Personalized Precision Medicine represents a paradigm shift and a new care reality for the health system, with training being a fundamental tool to contribute to its full incorporation and application in clinical practice. This has been manifested in the day Configuring the Medicine of the Future: training needs in Personalized Precision Medicine’, organized by Next Education with the collaboration of the Fundación Instituto Roche.
On this day, different experts of national reference have delved into the Training needs and challenges faced by health professionals and opportunities that brings the acquisition of skills in new areas of knowledge as a lever for the incorporation of Personalized Precision Medicine, for the benefit of patients and society in general.
The welcome was given by Manuel Campo Vidal, doctor in Sociology, journalist and president of Next Education, who moderated this panel to see where we are, where we are going and where we want to go “because there is no time to waste”.
The training of health professionals in the 21st century
Celia Gómez González, General Director of Professional Regulation of the Ministry of Health, interviewed by Manuel Campo Vidal, has assured that “we are at a time when plans are already being formed”, expressing the importance of big data and Artificial Intelligence. “We have a pool of leaders to be able to help the rest”, although “not all centers receive this training today”.
Are we more advanced in capturing than in analysis? According to the expert, yes: “You have to share experiences and the best way to teach is with the analysis of success stories.”
According to her, the pandemic has made it possible to make the leap to digital health, a basic tool for the system. Likewise, she has stressed that what we seek is to have tools whose access is equitable to all professionals, allowing knowledge to spread. To do this, you have to rely on leaders, she has opined. All this is a great “cultural change, but it is a necessary process, with a holistic perspective”. And it is that “having a global vision is fundamental”.
Thus, he has insisted that if this situation has taught us anything, it is that borders do not exist. That the more data we have, the better, and the greater knowledge. Therefore, it will create European Health Areagiving the opportunity to have shared data for what may be needed, being able to organize knowledge.
Regarding the speed of application to catch up, she believes that “the pandemic has helped speed up the process, although it is not new. In addition, we have the challenge of European Funds, etc.”. In conclusion: “You have to be optimistic.”
Training, key in the Medicine of the Future
Subsequently, there has been discussion table with great experts, in which they discussed the subject.
Juan Cruz Cigudosa, Minister of University, Innovation and Digital Transformation of the Government of Navarra, has specified that “we have a training deficit in precision medicine” and has stressed that “Spain is the only country in Europe that does not have the specialty of clinical genetics recognized in hospitals ”.
Sustainability, thus, comes from two sources: that a satisfactory budget is ensured for all and that we have to work together: “digitization and equity are fundamental. The data works.”
In all this we find 4 barriers, explained the professional: technological, training, ethical and legal knowledge, in addition to incorporating the patient in the decision.
Call of interest to institutions. All in one
Fernando Martin Sanchez, Professor of Research in Biomedical Informatics, at the National School of Health. Carlos III Health Institute, ensures that we must learn to manage data and that there are specific specialists to bet on precision medicine. “There are countries that have already gone through professionalization, defining accreditation programs. In Spain we are a little behind in this area”. In addition, he has specified that above all it must be taken into account that precision medicine differs from genomics in that it has a more holistic approach.
Health professionals are going to have two basic tools, he describes: The clinical history, “which perhaps has to change and be better, to support this type of process” and, second, decision support systems. Without them, everything cannot be put into practice, because we exceed the cognitive threshold of any person”.
According to the expert, now it is necessary to obtain the interest of the institutions (ministries, ministries, professional associations…) so that they put in motion all the instruments, which are based on a framework of competencies, and that they take those steps to have the professionals and make a credentialing mechanism a reality in this field.
Frederick Plaza, vice president of the Roche Institute Foundation, explained that in this document (‘Proposal for Competences in Personalized Precision Medicine for health professionals’), which they present, experts from different disciplines and advisors have participated because “we understand that precision medicine has to have a multidisciplinary profile”. And it is that, as he has pointed out, there has been an important milestone in these years: on the one hand, the emergence of omic sciences (genomics and others) together with an exponential development of health. What has conditioned the health system to adapt. To do this, “professionals need to be trained, not only have the tools, but know how to use them.” Likewise, he has insisted that “patients have to be an active part of the transformation of the system”.
Thus, precision medicine is not a need that is imposed, but an obvious social demand supported by digitization, he specified. And it is that, as he has remarked, “data heals and the research model is changing”.
In this way, this recommendation proposal document becomes “a roadmap that the system must follow, with the maximum possible permeability”.
“Nothing makes sense if it is not done in an environment and with a social purpose”
Carlos Lopez-Otin, professor of Biochemistry and Molecular Biology at the University of Oviedo, has opined that “if we do not educate ourselves globally we will miss the train of innovation”. In this sense, it is committed to education and dedicating all efforts to creating pedagogical structures. “For this, knowledge of the languages must be inserted so that they are not foreign.”
We must talk about configuring the medicine of the future, describing that medicine arises to respond to our imperfections. And you have to prevent. “Society has to educate itself and be co-responsible for its health.”
On the other hand, he has commented that, sometimes, “it seems that only an elite will take place in certain innovations and it is not true. The best way to combat this is to invest in Primary Care”.
In short, you have to become familiar with the data. “You have to lose the fear” to ask and get fully into it. Data must be taken not only from the patients, but also from the environments. And it is that no human mind can encompass all of this. Until we solve humanism we should not delve into post humanism. “We must not lose the human component yet. Knowledge is not scary, while ignorance is.