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Presentation by Prof. Fernando Martin-Sanchez at the "Carlton Connect" Interdisciplinary conference in Melbourne, 2012. …

Presentation by Prof. Fernando Martin-Sanchez at the "Carlton Connect" Interdisciplinary conference in Melbourne, 2012.

Published in Health & Medicine
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  • 1. Health  informa.cs     Fernando  Mar*n-­‐Sanchez   Ins$tute  for  a  Broadband-­‐Enabled  Society   &  Melbourne  Medical  School    
  • 2. Introduc$on  •  Broadband  can  provide  many   opportuni$es  for  the  health  sector:   –  Improving  youth  mental  health  and  aged   care  services   –  Monitoring  health  condi$ons       –  Enabling  shared  electronic  health  records    •  Broadband  technologies  are   revolu$onising  the  delivery  of  health   care.  Convergence  with  other   technologies  towards  Digitally  Enabled   Personalized  Medicine  
  • 3. Aging  Well  –  Mobile  and  broadband     technologies  for   social  isola.on  in  older  people  –  Smart  Homes  for  the  Elderly  –   recent  developments  in  Korea   Youth  Mental  Health      −  HORYZONS:  Online   Recovery  for  Youth  Onset   Psychosis  
  • 4. Telehealth  –  Individual  Electronic  Health  Records    –  The  Telestroke  Study  –  Hap*c  Tele-­‐Rehabilita/on    –  Teleden/stry      –  Virtual  visits:  Inves*ga*ng  the  acceptability  of  webcam  consulta*ons  for  young   adults’  sexual  health  –  Wireless  broadband  monitoring  of  knee  osteoarthri/s  –  Overcoming  geographical  barriers  for  community  health  –  Interpreter  mediated  cogni*ve  assessments  using  video  conferencing  soFware  –  SeeCare  IPTV:  Personalised  Health  Literacy  Demonstrator  –  Mobile  Augmented  Reality  –  Interpreter  mediated  cogni/ve  assessments  using  video  conferencing  soFware    –  High  resolu*on  monitoring  of  atmospheric  pollutants  to  iden*fy  their  impact  on   popula*on  health  –  Overcoming  geographical  barriers  for  community  health  –  Using  video-­‐conferencing  to  pilot  an  educa*on  and  clinical  support  package  for   rural  GPs  in  Mildura  
  • 5. Health Informatics: Towards Digitally EnabledPersonalised Medicine
  • 6. Current challenges in Medicine•  Need  of  earlier  diagnosis      •  More  personalized  therapies  •  Risk  profiling,  disease  predic$on  and   preven$on      •  Improve  disease  classifica$on  systems      •  Control  health  system  costs    •  Clinical  trials  and  the  development  of  new   drugs  need  to  be  more  agile  and  effec$ve.  •  Ci$zens  could  take  more  responsibility  for  the   maintenance  of  their  own  health.  •  Shortage  of  health  professionals  
  • 7. The Digitalization of Medicine•  Digital  revolu$on  in  other  domains  (banking,  insurance,   leisure,  government,…)  •  The  incorpora$on  of  digital  systems  in  healthcare  is  lagging   behind  other  sectors:   –  Reasons:  complexity,  privacy,  volume  of  data,  lack  of   demand   –  It  has  greatly  affected  healthcare  at  the  hospital  or   research  centre  level.     –  The  digital  revolu$on  has  not  yet  reached  medicine,  at   the  pa$ent/ci$zen  level     • BUT  THIS  IS  STARTING  TO  HAPPEN  NOW  !!!  
  • 8. Enabling scientific and technological advancements•  New  converging  areas  make  feasible  for  the  first   $me  the  idea  of  an  integrated  digital  infrastructure   for  medicine,  reaching  the  ci$zen,  that  will  make   feasible  the  concept  of  personalized  medicine   –  Nanotechnology   –  Biotechnology   –  Informa$on  Technologies   –  Cogni$ve  science  
  • 9. Enabling scientific and technological advancements•  Broadband  technologies  and  networks  •  High  performance  compu$ng  (and  A.I.  systems)  •  Ubiquity  of  smartphones,  tablets,  …  •  Sensors,  imaging  and  wearables  •  Personal  genome  sequencing,  gene$c  tes$ng  and   epigene$cs  •  Metagenomics  and  the  Human  Microbiome   Project•  Social  networks  and  the  Quan$fied  Self  •  Knowledge  management  on  gene$c  diseases  and   systems  biology  modelling  
  • 10. Smartphone apps•  Smartphone  ECG  system   to  provide  physicians   and  pa$ents  with   hospital-­‐quality  heart   rhythm  monitoring   outside  of  the  hospital   se`ng  
  • 11. Advances in genomic technology•  Benchtop  Ion  Proton™   Sequencer  –  designed  to   sequence  the  en$re  human   genome  in  a  day  for  $1,000  
  • 12. Graphs of my total cholesterol (blue), my “bad” LDL cholesterol (red), and my “good” cholesterol (green) over a decade. (Larry Smarr, CalTech)
  • 13. Remote  pa$ent  data  monitoring  and  data  collec$on   Environmental sensors Genomic sensors Phenomic sensorsEnvironmental risk factors Biomarkers (DNA sequence,(pollution, radiation, toxic agents, …) proteins, gene expression, epigenetics Physiological, biochemical parameters (cholesterol, temperature, glucose, heart rate…) Integrated personal health record
  • 14. Digitally  enabled  personalised  medicine    •  Personalized  medicine  refers  to  the  tailoring  of   medical  treatment  to  groups  of  pa$ents  with   similar  gene$c  or  molecular  profiles.    •  Ultra  high  speed  broadband  networks  will  be   required  to  transmit  enormous  volumes  of  data   from  pa$ents’  homes  to  health  prac$$oners  and   vice  versa  in  a  $mely  manner,  and  to  enable  the   processing  of  this  deluge  of  data.  •  Personalised  medicine  offers  enormous   opportuni$es  for  improving  preven$ve,  diagnos$c   and  therapeu$c  solu$ons  à  improving  healthcare   outcomes,  reducing  costs  and  increasing  pa$ent   safety.  
