In order to achieve 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 Roche Institute Foundation, includes some of the principles on which this change must be based.
During the presentation, Federico Plaza, vice president of the Roche Institute Foundation, “the situation we experienced was 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 in which information flows, which affect the way research, continuous measurement of results and a direct impact on how we manage patients.” For this reason, he hopes that this document “helps to draw up a roadmap in this area, which will be useful for those involved in decision-making”.
Paradigm shift
“Traditionally, we have trained doctors with high memory capacity, paper sources … and all this information in the health system is not in electronic history; Therefore, now the big challenge is to collect all the information from the National Health System that we can to incorporate it effectively in the decision-making process, both at the clinical and research level “, 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 PPM, because the big barrier is digital health.” Llerena indicated that, having complete information about the patient, both those contained in the clinical history and genomics, “a decision can be made with a common management.” There is a fundamental ingredient in this equation: coordination. “We need to step up joint action in data management, with comprehensive medical records, improving the niches that exist in some services and enhancing the digital capabilities of professionals and systems by connecting them more; This would allow Spain to lead the application of digital health, increasing the efficiency of the health system, “he said.
For Llerena, the urgent challenges that need to be addressed are “the rigidity of health systems, marked by a lack of connection and interoperability; makes information systems the axis of health systems and increases capacities in human training, allowing infrastructure and warehouses to increase data analysis capacity ”. “You have to use all these pieces to bring about change in health and biomedical research,” he concluded.
Boost for digitization
Joaquín Dopazo, director of the bioinformatics area of the Progreso y Salud Foundation, stressed that many countries abound in this issue in order to move to more digital health by detecting that “all available data must be used for the patient.” In this process of transformation, for Dopazo, there are three fundamental points. “We need to improve shared and secure access to data, connection and the ability to use it together, and strengthen citizens’ readiness to access and benefit from this data,” he said.
On the national stage, according to Dopazo, progress is being made in creating agencies in this field; “A secretariat for digital health has been created by the Ministry of Health, there is a strategy in this field with the collaboration of the autonomous communities, it has been proposed to create a state center for public health … these are steps to strengthen digitization”, he stated.
But there is still work to be done. “In terms of innovation and infrastructure, we need to increase investment 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 the 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 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 a capacity to manage data, the relevance of their access … not only at the regulatory level, but also at the commitment level,” Serrano said. In this line, he considers that a very important aspect of leadership in this transformation will be that “this process takes place without increasing the digital divide, that progress is being made without leaving behind a part of the population that has less access to these resources. digital ”.
However, he urged “to consider the analysis of the information and its explanation, given that information from different sources will be combined”. Also, that “one of the requirements to undertake this change will be continuity, because it is necessary the continuity of data and their standardization, which requires a lot of consensus.” Following this thread, he stressed the need to “promote standards and turn data into operational ones, as well as their confidentiality treatments”.
New capabilities and measurement of results
Another challenge resulting 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 into this strategy a training plan not only for health professionals but also for decision-makers and managers, in such a way.” so as to ensure that the knowledge needed to operate in the digital field is incorporated ‘. “New profiles concentrated and structured around data science are also needed; for this it is necessary to incorporate the vision of nurses, nurses, biologists or any other professional that reflects this new need ”. He indicated the president of SEOM.
Likewise, Rodríguez Lescure called for “incorporating university-level skills in medicine and healthcare in the field of genetics and data science”. Also, “consider incorporating double degrees, for example, in Bioinformatics and Biomedicine and promote all these trainings especially in postgraduate courses”.
Another point that Rodríguez-Lescure addressed is the need to advance in measuring results in order to advance in other aspects of health. Thus, he added that “we must promote and support digital tools that allow data analysis, the importance of prevention from a population perspective and, in the field of healthcare, to promote environments and structures so that professionals can converge all this information.” “We need to make sure that all the results of this convergence are incorporated and especially that they are applicable to this new vision of personalized precision medicine, which we have always wanted, but with appropriate tools for observation and analysis,” he concluded. .
