Personalized Medicine: Humanity s Ultimate Big Data Challenge. Rob Fassett, MD Chief Medical Informatics Officer Oracle Health Sciences

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1 Personalized Medicine: Humanity s Ultimate Big Data Challenge Rob Fassett, MD Chief Medical Informatics Officer Oracle Health Sciences

2 2012 Oracle Corporation Proprietary and Confidential 2

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4 Humanity and Big Data In 2010 we humans generated more bits of information than there are stars in the knowable universe. In 2009 humanity created more data than we have in all of human history.

5 Big Data and the Creative Reconstruction of Medicine Modality Megabytes HL7 CDA Doc Health Patient Chart 5 Chest Xray 16 MRI 45 PET Scan 100 Mammography 160 CT Scan (64 slice) 3,000 Genome (seq data only) 3,000++ Cellular Pathology Study 25, Oracle Corporation Proprietary and Confidential 5

6 The Rate Limit on Big Data for Healthcare What if we had to name every star according to the ancient constellation names? 2012 Oracle Corporation Proprietary and Confidential 6

7 With Our Big Data We Can Be Much More Precise 2012 Oracle Corporation Proprietary and Confidential 7

8 Creating the Healthcare Information Commons & Knowledge Network 2012 Oracle Corporation Proprietary and Confidential 8

9 DNA Sequencing is Just the Beginning of (Really) Big Omics Data DNA RNA Protein Metabolism You DNA Epigenetics RNA Proteomics Metabolomics Interactome Microbiome Connectome! 2012 Oracle Corporation 9

10 Huge Data: Monitoring Your Omics Profile Over Your Entire Lifetime 2012 Oracle Corporation 10

11 Somatic Darwinism: Cancer and the Survival of the Fittest Nucleic Acids 2012 Oracle Corporation 11

12 2012 Oracle Corporation 12

13 Your Doctor Should Must Be Your Friend! 2012 Oracle Corporation Proprietary and Confidential 13

14 Consumers are Engaging Remotely, Wirelessly 2012 Oracle Corporation 14

15 Analytics Throughout the Improvement Cycle Health Data From All Sources Big Data Warehouse Data Discovery Find Patients (Cohort Identification) Safety & Outcomes Measurement Enterprise Healthcare Analytics Hypothesis Generation & Comparative Effectiveness (Data Mining) Patient Engagement Analytics (Innovation in Data Visualization) Point of Care Tools (e.g. Predictive Analytics, Care Gaps, Bedside Data Mining) Performance Management (Reporting, Alerting, Nextgen Scorecarding)

16 Molecular Decision Support Nickolas Volker Treating each patient as if they are the average human is often not effective Must combine phenotype and genotype in the exam room Treating each person based on their uniqueness is a truly big data analytics challenge New tools are required for safe, high quality, cost effective, personalized medicine

17 Nicholas Volker After Treatment X-linked immunodeficiency Mutation in a gene coding for an apoptosis inhibitor Received an allogenic cord blood transfusion Living large: back to school and playing baseball & riding ATVs This is Big Data analytics in action at the bedside when it really matters!

18 2012 Oracle Corporation Proprietary and Confidential 18

19 Oracle s Precision Medicine Solution Patient s Data Biospecimen Data SpecimenID EHA Data Integration Integrated Clinical Data Oracle HDM Enterprise Warehouse SpecimenID Pre-built ETL +/- Deidentification Oracle Cohort Data Mart Phenotype + Genotype Oracle Cohort Explorer Sequencer Reference Data Sources Oracle Pre-built Loaders Oracle Omics DataModel De-identified cohorts Identified patient lists Available bio-specimens Bio-marker analysis Data export to Oracle R, SAS, etc & Other Sources Sequencer-independent Level 3 Omics & Reference Data Page 19

20 Tumor Board Molecular Decision Support UPMC is a nationally renowned integrated delivery system serving western Pennsylvania and a leader in innovative application of information technology UPMC is deploying the Oracle clinical and omics data warehousing and analytics solutions Application of the Oracle personalized medicine solution at UPMC: Tumor Board. The UPMC multidisciplinary oncology team will include informaticist support and have real time access to the rich clinical and omics data during tumor board meetings.

