How ICT Enables Personalized Medicine

HOW ICT ENABLES PERSONALIZED MEDICINEJohn Sharp, MSSA, PMP, FHIMSSSenior Manager, Personal Connected Health Alliance, HIMSS

@JohnSharp

Objectives

1. Defining Personalized Medicine and Precision Medicine2. What parts of this strategy are available now and what is

coming in the near future – IBM Watson and more3. Why the Electronic Medical Record is not ready for

Personalized Medicine and what to do about it4. Precision medicine in oncology and rare diseases – current

examples5. What will be the impact of personalized medicine on

healthcare organizations? How will it affect workflow for physicians and the healthcare team?

6. How to get ready for Personalized/Precision Medicine

DEFININGPERSONALIZED MEDICINEAND PRECISION MEDICINE

Defining Personalized Medicine

• Personalized Medicine is an older term with a meaning similar to precision medicine

• there was concern that the word “personalized” could be misinterpreted to imply that treatments and preventions are being developed uniquely for each individual

• in Precision Medicine, the focus is on identifying which approaches will be effective for which patients based on genetic, environmental, and lifestyle factors

• some people still use the two terms interchangeably.• http://

ghr.nlm.nih.gov/handbook/precisionmedicine/precisionvspersonalized

US Precision Medicine Initiative• President Obama announced

January 30, 2015• To enable a new era of medicine

through research, technology, and policies that empower patients, researchers, and providers to work together toward development of individualized treatments.

• Technology to support the storage and analysis of large amounts of data, with strong security safeguards.

• Novel analytics to help combine diverse data sets with appropriate privacy and security protections to answer precision medicine questions.

WHAT PARTS OF THIS STRATEGY ARE AVAILABLE NOW AND WHAT IS COMING IN THE NEAR FUTURE?

IBM Watson and more

IBM Watson and

Cognitive Computing

IBM Waston

Cognitive computing applied to Clinical Decision Support

The road toward artificial intelligence

IBM Watson Paths

Also gives level of confidence in the results

WHY THE ELECTRONIC MEDICAL RECORD IS NOT READY FOR PERSONALIZED MEDICINE

and what to do about it

http://www.syapse.com/products/capabilities/

Yes

PRECISION MEDICINE IN ONCOLOGY AND RARE DISEASES

current examples

http://cisncancer.org/research/what_we_know/omics/personalized_medicine_07.html

Breast Cancer as a treatment model

Treatment based on – Hormone receptor status (used to make decisions about the

use of hormone therapy)– HER2 receptor status (used to make decisions about the use of

the targeted therapy trastuzumab or other anti-HER2 drugs)– Oncotype Dx® is a tool that looks at a set of 21 genes in

tumor tissue to help estimate the potential benefit of chemotherapy in people with estrogen receptor-positive breast cancers. 

– https://ww5.komen.org/BreastCancer/PrecisionMedicine.html

http://cisncancer.org/research/what_we_know/omics/personalized_medicine_07.html

Pharmacogenomics and Personalized Medicine

PreCISE-Rx Pharmacogenomics-guided Care

• At University of Pittsburgh Medical Center• when the cath team places a stent to

reopen a blocked heart artery, a blood sample is drawn for testing at a specialized lab

• test determines if the patient carries certain variants of a drug metabolism gene that can prevent the antiplatelet medication clopidogrel from working properly

IMPACT ON HOSPITALS

And physician workflow

Health Systems developing Centers for Precision

Medicine• Geisinger Medical Center - Pennsylvania• Stanford Medical Center – California• University of Utah, Salt Lake City, Utah• Mt. Sinai School of Medicine, New York City• University of Arizona

Need to define a strategy• Begin with Oncology – Breast cancer gene

testing• Pharmacogenomics – based on what kinds

of patients you are treating• Develop a healthcare analytics program –

be able to analyze your EMR data and then include genomic data

NEED TO EDUCATE PATIENTS ABOUT PRECISION MEDICINE

HOW TO GET READY FOR PERSONALIZED/PRECISION MEDICINE

Getting Ready1. Learn more about how others are

implementing precision/personalized medicine2. Begin in areas where you have strengths –

oncology, rare diseases, pharmacy3. Build a program or a center4. Collaborate with other centers5. Understand your government’s incentives,

programs that will support your work

Health IT Role• Store data securely – EMR, genomic,

patient generated data• Analytics tools• More trained analysts and data

scientists• Be at the table during planning,

execution

Conclusions• Personalized medicine and Precision Medicine are

sometimes used interchangeably but Precision is currently more popular

• Precision Medicine is in its early stages but being boosted by government support in the US

• Big data analytics like IBM Watson is a key component• Showing some effectiveness in certain cancers where

cells are more sensitive to specific chemotherapy agents

• Also being used in rare diseases, cardiology and others

• Beginning a program of your own requires careful planning and funding

Sessions• Precision Medicine in the Information Age

March 2, 2016 — 08:30AM - 09:30AM PT• Advancing Health Equity through

Precision Medicine and HIT InnovationMarch 2, 2016 — 08:30AM - 09:30AM PT

THANK YOU!John SharpSenior Manager, Personal Connected Health [email protected]@JohnSharp