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      Propelling Health Care into the Twenties

      editorial
      a , * , b , c , a , d , e , f , g , h , i , j , k , l , m , n , o , p , q , r , s , t
      Biomedicine Hub
      S. Karger AG
      Health policy, regulatory, Member states, Innovation, European Commission, Incentives, Personalised medicine, Precision medicine, Preventive medicine, Public health, Pharmacoeconomics, Health economics, Frameworks, Reimbursement, Personalised health care, Diagnostics, Biomarkers, optimal, Real-world data, Data-translational research, Empowerment patient, Citizens, Access

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          Abstract

          The scope and potential of personalised health care are underappreciated and underrealised, often because of resistance to change. The consequence is that many inadequacies of health care in Europe persist unnecessarily, and many opportunities for improvement are neglected. This article identifies the principal challenges, outlines possible approaches to resolving them, and highlights the benefits that could result from greater adoption of personalised health care. It locates the discussion in the context of European policy, focusing particularly on the most recent and authoritative reviews of health care in the EU Member States, and on the newly acquired spirit of readiness and pragmatism among European officials to embrace change and innovative technologies in a new decade. It highlights the attention now being given by policymakers to incentives, innovation, and investment as levers to improve European citizens’ prospects in a rapidly evolving world, and how these distinct and disruptive themes contribute to a renaissance in thinking about delivering optimal health care in Europe. It explores the chances offered to patients by specific initiatives in health domains such as cancer and antimicrobial resistance, and by innovative science, novel therapies, earlier diagnosis tools, and deeper understanding of health promotion and prevention. And it reflects on how health care providers could benefit from a shift towards better primary care and towards deploying health data more effectively, including the use of artificial intelligence, coupled with a move to a smoother organisational/regulatory structure and realigned professional responsibilities. The conclusion is that preparing Europe’s health care systems for the inevitable strains of the coming years is both possible and necessary. A more courageous approach to embracing personalised health care could guarantee the sustainability of Europe’s health care systems before rising demands and exponential costs overwhelm them – an exercise in future-proofing, in ensuring that they are equipped to withstand whatever lies ahead. A focus on the potential and implementation of personalised care would permit more efficient use of resources and deliver better quality health-preserving care.

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          Most cited references6

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          A P5 cancer medicine approach: why personalized medicine cannot ignore psychology.

          A system approach termed P4 medicine has recently been proposed in the field of oncology. This approach has been advanced as an extension of what is usually called 'personalized' or 'genomic medicine'. P4 medicine creates effective predictive, personalized, preventive and participatory models to treat patients. In order to give more relevance to the behavioural component that impinges on the way individuals act to prevent, cope and react to illnesses, how they decide between different therapeutic options and interact with physicians and adhere to treatment, we propose that P4 medicine should be transformed into P5 medicine. The fifth P represents the psycho-cognitive aspects to be considered in order to empower the patient, increase his/her quality of life and transform him/her from a passive recipient into an active decision-maker in the treatment process. © 2011 Blackwell Publishing Ltd.
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            Is Open Access

            Building Capacity and Training for Digital Health: Challenges and Opportunities in Latin America

            Tackling global health challenges demands the appropriate use of available technologies. Although digital health could significantly improve health care access, use, quality, and outcomes, realizing this possibility requires personnel trained in digital health. There is growing evidence of the benefits of digital health for improving the performance of health systems and outcomes in developed countries. However, significant gaps remain in resource-constrained settings. Technological and socio-cultural disparities between different regions or between provinces within the same country are prevalent. Rural areas, where the promise and need are highest, are particularly deprived. In Latin America, there is an unmet need for training and building the capacity of professionals in digital health. This viewpoint paper aims to present a selection of experiences in building digital health capacity in Latin America to illustrate a series of challenges and opportunities for strengthening digital health training programs in resource-constrained environments. These describe how a successful digital health ecosystem for Latin America requires culturally relevant and collaborative research and training programs in digital health. These programs should be responsive to the needs of all relevant regional stakeholders, including government agencies, non–governmental organizations, industry, academic or research entities, professional societies, and communities. This paper highlights the role that collaborative partnerships can play in sharing resources, experiences, and lessons learned between countries to optimize training and research opportunities in Latin America.
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              Public-private integrated partnerships demonstrate the potential to improve health care access, quality, and efficiency.

              Around the world, publicly owned and run health services face challenges. In poor countries in particular, health services are characterized by such problems as inadequate infrastructure and equipment, frequent shortages of medicines and supplies, and low quality of care. Increasingly, both developed- and developing-country governments are embracing public-private partnerships to harness private financing and expertise to achieve public policy goals. An innovative form of these partnerships is the public-private integrated partnership, which goes a step further than more common hospital building and maintenance arrangements, by combining infrastructure renewal with delivery of clinical services. We describe the benefits and risks inherent in such integrated partnerships and present three case studies that demonstrate innovative design. We conclude that these partnerships have the potential to improve access, quality, and efficiency in health care. More such partnerships should be launched and rigorously evaluated, and their lessons should be widely shared to guide policy makers in the effective use of this model.
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                Author and article information

                Journal
                BMH
                BMH
                10.1159/issn.2296-6870
                Biomedicine Hub
                S. Karger AG
                2296-6870
                2020
                May - August 2020
                27 May 2020
                : 5
                : 2
                Affiliations
                [_a] aEuropean Alliance for Personalised Medicine, Brussels, Belgium
                [_b] bBioCampus, Institute of Global Health, University of Geneva, Geneva, Switzerland
                [_c] cCIHR Institute of Genetics, Ottawa, Ontario, Canada
                [_d] dThe European Institute for Innovation through Health Data (i-HD), Gent, Belgium
                [_e] eQueen’s University Belfast, Belfast, United Kingdom
                [_f] fIRCCS Istituto Nazionale Tumori Regina Elena, Rome, Italy
                [_g] gUZ Leuven, Leuven, Belgium
                [_h] hIstituto dei Tumori Giovanni Paolo II, Bari, Italy
                [_i] iErasmus MC, Rotterdam, The Netherlands
                [_j] jDepartment of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
                [_k] kApplied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
                [_l] lEstonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
                [_m] mDepartment of Biomedical Sciences, Humanitas University, Milan, Italy
                [_n] nLaboratory of Onco-Haematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
                [_o] oSezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italy
                [_p] pDepartment of Woman and Child Health and Public Health – Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
                [_q] qCancerCore Europe, Paris, France
                [_r] rDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA
                [_s] sBulgarian Alliance for Personalised and Precision Medicine, Sofia, Bulgaria
                [_t] tStockholm School of Economics (SSE), Stockholm, Sweden
                Author notes
                *Denis Horgan, European Alliance for Personalised Medicine, Rue de l’Aqueduc 88, BE–1050 Brussels (Belgium), denishorgan@euapm.eu
                Article
                508300 Biomed Hub 2020;5:508300
                10.1159/000508300
                415b4971-9fa8-4a5a-830b-3bc522602f32
                © 2020 The Author(s) Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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                Figures: 20, Tables: 3, Pages: 53
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                Categories
                Editorial

                Oncology & Radiotherapy,Geriatric medicine,Cardiovascular Medicine,Clinical Psychology & Psychiatry,Public health
                Pharmacoeconomics,Frameworks,Public health,Precision medicine,Innovation,Preventive medicine,Access,Diagnostics,Empowerment patient,Biomarkers, optimal,European Commission,Personalised health care,Health economics,Member states,Citizens,Incentives,Personalised medicine,Health policy, regulatory,Real-world data,Data-translational research,Reimbursement

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