate releases for success in the real system.
Agile development helped MoH to build the right solution. Instead of committing to market a piece of software that hasn’t been written yet, Agile allowed to continuously replan the Biomedical Research Workflow Management System release to optimize its functionality.
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| 9. What were the main obstacles encountered and how were they overcome?
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The main obstacle was represented by the initial resistance opposed by the institutional subjects involved in the process, that at first had problems in adapting to such an innovative ICT tool.
It took some time to accept the new system, that substituted all the different means of communication previously used in a single flow, and was accessible only through a personal password, entailing a unique identification of the contact persons, that were included in a specific database referring to all the Institutional subject defined by law (about 100 institutions, as divided: 48 healthcare centers - IRCCS, 10 veterinary institutes - IZS, 21 Regions and Autonomous Provinces, the National Institute for Insurance against Accidents at Work – INAIL, the National Agency for regional health services - AGENAS, and the Italian National Health Institute - ISS).
Such problems were gradually overcome thanks to the clear identification of the centers of stewardship and by establishing the obligatoriness to comply with the Workflow System; furthermore, special cycles of training, exercised in single institutions and plenary sessions, were implemented. Other occasions of training and moments of synthesis and sharing of subsequent pathways are represented by the annual conventions dedicated to the research system.
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