Digital health Personalized medicine Switzerland. Christian Lovis MD MPH

Transcription

1 Digital health Personalized medicine Switzerland Christian Lovis MD MPH

2 THE PERSONALIZED HEALTH CHALLENGE THE DATA DRIVEN SCIENCE

3 THE PERSONALIZED HEALTH CHALLENGE CONVERGENCE AND COLLABORATION Research Care Health Environment Genome & *Omics Phenotype Ecosystem Biology, Engineering, medicine, mathematics, IT, ethics, humanities, linguistics, etc

4 SWISS PERSONALIZED HEALTH NETWORK INITIATIVE Concept 2015 Plan 2016 Structure 2017 Start 1) Personalized Health. Report to discuss options and frame for a new Swiss Initiative. - By an interdisciplinary and inter-institutional working group, June ) Konzept Nationale Förderinitiative: Systems Medicine Personalized Health. - 1st SERI commissioned Report by Working Group 1, September ) Interoperability of clinical and omics data in Switzerland - 2nd SERI commissioned Report by Working Group 2, February ) Setting up an Organisational Structure until end of rd SERI commissioned Working Group 3 Peter Meier-Abt

5 Translatio nal Research Platform T e c h n o l o g y ( * o m i c s, I T, B I X ) C l i n i c a l R e s e a r c h B i o b a n k i n g Clin ical Bio inf or ma tics (cli nic al dat a) Translational Research Platform Tech nolo gy (*om ics, IT, BIX) Clinica l Resear ch Bioba nking ETHZ Translational Research Platform Technology (*omics, IT, BIX) Clinical Research Biobanking Clinical Bioinformatics (clinical data) Translatio nal Research Platform T e c h n o l o g y ( * o m i c s, I T, B I X ) C l i n i c a l R e s e a r c h B i o b a n k i n g Cli nic al Bio inf or ma tics (cli nic al dat a) Translational Research Platform T e c h n o l o g y ( * o m i c s, I T, B I X ) C l i n i c a l R e s e a r c h B i o b a n k i n g Cl in ic al Bi oi nf o r m at ic s (c li ni c al d at a) Translational Research Platform Technology (*omics, IT, BIX) Clinical Research Biobanking Clinical Bioinformatics (clinical data) Swiss TPH Interdisciplinary Steering Board (Central Administration Office) Data Coordinating Center Peter Meier-Abt SWISS PERSONALIZED HEALTH NETWORK INITIATIVE DISTRIBUTED NETWORK OF REGIONAL CLINICAL DATA CLUSTERS Interdisciplinary Executive Board (Central Administration Office)

6 SWISS PERSONALIZED HEALTH NETWORK INITIATIVE FUNDING SCHEME >2020

7 NATIONAL REGULATORY FRAMEWORK CARE SYSTEM FEDERAL LAW FOR THE SHARED PATIENT RECORD

8 NATIONAL REGULATORY FRAMEWORK CARE SYSTEM DISTRIBUTED GRID OF CERTIFIED COMMUNITIES OF CARE PROVIDERS P I canton A P I canton B Unique patient ID Decentralized docs repository Centralized services for HPI P I services P I Org. 1 R D canton R D services R D physician R D hospital I B physician I B hospital I B services I B outpatient I B pharmacy Identification patient - Rules, laws Standards & infrastructure Identification professionals portals gestion Other processes des droits A B C D Decentralized storage Insurers, research, etc

9 NATIONAL REGULATORY FRAMEWORK CARE SYSTEM INTERNATIONAL STANDARDS OF INTEROPERABILITY IHE driven process and methodology IHE XCA-XDS profiles HL7- CDA data models LOINC and SNOMED CT semantics

10 PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?

11 PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?

12 PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?

13 PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?

14 PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION? Information tsunami ~4 000 papers indexed/day

15 PERSONALIZED MEDICINE A GLOBAL CHALLENGE HEALTH AND CITIZEN CENTRED PARADIGM

16 PERSONALIZED MEDICINE A GLOBAL CHALLENGE HEALTH AND CITIZEN CENTRED PARADIGM

17 PERSONALIZED MEDICINE A GLOBAL CHALLENGE HEALTH AND CITIZEN CENTRED PARADIGM

18

19 PERSONALIZED MEDICINE A GLOBAL CHALLENGE CONNECTED NEEDS Genomics Bigdata Personalized health Knowledge management Phenotype Artificial intelligence

20 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE OF THE SWISS REGIONAL COLLABORATIVE APPROACH

21 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY BUILDING THE DATA DRIVEN SCIENCE HEALTH DETERMINANTS

22 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY PHENOTYPIC DATA

23 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY PHENOTYPIC DATA Regional cluster ~6 000 beds I2B2

24 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA > Lab > OE

25 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA > Lab > OE > Facts

26 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA Pain Finding site Severity Thumb structure Severe Laterality Left > Lab > OE > Facts > docs > images/day pain : finding site = ( thumb structure : laterality = left ), severity = severe Courtesy Stefan Schulz

27 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA coding ICD coding ICPC ENGLISH FRENCH German Human language coding etc machine language SNOMED CT coding ATC coding ICNP

28 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE

29 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE DebugIT vs EARS-Net European Antimicrobial Resistance Surveillance Network (EARS-Net) Gray dashed lines indicate Δ = ±0.130 Gray horizontal bars indicate two one-sided convolution confidence interval (CI). 95% CIa (P <.001); 95% CIb (P <.001).

30 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE

31 PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY CAMPUS BIOTECH LARGEST SWISS R&D PUBLIC PRIVATE INITIATIVE CERN of Neurosciences Digital and Global Health 40,000 m² researchers Startups Industries

32 PERSONALIZED MEDICINE CONCLUSION ALL DATA: NO BAD DATA ONLY SIGNALS Encompass all data, a new paradigm of approaching evidence Structured Unstructured Streaming Big Data = all data Quality cannot be improved, deal with what you have Data is flowing without stop, needs realtime analytics

33 PERSONALIZED MEDICINE CONCLUSION CONVERGING ACTIONS TO BUILD INDIVIDUAL AND GLOBAL VALUE Value for me

34 PERSONALIZED MEDICINE CONCLUSION NUMEROUS SCIENTIFIC CHALLENGES Interoperability semantics Privacy Streamed Data Distributed incremental Analytics

35 Messerli FH. Chocolate consumption, cognitive function, and Nobel laureates. N Engl J Med Oct (16): PubMed PMID: