The Age of Personalized Medicine Moves Research to the Bedside

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23 Οκτ 2013 (πριν από 3 χρόνια και 7 μήνες)

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The Age of Personalized Medicine
Moves Research to the Bedside


The UPMC Strategic Framework

Steven D. Shapiro M.D.

Executive Vice President, UPMC

Chief Medical and Scientific Officer

President, Physicians Services Division


Greatest
challenge:


Aging population, increasing chronic disease


Costs are spiraling


But also a great
opportunity
with
revolutions in science and technology

The way forward for UPMC


Develop
New Models of Clinical Care


Based upon
Big Data
and

Big Science


Leading to improved to
Personalized
Care

Healthcare is at a Pivotal Juncture in History

UPMC’s Global Academic Integrated Delivery
and Finance System (IDFS)

IDFS structure promotes high quality, low cost care and unleashes
innovation while others live “Life in the Gap”

Insurance
Services

International and
Commercial Services

Physician
Services


21+ hospitals


234,000
admissions


>4.8M
outpatient
visits


3,321 employed


>5,500 total


2.0 M
members


Hospitals:
Italy
, Ireland


and others

55,000 employees, $10B Revenue

Enterprise Services

Oracle

Informatica

Hospital and

Community
Services

The UPMC
Strategic Framework

Smart
Technology

Big Data

New
Models
of
Care

Improved Outcomes
-

Cost Effective

Good
Science

Big Science

Patient

Self
-
management

Re
-
engineer
Discharge

Palliative /

Support Care

Hospice

Medical
Neighborhood

Specialty Care

Telehealth

Personalized

Medicine

Care Pathways /
Analytics

Medical Home

Primary Care
Team

Hospital

Emergency
Department

ICU

Hospice

New Models of Care: System Re
-
Design

Coordinated,
Continuous
, Patient
-
Centered Care




Skilled Nursing
Facilities


Supporting
Finance


Horizontal
Analysis




Cost
Accounting



Bundling

Smart Technology…


…Bringing Intelligence to Information

Enterprise
-
Level Data Warehouse

Delivering real
-
time data to the bedside

Enterprise Analytics


Deliver better outcomes/optimize cost


Develop new models of care


Enable the center for innovative science

Aggregate
data into central data warehouse:

Cerner, Epic, Peoplesoft, HealthPlaNET, etc.

Harmonize structured data (db
Motion
)

and unstructured data (Nuance
)

Ingest over 200 data sources

Make digital information usable

Advanced data mining

Ask new questions

Clinical
Data
(
Provider)

Financial

Genetics

Genomics

Population Data
(Payer)

Big Data and Big Science for Appropriate
Variation in Care and Personalized Medicine

Clinical Redesign

DECREASE variation in population care

Personalized Medicine

INCREASE variation in individual care

Big Science

omics


+

Systems Biology

Go from “Syndrome” to precise individual network

Big Data
Analytics

Time: Growth and
Development, Adult Aging

HOST

Framework for Good Science


Personalized Medicine

Environment

D
iet
, infection,
smoking
,
pathogens…

INDIVIDUAL DISEASE

Susceptibility
, Course, Treatment
response

Biomarkers

Individualized care, Prevent
OverDx
/Rx

Basic science,
Drug discovery

Discover new treatment for

aggressive disease

Prostate, Breast CA Examples

Genetics

Bioinformatics/

Systems Biology

Better Personalized Medicine

Genomic
Tests


DNA, RNA

Hyperplexed
Pathology

Patient Stratification,

Diagnostic/Prognostic Tests

& Companion Diagnostics

Patient
Samples

Proteomics Tests

VOL., CLX … No. 55,495

SATURDAY, JULY 7, 2012

IN GENE SEQUENCING TREATMENT FOR
LEUKEMIA, GLIMPSES OF THE FUTURE

Where are the Innovators in Health Care?



Integrated global delivery
system


Academic partner


Commercialization engine


Unleashes innovation

“…bad business model preventing innovation”

C. Christenson, Harvard Business School


The Center of Advanced
Genetic/Genomic,
Computational Biology Research



Leading to Personalized
Medicine at the Bedside



Unleashing Unlimited
Commercial Opportunities and
Industry Partnerships around
Health IT, Personalized Drug
Therapy, and New products not
yet imagined

The
Fondazione

Ri.MED

Biomedical
Research and Biotechnology Center


17

Oracle

Informatica

1. First bring the problem to the solution 2. Then bring the solution to the problem

The General Process of Becoming
Affordable and Accessible

Copyright Clayton M. Christensen

Minicomputers

Desktops

Laptops

Smartphones

1. First bring the problem to the solution 2. Then bring the solution to the problem

The Decentralization That Follows Centralization
is Only the Beginning of Healthcare

Specialist Physicians

Nurse Practitioners

Pharmacists

Family
Care

Personal Physicians

Clinics

Retail Clinic

Homes

Offices

Imaging:

MRI, CT, PET Scanners

High
-
speed,

Multi
-
Channel Testers

Surgical Suites

20


Center for Innovative Science

Areas of research focus include:


Personalized Medicine




-

Core to enable campus


Cancer Biology



Biology of Aging






The
Fondazione

Ri.MED

Biomedical
Research and Biotechnology Center

Carini
, Italy