Trends in Technology based Health Investments (A USA view)

Transcription

1 Trends in Technology based Health Investments (A USA view) Second UPM innovatech International Workshop Investing in High Technology for Success Center for Support of Technological Innovation CAIT Technical University of Madrid Michael G. Kahn MD, PhD Professor, Pediatric Epidemiology Co Director, Center for Clinical and Translational Research Associate Director, Center for Biomedical Informatics and Personalized Medicine Director, Research Informatics Children s Hospital Colorado University of Colorado Michael.Kahn@ucdenver.edu 3 December

2 Embi, Payne: J. Am Med Inform Assoc 16(3) 2009

3 In 2015, HIT will move away from Big Data to Big Data Analytics Putting the unrealized promises of Personalized Medicine into practice 3

4 Prescribed Drugs are often Ineffective % Ineffective Depression 38% Asthma Diabetes Arthritis Alzheimer s Cancer 40% 43% 50% 70% 75% Spear. Trends Mol Med 2001; 7:201

5 The Promise of Personalized Medicine Predisposition Markers Prognostic Markers disease aggressiveness Predictive Markers response to therapy Low Follow Testing Treat with Drug A High Testing Treat with Drug B From: David Schwartz MD, University of Colorado

6 Medicine and Science are at an Inflection Point Quantitative Understanding Detailed Description

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8 We are all Surrounded by Billions of Data Points From: Lee Hood

9 Investment #1: Data integration and patient linkage technologies Weber, G. M., Mandl, K. D. & Kohane, I. S. Finding the missing link for big biomedical data. JAMA 311, (2014). 9

10 Breast Cancer 25 years ago Radical Surgery Hormonal Suppression Chemotherapy Prevention 87% vs. 8% 2013

11 Predicting the Response to Drugs CYP2C19 Plavix poor metabolizer CYP2D6 Tamoxifen and Antidepressants poor metabolizer CYP2C19 Plavix Rapid metabolizer Investment #2: Pharmacogenomic panels: Efficacy & Adverse Events SLCO1B1 Statin myopathy CYP2C9 Coumadin slow metabolizer CYP2C9 Coumadin ultra slow metabolizer VKORC1 Coumadin dose IL28 Hepatitis C therapy Vanderbilt University: PREDICT (Pharmacogenomic Resource for Enhanced Decisions in Care and Treatment).

12 Integrating the Clinical Research Enterprise and the Clinical Care Environment Knowledge Network Investment #3: Knowledge integration tools and content

13 The Continuous Learning System Operational EMR Extract, Transform, Load (ETL) Extract, Transform, Load (ETL) Operational EMR CDS Engine Analytics Analytics Engine Engine CDS Engine Investment #4: Data discovery and implementation platforms/services Evidence and Clinical Decision Support (CDS) Shared Data Warehouse and Analytics Engine Evidence and Clinical Decision Support (CDS) Research, Knowledge, Learning Research, Knowledge, Learning Modified from Steve Hess, UCH

14 used with permission 14

15 Crowdsourcing Health Informatics Created by Tom Goetz (former Wired editor) + Matt Mohebbi (former Google engineer) Drug information based on massive online consumer surveys plus authoritative sources Interactive graphics to tailor to your situation NO BUSINESS MODEL yet established. 15

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17 Investment #5?: Consumer driven health and wellness uncertain business models used with permission 17

18 Investment #6: Using Big Data Analytics to Detect Fraud / Drug Abuse 6.5 million American >= 12 abused prescription drugs in 2013 Prescription drugs cause more than half unintended overdoses Electronic Prescriptions for Controlled Substances (EPCS) being implemented to fight and track prescribing and fraud In NY EPCS identified 200 incidents of patients shopping for doctors who would prescribe drugs In just 3 days.. Washington Post 13 Sep

19 Six HIT investments for Data integration and patient linkage technologies 2. Pharmacogenomic panels: Efficacy & Adverse Events 3. Knowledge integration tools and content 4. Data discovery and implementation platforms/services 5. Consumer driven health and wellness uncertain business models 6. Using Big Data Analytics to Detect Fraud / Drug Abuse 19