Dr Joan Comella has dedicated most of his career to innovation. He was director of the Vall d'Hebron Research Institute (VHIR) and is currently head of Research and Development at the prestigious SJD Barcelona Children's Hospital, one of the leading paediatric hospitals in Europe. He is also a member of the Advisory Board of the UOC's eHealth Center. In this interview he gives us his vision of the state of innovation in the health sector and in Catalonia and Spain.
 

How do you see the state of innovation in health in hospitals in our country?

The innovation ecosystem in the hospital environment has seen significant improvements in recent years, thanks to technological development and the hard work of centres and universities, and initiatives promoted by organizations such as the Carlos III Institute of Health (ISCIII), for all Spain, or the Centre for the Development of Industrial Technology (CDTI), in Catalonia. Specific aid from national and European funds has also helped.

Structures to support innovation, both inside and outside hospitals, have been developed, making it possible to transfer research results to the market, create an innovative culture and begin to generate an innovation ecosystem, with the creation of start-ups and spin-offs, investment funds, accelerators and other forms of support for innovation.
 

What challenges does this innovation system face?

The ecosystem is immature and there's an imbalance between the different autonomous communities. We have a lot of talent in this country and top-class research at international level, but in innovation we're behind. The challenges include retaining talent and transforming knowledge into solutions that have an impact and reach the market, generating economic progress and jobs. And ensuring that they're adopted by the health system.
 

And what difficulties do entrepreneurs who innovate encounter?

Firstly, they lack funding to be able to tackle the process of developing and clinically validating solutions. And there is also the regulatory process, which in Europe is complex and costly. Moreover, European health systems all have different rules, making it difficult for their products to gain a foothold. Another challenge they face is the difficulty of finding and retaining talent.

What advice would you give to innovators to make it easier for their products to enter the health system?

There are a few key points to bear in mind: innovations must be based on clinical needs that have not yet been met and they must add value with respect to the products already available on the market. It's easier for them to be adopted if they fall within existing product coding categories. A new product that is already certified normally takes about two years to enter the market.

To incorporate new solutions in the health system, we also have options such as innovative public procurement and pre-commercial public procurement. These are funding models that allow healthcare organizations and innovators to adopt shared risk models.

Previously, you led research at Vall d'Hebron Hospital. Currently you're facing this challenge at SJD Barcelona Children's Hospital. What objectives have you set yourself?

To improve the quality and efficiency of medical care, making it more patient-centred and based on scientific evidence. At the same time, we need to optimize the resources available. In this sense, initiatives such as telemedicine and out-of-hospital care – what we call the liquid hospital – will be priority areas for development.

Another objective is to promote innovation and research. We want to continue to be leaders in the development of new technologies and innovative medical practices, and to promote research into paediatric disorders, especially rare diseases.

We want to strengthen networking with other organizations to expand the impact of our activity and promote excellence in training health professionals at all stages, as well as educating our patients' families and caregivers. In short, to continue to be a benchmark in paediatric medical care with an ultimate goal: to improve the health and well-being of children and families.
 

As a teacher in the Faculty of Medicine at the Universitat Autònoma de Barcelona (UAB), do you think that future doctors are being well prepared to work in digital healthcare?

Although digital technologies are being incorporated in medical training, there are still aspects that can be reinforced. It is essential to include training in the use of digital tools, such as medical information management systems, telemedicine, and data analytics. We also need to promote skills such as technology management and the ability to adapt to technological innovations, which are constantly evolving in the field of health. This will ensure that future doctors are better prepared to take advantage of the opportunities presented by an increasingly digitalized healthcare system.
 

What technological advances do you think will make a difference in the world of healthcare in the short to medium term?

In the last twenty years, the development of technologies that allow us to see the mechanisms through which the body functions has sped up and, in this way, we've advanced in diagnostic systems and personalized treatment. The arrival of new information technologies, precision robotics, artificial intelligence and advanced therapies will allow us to personalize treatment more and enable us to predict diseases before they become evident.

The automation of data analysis and processing should also allow us to deal with administrative tasks more efficiently and help specialists to devote more time to the patient. Telemedicine and interconnected data management will allow for more integrated medicine in all areas of care, as well as enabling us to treat and monitor the patient remotely. We're already seeing some experiences of this type, such as our paediatric service's hospital-at-home project for chronic and palliative patients.
 

Finally, what do you think should be the role of the eHealth Center in the world of e-health solutions?

The eHealth Center has the potential to be a key player in the promotion and advancement of digital health solutions, helping to improve the quality, accessibility and efficiency of medical care. I think it can make a particularly valuable contribution to research into new digital solutions and their development, the implementation and evaluation of these solutions, professional development and training, and the dissemination of good practice in the field of digital health.