Academic Health Science Centres Global Perspectives
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1 Academic Health Science Centres Global Perspectives Dermot Kelleher Dean, Faculty of Medicine, Imperial College London Dean, Lee Kong Chian School of Medicine Singapore
2 The Imperial Academic Health Science Centre The College s partnership with Imperial College Healthcare NHS Trust (Department of Health Designation 2009) Hospital Campuses: Charing Cross Campus Hammersmith St Mary s Initial single governance structure CEO/Dean Currently overlapping governance with Joint Strategic Board and Joint Executive Group but distinct Dean and CEO functions
3 Academic Health Science Centre (AHSC) / Imperial College Health Partners (AHSP/N) AHSC AHSP NHS Trusts involved Annual NHS Budget 1 11 (+ Primary Care representation) ~ 900 million ~ 3 billion Patient population ~650,000 ~2,000,000 Translation T1 T2-4
4 Imperial Centre for Translational and Experimental Medicine Imperial West Translation and Innovation Hub Located adjacent to AHSC campus Interdisciplinary hub Big data, engineering, physics, chemistry Population Health Clinical trials
5 Lee Kong Chian School of Medicine: Partnership with NTU Singapore Metabolic Disease Infectious Disease Neuroscience Bio-engineering Structural Biology Exciting Research Synergies Opening August 2013
6 Global Perspectives 1. International Health, Public Health and Policy 2. Population Demographics 3. Integrated Care Pathways 4. Translational / Stratified Medicine 5. Big Data 6. Cost
7 1.International Health / Public Health Determinants/ Expecting the Unexpected
8 International Health at Imperial Policy Infectious Disease International Health at Imperial Innovation and Technology disease communicable Non - AFRICA ASIA SOUTH AMERICA ABU DHABI QATAR SINGAPORE IMPERIAL CORE STRENGTHS IMPERIAL INTERNATIONAL
9 Non-communicable disease. A clinical problem at Ealing London... Indian Asians ~15% of local population Compared to Europeans, increased - MI admission rates x2 - CVD mortality x1.7 - T2D prevalence x3
10 Burden of T2D in India Largest numbers with T2D for any country worldwide 2007: 41M 2025: 70M Accounted for ~908,000 deaths in 2007 Major economic burden 2005: 3.4 billion USD 2025: 5.4 billion USD
11 LOLIPOP Discovery Kooner, Chambers, Elliot, Nicholson cell methodology bioinformatics DNA Genomics LOLIPOP RNA protein Transcriptomics Proteomics Data validation Data integration Data use metabolites Metabolomics Integrative/System Biology The difference is genetic
12 LOLIPOP discoveries Harst P. 197 authors Kooner JS, Ouwehand W, Soranzo N, Chambers JC. Seventy-five genetic loci influencing the human red blood cell. Nature 2012 (AOP December 6th). Chambers JC et al. Genome-wide association study identifies loci influencing concentrations of liver enzymes in plasma. Nature Genetics 2011;43: Kooner JS, Saleheen S, authors... Mccarthy MI, Danesh J, Tai ES and Chambers JC. Genome-wide association study in people of South Asian ancestry identifies six novel susceptibility loci for type 2 diabetes. Nature Genetics 2011; 43: Peden JF, Hopewell JC, Saleheen D, Chambers JC et al. A genome-wide association study in Europeans and South Asians identifies five new loci for coronary artery disease. Nature Genetics 2011; 43: Chambers JC, Zhao J, Terracciano CM, Bezzina CR, Zhang W, Kaba R et al. Genetic variation in SCN10A influences cardiac conduction. Nature Genetics 2010; 42: Chambers JC et al. Genetic loci influencing kidney function and chronic kidney disease in man. Nature Genetics 2010; 42: Chambers JC, Zhang W, Li Y, Sehmi J, Wass MN, Zabaneh D et al. Genome-wide association study identifies variants in TMPRSS6 associated with hemoglobin levels. Nature Genetics 2009;41: Chambers JC, Elliott P, Zabaneh D, Zhang W, Li Y, Froguel P et al. Common genetic variation near MC4R is associated with waist circumference and insulin resistance. Nature Genetics 2008;40: Kooner JS, Chambers JC, Aguilar-Salinas CA, Hinds DA, Hyde CL, Warnes GR et al. Genomewide scan identifies variation in MLXIPL associated with plasma triglycerides. Nature Genetics
13 Imperial College London Diabetes Centre Abu Dhabi ICLDC Clinical collaboration ICL-ICLDC 20% Abu Dhabi Diabetic population Clinical Care Delivery Dr Maha Barakhat / Prof Stephen Bloom Teaching and training courses since 2009 MRCP UK Acute Medicine Advanced Medicine
14 Medicine Science Policy IMPACT Engineering 14 The Institute of Global Health Innovation
15 Global Health Policy Summit The Institute of Global Health Innovation, Imperial College 500 health leaders from over 40 countries including over a dozen ministers Keynote speeches by HH Sheikha Moza, HRH Duke of York, Donald Berwick, Sir Andrew Witty & the PM 15 1 AUGUST 2012, THE INSTITUTE PARTNERED WITH QATAR FOUNDATION TO CONVENE THE GLOBAL HEALTH POLICY FORUM IN LONDON
16 A LANCET COMMISSION ON TECHNOLOGIES FOR GLOBAL HEALTH WAS ALSO PUBLISHED ON THE DAY Latest in the prestigious Lancet Commission series Assesses the problems and ways forward for expanding use of technologies for health in LMICs Huge potential if leaders focus on frugal technologies both in developing and developed countries 16 The Institute of Global Health Innovation
17 Policy in the AHSC paradigm Research Economics Education Policy Service Policy as a driver of international health Bi-directional economic impacts
18 International Health Global partnerships New insights to old problems Harnessing technologies Delivering innovation Driving Policy
19 2.Population Dynamics
20 Costs of a long life
21 Age vs Disability
22 Growing old, Stones-style If pensioners can now dance so wildly on stage, might it be time to rethink the whole concept of retirement? Gillian Tett FT Dec 2012 Berlin Declaration on Quality of Life for Older Adults Int J Psychol 2009 Death in the New York Times QJM 2013 Epstein and Epstein
23 3.Integrated Care Pathways Implementation Cost Proof of Efficacy IT Allied Health Professionals Education AHSC vs AHSS
24 Success the cost and benefit : Asthma in Finland Improvements in Health outcome Cost re-distribution Full economic costs employment, disability T Haahtela et al Thorax 2006
25 4.Translational Medicine/Stratified Medicine + =
26 The Big Pharma Model The end of the blockbuster era? Revenue Implications New partnerships with academic medicine New synergies personalised/stratified medicine How do we forge new types of relationships
27 Stratified Medicine the onset of the omics Genetics, Genomics, Proteomics, Metabolomics, Phenomics
28 Innovation Agenda Economic value of research Health and Wealth Increasing driver in academic institutions but rarely a net revenue generator Synergies with biotechnology and pharma Imperial Innovations
29 5.Big Data the challenges Genetics and Genomic Medicine where are the limits? Genetics and Genomics in Stratified Medicine Organisation of healthcare genomic data Governance /Ethics of healthcare genomic data The other omics proteomics, metabolomics How do we make sense? How do we use?
30 6.Costs Rising Costs of Health Care Costs of Stratified Medicine Costs of Big Data Balance of AHSC vs AHSS shifting costs or reducing costs? Present vs Future Costs technology
31 Global Trends and Challenges Translational Medicine Clinician Scientists Stratified Medicine Interdisciplinarity Population Health Costs Economic Model Pharma Integrated Care Big Data
32 THANK YOU
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