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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 andCommunity Services
The UPMC Strategic Framework
Smart TechnologyBig Data
New Models of CareImproved Outcomes - Cost Effective
Good ScienceBig Science
Patient Self-management
Re-engineer Discharge
Palliative /Support Care
Hospice
Medical Neighborhood
Specialty Care
Telehealth
PersonalizedMedicine
Care Pathways / Analytics
Medical Home
Primary Care Team
Hospital
Emergency Department
ICU Hospice
New Models of Care: System Re-DesignCoordinated, 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
GeneticsGenomics
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
EnvironmentDiet, infection, smoking,
pathogens…
INDIVIDUAL DISEASESusceptibility, Course, Treatment response
BiomarkersIndividualized care, Prevent
OverDx/Rx
Basic science, Drug discoveryDiscover 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