In order to carry out a correct implementation of personalized precision medicine (MPP), a greater commitment to digital transformation is necessary. The report ‘Proposal of recommendations for the digital transformation of the health 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 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 of research, continuously measuring results and a direct impact on how we manage patients.” For this reason, he hopes that this document “contributes to drawing up a roadmap in this area, which will be useful for those who participate in decision-making”.
“Traditionally we have trained doctors with great memory capacity, paper sources… and all this information from the health system is not in the electronic history; Therefore, now the great challenge is to collect all the information from the National Health System that we can to incorporate it effectively into decision-making, 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 the one that will really allow the integration of a patient-centered PPM, since the great barrier is digital health.” Llerena indicated that, by having complete information on the patient, both that contained in the clinical history and the genomic, “a decision can be made with joint management.” Within this equation there is a fundamental ingredient: coordination. “We must 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 be at the forefront of the application of digital health, increasing the efficiency of the health system ”, he asserted.
For Llerena, among the urgent challenges to be solved are the “rigidity of the health systems, marked by the lack of connection and interoperability; make information systems the axis of health systems and increase capacities in human training, allowing for infrastructure and repositories to increase data analysis capacity ”. “You have to use all these pieces to generate a change in healthcare and biomedical research,” he concluded.
Boost for digitization
Joaquín Dopazo, director of the Bioinformatics Area of the Progreso y Salud Foundation, pointed out that many countries are abounding in this problem to move towards a more digital health by detecting that “all the amount of data available must use it for the patient ”. In this transformation process, for Dopazo, there are three fundamental points. “We must improve shared and secure access to data, connection and the possibility of using all of them together and strengthen the training of citizens to access and benefit from this data,” he stated.
On the national scene, according to Dopazo, progress is being made with the creation of agencies in this area; “From the Ministry of Health, a Digital Health Secretariat has been created, 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… these are steps that are being taken towards the consolidation of digitization ”, he stated.
But, there is still work to be done. “Regarding innovation and infrastructure, we must increase investment in R + D + i, which is not only interesting for the patient, but for the SNS, 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 a clear governance and leadership is key 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 always has to be a capacity to manage the data, the relevance of its access … not only at the regulatory level, but also at the commitment level,” said Serrano. 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, that progress is made without leaving behind a part of the population that has less access to these resources digital ”.
With all this, he urged “to take into account the analysis of information and its explanation, taking into account that information from different sources will be combined”. Also, that “one of the requirements to undertake this change will be continuity, since continuity of the data and its standardization is needed, which requires many consensuses”. Following this thread, he highlighted the need to “promote standards and make data operational, and their privacy treatments.”
New capabilities and results measurement
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 into this strategy a training plan not only for healthcare professionals, but also for decision-makers and managers, in such a way as to ensure that the necessary knowledge to function in the digital field is incorporated ”. “New profiles focused and structured around data science are also needed; for this we must 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 competences at the university level in degrees in 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 of the points that Rodríguez-Lescure addressed is the need to advance in the measurement of results to advance in the rest of the health aspects. 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 healthcare field, 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 adequate observation and analysis tools. ”, He concluded.