Digital health Personalized medicine Switzerland Christian Lovis MD MPH
THE PERSONALIZED HEALTH CHALLENGE THE DATA DRIVEN SCIENCE
THE PERSONALIZED HEALTH CHALLENGE CONVERGENCE AND COLLABORATION Research Care Health Environment Genome & *Omics Phenotype Ecosystem Biology, Engineering, medicine, mathematics, IT, ethics, humanities, linguistics, etc
SWISS PERSONALIZED HEALTH NETWORK INITIATIVE 2017-2020 2014 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 2014. 2) Konzept Nationale Förderinitiative: Systems Medicine Personalized Health. - 1st SERI commissioned Report by Working Group 1, September 2014. 3) Interoperability of clinical and omics data in Switzerland - 2nd SERI commissioned Report by Working Group 2, February 2015 4) Setting up an Organisational Structure until end of 2015-3rd SERI commissioned Working Group 3 Peter Meier-Abt
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)
SWISS PERSONALIZED HEALTH NETWORK INITIATIVE FUNDING SCHEME 2017 2020 >2020
NATIONAL REGULATORY FRAMEWORK CARE SYSTEM FEDERAL LAW FOR THE SHARED PATIENT RECORD - 2017
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
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
PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?
PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?
PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?
PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION?
PERSONALIZED MEDICINE A GLOBAL CHALLENGE SCIENCE OR FICTION? Information tsunami ~4 000 papers indexed/day http://dan.corlan.net/medline-trend
PERSONALIZED MEDICINE A GLOBAL CHALLENGE HEALTH AND CITIZEN CENTRED PARADIGM
PERSONALIZED MEDICINE A GLOBAL CHALLENGE HEALTH AND CITIZEN CENTRED PARADIGM
PERSONALIZED MEDICINE A GLOBAL CHALLENGE HEALTH AND CITIZEN CENTRED PARADIGM
PERSONALIZED MEDICINE A GLOBAL CHALLENGE CONNECTED NEEDS Genomics Bigdata Personalized health Knowledge management Phenotype Artificial intelligence
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE OF THE SWISS REGIONAL COLLABORATIVE APPROACH
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY BUILDING THE DATA DRIVEN SCIENCE HEALTH DETERMINANTS
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY PHENOTYPIC DATA
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY PHENOTYPIC DATA Regional cluster ~6 000 beds I2B2
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA > 130 000 000 Lab > 30 000 000 OE
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA > 130 000 000 Lab > 30 000 000 OE > 1 000 000 000 Facts
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY MEANINGFUL ACTIONABLE DATA Pain Finding site Severity Thumb structure Severe Laterality Left > 130 000 000 Lab > 30 000 000 OE > 1 000 000 000 Facts > 30 000 000 docs > 300 000 images/day 22253000 pain : 363698007 finding site = (76505004 thumb structure : 272741003 laterality =7771000 left ), 246112005 severity =24484000 severe Courtesy Stefan Schulz
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
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE
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 0 0.030 (P <.001); 95% CIb 0.002 0.026 (P <.001).
PERSONALIZED MEDICINE THE LEMANIC HEALTH VALLEY EXAMPLE
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 1 500 researchers Startups Industries
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
PERSONALIZED MEDICINE CONCLUSION CONVERGING ACTIONS TO BUILD INDIVIDUAL AND GLOBAL VALUE Value for me
PERSONALIZED MEDICINE CONCLUSION NUMEROUS SCIENTIFIC CHALLENGES Interoperability semantics Privacy Streamed Data Distributed incremental Analytics
Messerli FH. Chocolate consumption, cognitive function, and Nobel laureates. N Engl J Med. 2012 Oct 18 367(16):1562-4. PubMed PMID: 23050509