During the first of our virtual meetings, we were able to see how eHealth, understood as the set of Information and Communication Technologies (I.C.T.s), used in the health environment in terms of prevention, diagnosis, treatment, monitoring, as well as health management, is going to be implemented exponentially. And the experts referred to several initiatives that had already been launched quite successfully, such as telemedicine and home delivery of medicines.
From the point of view of health policy, various individuals have suggested that possibly the ‘voice of the patient’ during the crisis has been considered too passive, similar to that of the general population, whose fundamental objective has been to ‘flatten the curve.’ However, patient associations have also highlighted the apparent importance of connecting patients and health professionals during this pandemic. And on 18 April (European Patients’ Rights Day), they pointed out that this relationship should not be an exception or forgotten. They released a manifesto that looks into the eyes and listens, proposing a more humane medicine.
It seems clear that we are in a moment of change, although we do not know its magnitude and meaning. At the macro level, working groups related to the WHO and regulatory agencies are developing various practical initiatives to include patients as key subjects in the development, market access, and safe use of medicines. And they also propose the development of I.C.T.s to incorporate patients into effective communication with doctors and the pharmaceutical and medical device industry, with regulators, managers, and academia. At the macro level, models such as developed by the ‘Programa d’Harmonització Farmacoterapèutica de Catalunya’ in which patients are effectively incorporated into the evaluation and prioritization of medicines seem to be an example to follow.
Possibly, some of the aspects that are being worked on as of late and that can be accelerated by the current crisis situation are those related to an adequate assessment of health outcomes, trying to incorporate variables that matter to patients, and encouraging patients through the use of I.C.T.s to be the ones who quantify those variables. It is also interesting to recall the insufficient use of Real World Evidence today, except for some commendable proposals. There is an essential discussion on the value propositions of therapeutic Innovation, mainly in oncological therapies, with a clear focus on efficacy and safety and minimal on other variables of importance to patients. And this links directly to various proposals that suggest incorporating other criteria for assessing and incorporating drugs into health systems.
It is also necessary to think about the change of model in the doctor-patient relationship that we are experiencing. We are moving away from the paternalistic model of relationship and towards a shared decision-making model, where the professional will behave as an influential advisor to the patient in which they jointly value the different options and make consensual decisions, taking into account the patient’s values and preferences. This model requires the development of short, synthetic, and methodologically valid shared decision-making tools and a more rigorous assessment of priorities that can provide valuable information in the consultation and at the manager/regulator level (conjoint analysis).
To reflect on all these points, we have an excellent panel of opinion leaders, with diverse areas of expertise. Vicente Escudero, Pharmacist of the Hospital Gregorio Marañón; Caridad Pontes, Medical Manager of the Servei Catalá de Salut; Josep Piera, Head of the Medical Oncology Service of the UGC de Oncología de Gipuzkoa del HU Donostia-Onkologikoa; and Natacha Bolaños, Global Alliances Manager of the Lymphoma Coalition, who will be moderated by Luis Lizán, director of Outcomes’10.
