Trends nds i in Personaliz nalized ed Medicine icine Scot cott Jenki Jenkins, Ph. h. D. Vice e President ident Dell l Healt lthcar hcare e & Life Sciences nces
Time M me Magazine ine – Januar January 18, 18, 2010 2010 DELL CONFIDENTIAL
US US Healthca Healthcare System e System - 10,000+ hospitals, 750,000+ physicians – Employed (150K) Independent(300 Affiliated, 300 Unaffiliated) Hospita Hospita Sell to Hospital l 2 l 1 Employed (150k) Hospital, then Doc Affiliated (300K) Hospita Hospita l 5 l 3 Doc Hospita l 4 Independent (600K)
Private Exchanges – Single Stakeholder Primary goals of a private HIE: physic physicia ian attract attractio ion n and ARRA ARRA readin readines ess Governance a Governance and nd Project Management Office Project Management Office Design, D Design, Deployment, eployment, Hosting and Helpdesk Hosting and Helpdesk Support Support Confidential 4
Metcalf’ calf’s L Law 1 Metcalfe's law characterizes many of the network effects of communication technologies and networks such as the Internet, social networking, and the World 10 Wide Web. It is related to the fact that the number of unique connections in a network of a number of nodes (n) can be expressed mathematically as the triangular number n(n − 1)/2, which is proportional to n2 asymptotically. 66 DELL CONFIDENTIAL
SINGLE LE M Molecule cule 15 yrs 10 yrs 5 yrs DELL CONFIDENTIAL
Single M ngle Molecul cule 1 Tb - 30 Mins, HG = $20k 2yrs: 10 Tb - 30 Mins, HG =$1k
Patient ient C Centric L c LifeC eCar are Hospital BioBank Baby Genotype recorded Secure database Physician’s office Patient scenario Personalized immunization in the future + Screening • Improve Screening schedule based on quality of life + biomolecular • Increase life Preventive measures profiling span Drugs Refined treatment Life Adult Developed to target particular disease subtypes on particular genetic background Source: Science, Vol. 207, 17 March 2000 DELL CONFIDENTIAL
Today ay’s m medicine c icine challenge: llenge: One si ne size doesn’ e doesn’t f fit al all DELL CONFIDENTIAL
Large Lar ge pat patien ent net netw orks w w ill enabl enable target eted t ed treat atment nts GCCCGCCTC Diagnostics/Biomarkers GCCCACCTC Drug Metabolism Governments and academic medical centers building ‘biobank’ repositories of samples and information. DELL CONFIDENTIAL
What hat is s at at st stake? ake? Top op Globa obal 15 15 Produ oducts Data from IMS HEALTH: http://www.imshealth.com/deployedfiles/imshealth/Global/Content/StaticFile/Top_Line_Data/Global_Top_15_Products.pdf Note: Lipitor loses patent exclusivity in 2011 – Generic Drugs will be available 11
HIPAA & & Unint nten ended C ded Consequences equences How can family members of a deceased individual obtain the deceased individual's protected health information that is relevant to their ow n health care? Answer: Second ond, , a covered ed entity mu must treat a deceas ased ed indiv ividual’ idual’s legall gally The HIPAA Privacy Rule recognizes that a deceased individual’s author horiz ized ed execut utor or or adminis nistrator or, , or a person on w ho is other erw is ise e protected health information may be relevant to a family legally aut authorized to o act act on on the he behal behalf of of the he decea deceased indi ndividual or or member’s health care. The Rule provides two ways for a surviving his estate, e, as a personal onal repres esent entativ ive e w ith h respect ect to protect ected ed family member to obtain the protected health information of a healt lth h infor orma mation ion relevant ant to such ch repres esent entation. ion. deceased relative. Theref efor ore, e, if it is w ithin in the scope e of such ch personal onal repres esent entativ ive’ e’s First, disclosures of protected health information for treatment aut authority unde under ot other her law, the he Rul ule e per permits the he per personal repr presentative purposes—even the treatment of another individual—do not to obtain ain the informa mation ion or provide de the appropr opria iate e author oriz ization ion for require an authorization; thus, a covered entity may disclose a its disclos losur ure. e. decedent’s protected health information, w ithout authorization, to the health care provider w ho is treating the surviving relative. DELL CONFIDENTIAL
Previv ivor or - Cancer Free at 33, but Weighing a Mastectomy Personalized Medicine - Biomarkers •Family History of Cancer Breast/Ovarian/Colon •Mother recovering from Chemotherapy •Asymptomatic for pre-cancerous cells •Positive for BRAC-1 Diagnostic Monitoring •Mammography Search NYTimes Archive 2007 = “previvor” •Breast MRI •Breast Ultrasound •Ovarian Ultrasound w/CA-128 Blood Test Preventative Measures http://www.nytimes.com/2007/09/16/health/16gene.html?_r=1 •Prophylactic oophoectomy •Prophylactic Mastecomy Source: NY Time, Sep 16, 2007 •Tamoxifen DELL CONFIDENTIAL
Getting t ing the R Right ht S Statin in Dia iagnos nosed: d: High h Choles lester erol ol He e tried ed Les Lescol col tw ice, b but ut it di didn dn’t Novartis CEO agree w e w ith h h him. Daniel Vasella “I have side effects on our ow n lipid-lowering drug,” he told the Health Blog “I don’t have them on Lipitor, so I take Lipitor. It’s funny but it’s true.” Health Blog WSJ's blog on health and the business of health DELL CONFIDENTIAL JANUARY 3, 2008, 9:23 AM ET
Fer Fertility y and and Genet enetic Test ests Basic Medicine •40 Yr Female •Healthy •No family history of fertility problems •Several Miscarriages •Full workup (Slightly High FSH) •Specialties have no definitive answers •3 IVF end in Miscarriage Personalized Medicine in Action •New Blood test for Key genetic markers (was included as an after thought) • Tested Positive for PAI - 1 (Plasminogen activator inhibitor-1) • Lovenox (Blood thinner) used to counteract natural mechanism DELL CONFIDENTIAL
What hat Happen appened? DELL CONFIDENTIAL
Thank You hank You
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