Monday , June 21 2021

Personalized medicine, a distant dream in Mexico



Health care in Mexico lacks sufficient human talent and technology to allow the entire population to access health services that improve quality of life in the short term.

In the public network, according to data from the Ministry of Health, in the country there is a deficit of 200 thousand doctors and 300 thousand nurses. The data were provided by the Secretary of Health, Jorge Alcocer, in April this year, while the Covid pandemic was in full growth.

Subsequently, the undersecretary for Prevention and Health Promotion, Hugo-López Gatell, guaranteed that, during this period, the Federal Government hired 50 thousand doctors to take care of the pandemic, but the deficit remains at 150 thousand doctors.

But in the 21st century, health presents a new trend: personalization of care.

This means that each patient has a punctual follow-up and a file that allows medical personnel to meet each of the needs of more than 127 million Mexicans.

According to research by The Economist Research Unit, personalized service implies accurate and early diagnosis, remote monitoring, improvement in risk management, removal of the single model for all patients, as well as options for personalized treatment and individualized care plans.

There has been a dramatic increase in the need to serve people remotely, not just directly in the health sector, but in everything around it

The first step in achieving this type of assistance is the creation of electronic medical records, which are gathered in a database accessible to all specialists, without the patient having to transfer his physical file at each visit of a new doctor. for a specific disease.

A study by the Pan American Health Organization (PAHO) and the World Health Organization (WHO) found that in Latin America “there are no data that allow us to know the degree of adoption” of the Electronic Health Record.

In Mexico, since the previous administration, it was proposed to create an Electronic Medical Record, together with the Electronic Birth Certificate and the development of the Electronic Vaccination Card, within the National Digital Strategy, under the responsibility of Alejandra Lagunes, but everything was in the inkwell, because so far there is no initiative in Mexico on this issue.

The Economist document reflects that among nine countries analyzed in Latin America, six are ready to decide how to implant personalized medicine, while Mexico is at a second level, which implies “strengthening the bases”, a place that occupies together with Chile.

The biggest backwardness is in Peru and Ecuador, which, according to the study, are “beginning the journey”.

Julio Castrejón Saráchaga, Pure Storage’s regional director for Mexico, highlights that the implementation of the technology allows complete patient information to be shared in milliseconds to improve care between different areas of the hospital or between different hospitals.

IN A SLOW RHYTHM

Mexico began the journey to personalized medicine almost 30 years ago, when the government modified the Official Mexican Standard (NOM) 168 to allow medical records to be captured in magnetic, electromagnetic or telecommunications media.

This was the first step towards the Electronic Medical Record, but the Telecommunications Reform elevated the State’s obligation to create this instrument to improve service to Mexicans to constitutional status.

The transitional article 14 of the reform approved in 2013 establishes the Electronic Health Record (ECE) as part of the Universal Digital Inclusion Policy.

The law of each patient, by law, must be kept for five years to carry out a comprehensive monitoring of their health.

According to the Ministry of Health, this file is “a set of information stored electronically with a focus on the patient. It documents the medical care provided by health professionals according to health regulations, within a health unit ”.

However, in most public health centers, such as the Mexican Social Security Institute (IMSS) or ISSSTE, the largest service centers, records are still captured manually or, at best, with a typewriter.

In addition, President Andrés Manuel López Obrador’s Digital Inclusion Agenda does not consider stimulating strategies that promote electronic medical records in the public sector.

The companies providing the service do not have access to hospital information and have unbreakable security protocols for accessing the informationJulio Castrejón / Managing Director of Pure Storage in Mexico

In the midst of the pandemic, technology allows faster access to information about patients in general, both in health and in any other niche, said Julio Castrejón Saráchaga, regional director of Pure Storage for Mexico.

“There has been a dramatic increase in the need to serve people remotely, not only directly in the health sector, but in everything around it, especially in isolation,” he commented in an interview with El Sol de México.

The Economist study points out that the lack of political will is one of the main problems for the development of personalized medicine.

“The implementation of personalized medicine in entire populations requires vision and commitment; a good example of this is the Precision Medicine Initiative launched in the United States in 2015. However, the experts interviewed for this study indicate that this political will is often absent in many of the countries that make up the study ”.

For health care workers, the document adds, personalized interventions are not solutions to the most pressing health problems.

“Demonstrate that certain interventions can be economical in an economy of governance, awareness and attitudes, infrastructure, financial management, political will, attitudes and skills of the workforce, information systems and data collection, financing and reimbursement, also as a strategy, regulation, or laboratory tests and recognition of emerging market value, and that others may even assume cost savings, will be the quickest way to involve decision makers ”, research by The Economist Intelligence Unit abounds.

PAPER PROGRESS

In 2010, NOM-024 was adjusted, which regulates Electronic Health Record Systems, whose objective “is to reduce redundant treatments and prevent medical errors, which may impact the number of lives saved in health institutions, reducing the costs of medical care in them” .

The implementation of the technology, says Julio Castrejón, allows remote, fast service and with consumption models that adapt to the needs of each public or private hospital.

The director of the company specializing in cloud storage says that the systems that are available allow remote access to the medical information of patients who enter these platforms.

“When everyone has to be at home, this represents a major challenge, as it is necessary to increase the infrastructure quickly, resistant and easy to use,” said the manager.

Technological solutions do not consume the necessary storage space for paper, which means savings and generates more accessible costs for the public and private sector, says Julio Castrejón.

One of the main concerns around electronic information management is security and confidentiality.

In this sense, the NOM-24 of 2010 states that the Electronic Health Record Systems “must guarantee the confidentiality of the patients’ identity, as well as the integrity and reliability of the clinical information and establish the pertinent and adequate security measures to prevent the illicit use or illegitimate law that could harm the legal sphere of the information holder ”.

“If a patient arrives, the hospital raises a history that generates a file with the medical record and the companies that provide the service do not have access to the hospital’s information and have unbreakable security protocols for accessing the information”, guarantees privacy, says Castrejón.

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