2023-09-24 16:19:43
In a embryonic phase. This is how you find the National Health Data Space, also called Sanitary Data Lake. This ambitious project aims to collect information from the different regional information systems, allowing its massive analysis for the identification and improvement of diagnoses and treatments, as explained by the Ministry of Health. However, scientific societies are not within this plan, and they might be one of the main sources of information.
With this project, Spain wants to adapt to what Europe dictates and exploit all the informative power of health data, a process known as Real World Data (RWD) and its derivative Real World Evidence (RWE). Within it, there is, for example, the digital medical history. All of this is framed in the Digital Health Strategy of the National Health System (SNS) and for which the Ministry of Economy and Digital Transformation has recently announced the next tender of 45 million euros.
However, this space will only be the tip of the iceberg. Inside it there must be many structures that give it shape, for example, the Electronic Health Records. As Andrés García, coordinator of the Results Evaluation and Clinical Practice Section of the Spanish Society of Medical Oncology (SEOM), explains, evolution of the practice of medicine is transforming clinical information into a much broader concept called health information.
“Almost everything remains to be done. We are still in the electronic medical record phase, which in most of the SNS is not prepared to create an automated workflow. There are some very interesting software initiatives that can extract data and analyze information, but they are mostly private, involve a high additional cost in many cases, do not ensure interoperability and leave many chiaroscuros in terms of data security. I don’t think that’s the way if we want to create a National Space“, reports García.
In this sense, there is not only the pathobiological data, but also the data provided by different health professionals (not only doctors), together with socio-health information and, in the future, the derived from mobile devices, creating the so-called Electronic Health Records. This, without a doubt, is a step further: “They are individual and interoperable records framed in an electronic ecosystem whose conception goes beyond the mere clinical-care function, allowing collect, store and analyze data for clinical research purposes in the RWD framework,” says García, who adds that it would be a first stage to establish the National Disease Registries.
Specifically, for Oncology a National Cancer Registry with clinical and socio-health data that describe the socioeconomic and educational profile, work exposures, digital footprint and many other information from various sources such as biomedical sensorsassociation of readings from interaction with social media, health websites or smartphone applications.
“For its creation, it is basic National Health Data Space, whose architecture cannot be other than that of the data lake. Electronic Health Records and their previous format, the electronic medical record, are built with structured datathe minority, along with an immense majority of unstructured and semi-structured data in various formats,” explains the expert.
Phases of the National Data Space
Therefore, all this amount of health data requires a key process: automation. This should have two phases and the first would be, as García details, the Structured data flow in real time and with minimal technical supervision. “These structured data already exist, you would only have to add the alphanumeric identifier, for example, combining the medical record number with the ICD classification of the diagnosis. Once the record is generated, the rest of the semi-structured and unstructured data would flow into a centralized storage with data lake structure (data lake)”, he comments.
While the second phase would be the conversion of raw data into RWD, which would imply the participation of the paradigma Big Data and applications of Artificial Intelligence (AI). It is at this moment where scientific societies take on great prominence, since “they risk the information extracted is relevantactionable and constitutive of reliable evidence”.
In this case, it would be regarding defining RWD research projects with the capabilities and functionalities necessary to align the data lake technological structure with the initiatives that they wish to carry out. “These projects should always be analyzed by scientific societies guarantors that the procedure that is going to be initiated can provide relevant information and that the research team has the sufficiency to tackle the project,” he comments.
Therefore, generating this model would be the starting point of the digital transformation of health services, since predictive information on the future evolution of healthcare work would be derived from the results obtained. “Almost everything needs to be done. We are still in the phase of the electronic medical record, which in most of the SNS is not ready to create an automated flow of work. There are some very interesting software initiatives that can extract data and analyze information, but they are mostly private, involve a high additional cost in many cases, do not ensure interoperability and leave many chiaroscuros in terms of data security. I don’t think that is the way if we want to create a National Space,” García reports.
Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any health-related questions be consulted with a healthcare professional.
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