To properly implement personalized precision medicine (MPP), greater commitment to digital transformation is needed. The report ‘Proposed Recommendations for the Digital Transformation of the Health System for the Incorporation of Personalized Precision Medicine’, promoted by the Roche Institute Foundation, contains some principles on which this change should be based.
Speaking during the presentation, Federico Plaza, vice president of the Roche Institute Foundation, said, “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, influences research methods, continuously measures results and has a direct impact on how we interact with patients.” For this reason, he hopes that this document “helps to develop a roadmap in this area, which will be useful to those taking part in decision-making.”
Paradigm shift
“Traditionally we have trained doctors with a large memory capacity, paper sources… and all this information from the health system is not in the electronic history; Therefore, the major challenge now is to gather all the information from the National Health System that we can use to effectively integrate it into decision-making, both at the clinical and research level, ”said Adrián Llerena, President of the Spanish Association of Pharmacogenetics and Pharmacogenomics (SEFF).
The expert felt that “this paradigm shift will really enable the integration of a PPM focused on the patient, as digital health is the great barrier”. Llerena indicated that by having complete information about the patient, both clinical history and genomics, “a decision can be made with joint treatment.” Within this equation there is a fundamental ingredient: coordination. “We need to increase collaborative data management action, with full health records, alleviate the niches that exist in some services, and increase the digital capabilities of professionals and systems, by connecting them more closely; This would allow Spain to be at the forefront of digital health adoption, increasing the efficiency of the health system, ”he said.
For Llerena, one of the urgent challenges to be resolved is the “rigidity of health systems, characterized by lack of connectivity and interoperability; make information systems the axis of health systems and increase human training capacities, allowing infrastructure and repositories to increase the capacity for data analysis ”. “You have to use all these pieces to bring about a change in healthcare and biomedical research,” he concluded.
Boost for digitization
Joaquín Dopazo, director of the Progreso y Salud Foundation’s Bioinformatics Area, pointed out that many countries are liberally addressing this issue in order to move towards a more digital health by discovering that “all available data should use it for the patient.” In this transformation process there are three fundamental points for Dopazo: “We need to improve the shared and secure access to data, connections and the ability to use them all together, and educate citizens to access and benefit from this data , strengthen, ”he stated.
According to Dopazo, progress is being made on the national stage with the creation of agencies in this field; “A Digital Health Secretariat has been established by the Ministry of Health, a strategy in this area with the cooperation of the Autonomous Communities has been proposed, the creation of a State Center for Public Health has been proposed … these are steps being taken towards the consolidation of digitization ”, he says.
But there is still work to be done. “In terms of innovation and infrastructure, we need to invest more in R + D + i, which is interesting not only for the patient, but also for the NHS, because by developing more technologies we will not be so dependent on third parties”, the expert.
Cooperation between administrations
Pablo Serrano, planning director of 12 de Octubre University Hospital (Madrid), referred to the need for leadership. “Having clear governance and leadership is essential in the digital transformation, both at the state level and in the autonomous communities; the ministry needs the cooperation of other administrations, such as the ministries involved in digital competences and all agents of the sector, ”he explains.
“There must always be a capacity to manage the data, the relevance of the access… not only at the regulatory level, but also at the level of commitments,” said Serrano. In this sense, he believes that a very important aspect of leadership in this transformation will be that “this process is carried out without increasing the digital divide, that progress is made without leaving a segment of the population with less access. to these sources. digital ”.
In all this he insisted “to take into account the analysis of information and its interpretation, bearing in mind that information from different sources will be combined”. Also that “one of the requirements to make this change will be continuity, as continuity of the data and its standardization is needed, which requires a lot of consensus”. Echoing this thread, he stressed the need to “promote standards and make data operational, and their privacy treatments.”
New possibilities and result measurement
Another challenge that arises from this transformation is the need for new professional profiles. Álvaro Rodríguez-Lescure, President of the Spanish Association of Medical Oncology (SEOM), hinted at the urgency to include in this strategy a training plan, not only for healthcare professionals, but also for decision makers and managers, in such a way to ensure that the necessary knowledge to function in the digital field is incorporated ”. “New profiles are also needed that are focused and structured around data science; for this it is necessary to integrate the vision of nurses, assistants, biologists or any other professional who reflects this new need ”. It designated the president of SEOM.
Likewise, Rodríguez Lescure urged “to incorporate university-level competences in medicine and nursing in the fields of genetics and data science”. “Also consider the inclusion of double degrees, for example in Bioinformatics and Biomedicine, and promote all of these courses specifically in postgraduate courses”.
Another point that Rodríguez-Lescure made is the need to make progress in measuring outcomes in order to progress in the rest of the health aspects. So he added that “we need to promote and support digital tools that enable data analysis, promote the importance of prevention from a population perspective and, in healthcare, environments and structures so that professionals can bring all this information together.” “We must ensure that all the results obtained from this convergence are included and, above all, that they are applicable to this new vision of personalized precision medicine, which is what we have always wanted, but with adequate observation and analysis tools.”