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25 Patient Engagement Analytics Health Data From All Sources Big Data Warehouse Information Discovery Find Patients (Cohort Identification) Safety & Outcomes Measurement Enterprise Healthcare Analytics Hypothesis Generation & Comparative Effectiveness (Data Mining) Patient Engagement Analytics (Innovation in Data Visualization) Point of Care Tools (e.g. Predictive Analytics, Care Gaps, Bedside Data Mining) Performance Management (Reporting, Alerting, Nextgen Scorecarding)

26 What Determines Your Health? Source: World Health Organization Social Determinants of Health, October Oracle Corporation 26

27 Our Return on Investment? $ 2,700,000,000,000 / yr Source: World Health Organization Social Determinants of Health, October Oracle Corporation 27

28 Our Return on Investment? $ 2,700,000,000,000 / yr Institute of Medicine, January 2013 Source: World Health Organization Social Determinants of Health, October Oracle Corporation 28

29 Better Health Through Patient Engagement $ 2,700,000,000,000 / yr Patient Engagement! Source: World Health Organization Social Determinants of Health, October Oracle Corporation 29

30 Better Health Through Patient Engagement $ 2,700,000,000,000 / yr Patient Engagement! Source: World Health Organization Social Determinants of Health, October Oracle Corporation 30

31 The Smart Money is On Patient Engagement 2012 Oracle Corporation Proprietary and Confidential 31

32 Democratizing Analytics Enterprise Executives Facility Executives Department Leaders Clinicians Point of Care Patients Analytics are increasing having an impact at the point of care and beyond

33 Patient Engagement Analytics Russ Bessette, MD Director, Louisville Informatics Institute Univ of Louisville Deploying innovative visual analytics to help traditionally underserved patients in Kentucky get engaged in their health and wellness. Dr. Bessette used data mining to identify key indicators of disease progression for dialysis patients Used innovative visual analytic techniques to help dialysis patients understand their health and get engaged Training nurse Knowledge Workers and community-based Health Coaches to use these tool to help underserved patients get engaged in their care Dr. Bessette s effort has gained momentum with hospitals, physician groups, and payers across the state.

34 Enterprise Healthcare Analytics Solution Security Metadata Management System Exception Management System Business Rules Data Marts OBI-EE Reporting Oracle EHA Apps All Sources Extract Interface EHA Staging Area Tables Consolidation, Integration & Validation EHA Data Warehouse Ad Hoc Query EHA Partner Apps Exec Clinical Financial Administrative Research Term. Service MPI Unit of Measure NLP De identification OLAP Data Mining Custom Applications Clinician Master Data Management & Other Services Real Time Researcher Source Mapping ETL Warehouse Integration ETL Data Mart ETL Source Dependent Source Independent

35 Immediate Value From A Scalable, Strategic Analytics Platform Scalable, Enterprise Class Solution Strategic Platform to Transform Healthcare Rapid Time-to-value Wide range of pre-built analytic applications (EHA App Store ) Pre-built data acquisition, validation, integration, and warehousing (EHA DI and HDM) Engineered for ease of new analytic development Data model built specifically for all provider data Built with the leading database and middleware tools and backed by the world s largest enterprise software vendor Performance tested solution at scale Optional hardware and software engineered systems maximal scalability and performance Integrated clinical, financial, administrative, and research data provide true enterprise view of your health system Integrated view analytics are an engine for accountable, value-based care Deliver analytic insights to clinicians at the point of care and provide feedback to patients and populations to bolster their engagement The longitudinal view of comprehensive integrated data enables comparative effectiveness analysis and, when combined with omics data, translational research

36 The preceding is intended to outline our general product direction. It is intended for information purposes only, and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle s products remains at the sole discretion of Oracle.

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