In the name of carrying out a correct implementation of personalized precision medicine (MPP), a greater commitment to digital transformation is needed. The report ‘Proposal for recommendations for the digital transformation of the healthcare system for the incorporation of Personalized Precision Medicine’, promoted by the Institut Roche Foundation, sets out some of the principles on which this change must be based.
During the presentation of the same, Federico Plaza, vice president of the Roche Institute Foundation, “the situation we have experienced has been complicated, but also an accelerator to make certain changes in the health system.” In this regard, he added that “this is a comprehensive and integrated process where information flows, which affects the way we research, measure results continuously and a direct impact on how we manage patients.” He therefore hopes that this document “will help to draw up a roadmap in this area, which will be useful to those involved in decision-making”.
Paradigm shift
“Traditionally we have trained doctors with great memory capacity, paper sources … and all this information about the health system is not in electronic history; therefore, now the big challenge is to collect all the information from the National Health System. Health that we can to incorporate it effectively in decision-making, both clinically and research, “said Adrián Llerena, president of the Spanish Society of Pharmacogenetics and Pharmacogenomics (SEFF).
The expert considered that “this paradigm shift is what will really allow the integration of a patient-centered MPP, as the big barrier is digital health.” Llerena indicated that, having complete information about the patient, both contained in the medical history and genomics, “a decision can be made with joint management.” Within this equation 1 there is a fundamental ingredient: coordination. “It is necessary to increase joint action in data management, with complete medical records, alleviating the niches that exist in some services and increasing the digital capabilities of professionals and systems, connecting them more; this would allow Spain to put is at the forefront of the application of digital health, increasing the efficiency of the health system, “he said.
For Llerena, among the challenges that need to be solved are the “rigidity of health systems, marked by the lack of connection and interoperability; make information systems the axis of health systems and increase capacity in human training, allowing to have infrastructures and repositories to increase data analysis capacity “. “All of these pieces need to be used to drive change in healthcare and biomedical research,” he concluded.
Promotion of digitization
Joaquín Dopazo, director of the Bioinformatics Area of the Progrés i Salut Foundation, pointed out that many countries are abundant in this problem to move towards more digital health by detecting that “the whole amount of data that it must be used for the patient. ” In this process of transformation, for Dopazo, there are three fundamental points. “There is a need to improve shared and secure access to data, the connection and the possibility of using all of them together and to strengthen the training of citizens to access and benefit from this data,” he said.
In the national panorama, according to Dopazo, advances are taking place with the creation of organisms in the matter; “The Ministry of Health has created a Digital Health Secretariat, there is a strategy in this area with the collaboration of the autonomous communities, the creation of a State Center for Public Health has been proposed … they are steps towards the consolidation of digitization, “he said.
But there is still work to be done. “Regarding innovation and infrastructure, it is necessary to increase investment in R & D & I, which is not only interesting for the patient, but for the NHS, because by developing more technologies we will not be so dependent on third parties,” he said. the expert.
Cooperation between administrations
Pablo Serrano, Director of Planning at the 12 de Octubre University Hospital (Madrid), referred to the need for leadership. “Having clear governance and leadership is key to the digital transformation, both at the state level and in the autonomous communities; the Ministry needs the collaboration of other administrations, such as the ministries involved in digital skills and all the agents of the sector, ”he detailed.
“There must always be an ability to manage the data, the relevance in its access … not only at the regulatory level, but of commitment,” Serrano noted. In this line, he considers that a very important aspect of leadership in this transformation will be that “this process is carried out without increasing the digital divide, which is advanced without leaving behind a part of the population that has less access to these digital resources “.
With all this, he urged to “take into account the analysis of information and its explanation, noting that information from different sources will be combined.” Also, that “one of the requirements to undertake this change will be continuity, as continuity of data and its standardization is needed, which requires a lot of consensus.” Following this thread, he stressed the need to “promote standards and make the data operational, and the privacy treatments thereof.”
New capabilities and measurement of results
Another challenge arising from this transformation is the need for new professional profiles. Álvaro Rodríguez-Lescure, president of the Spanish Society of Medical Oncology (SEOM), alluded to the urgency of “incorporating in this strategy a training plan not only for health professionals, but for decision makers and managers, such in a way that ensures that the knowledge needed to develop in the digital field is incorporated. ” “We also need new profiles centered and structured around data science; that’s why we need to incorporate the vision of nurses, assistants, biologists or any other professional that reflects this new need.” It indicated the president of SEOM.
Likewise, Rodríguez Lescure urged to “incorporate competencies in the field of the university in degrees of Medicine and Nursing on genetics and data science”. Also, “consider the incorporation of double degrees, for example, in Bioinformatics and Biomedicine and promote all this training specifically in postgraduate courses.”
Another point addressed by Rodríguez-Lescure is the need to make progress in measuring results to make progress in other aspects of health. Thus, he added that “it is necessary to promote and support digital tools to analyze data, the importance of prevention from a population perspective and, in the field of care, promote environments and structures so that professionals can converge all this information.” . “We must ensure that all the results obtained from this convergence are incorporated and especially that they are applicable to this new vision of personalized precision medicine, which is what we have always wanted, but with tools of observation and d ‘proper analysis,’ he concluded.