  • 15. Digitally   enabled  personalised   medicine  
  • 16. Patient Data (sensors and imaging) Sensors Genomic Phenomic Environmental Integrated Personal EHR Health Record Module 1 Health Profile GWAS Assessment Tables (weighted factors) Modelling Risks Diagnosis Personal Health Profile CDSS Health Profile Module 2 Improvement TrialbanksNBN Risk reduction Decision matrix, protocols Follow-up Personalised Therapy Health Recommendations
  • 17. Social  media  and  biomedical  and     clinical  research  •  We  are  witnessing  a  transi$on  from  research  informa$on  systems   centralized  at  hospitals  and  clinical  research  centres  to  distributed  systems   that  reach  out  to  the  residence  of  any  ci$zen  /  pa$ent  who  opts  in.    •  Social  media  as  a  research  tool  •  Clinical  Research  with  the  pa$ents,  not  on  the  pa$ents  •  Examples   –  23andMe  –  Parkinson’s  Disease  –  PLoS  Gene$cs,  2  new  gene$c   associa$ons   –  Pa$entsLikeMe  –  Nature  Biotech.  Self-­‐reported  data  from  600  pa$ents   on  the  use  of  lithium  for  Amyotrophic  Lateral  Sclerosis  (ALS)  
  • 18. Pa$ent  empowerment  Current NBN-enabled Driving forces: patient empowerment,networks personalized medicine, social networksEHR – Personally Citizens are able to maintain and controlElectronic Controlled EHR their own health informationHealth RecordGene-disease Personal Citizens ask for genetic analysis of theirassociation genomics DNA through the Internet and receivestudies reports on various aspects of their healthClinical trials Crowdsourced The patient voluntarily shares information clinical trials on treatments and evolution of his/her illness with other patients
  • 19. Barriers•  New  regulatory  framework  (new  models  of  clinical   trials)  •  New  informa$cs  methods  to  compile  and  interpret  all   the  informa$on  •  Educa$on  of  pa$ents  and  health  professionals  •  Ethics,  data  security  and  confiden$ality  issues  •  Wide  availability  of  clinical  decision  support  systems  at   the  point-­‐of-­‐care  •  New  cost-­‐effec$veness  assessment  and  financial   models  of  care  •  Need  to  prove  clinical  effec$veness  before  DTC  services   are  offered.  
  • 20. Conclusions•  The  rou$ne  applica$on  of  personalised  medicine  is  s$ll  a   long  way  ahead,  however  we  have  now  all  the   ingredients  to  make  it  happen.•  The  convergence  of  medicine  and  the  digital  revolu$on   will  produce  an  informa.on  ecosystem  that  will  facilitate   the  advent  of  safer  and  more  efficient  preven$ve,   diagnos$c  and  therapeu$c  solu$ons.    •  The  ci$zen  will  have  access  to  her  gene.c  profile  and   clinical  record,  and  will  monitor  and  adjust  her  health   using  next  genera$on  sensors  and  social  networks  to   share  this  informa$on  with  peers,  clinicians  and   researchers.    Virtual  pa$ent  –  Pa$ent  avatar  
  • 21. Conclusions•  But  all  of  this  will  only  be  possible  if  we  realise  that  it  is  .me  for  us   to  take  responsibility  for  our  own  health.     –  “The  Crea$ve  Destruc$on  of  Medicine”  (Topol),   –   “Networked  individualism”  (Rainie),  or   –   “P4  Medicine”  (Hood).  •  We  prefer  the  term  “Digitally  enabled  personalized  medicine”  and   have  already  started  research  work  in  several  areas:  clinical   genomics,  modelling  and  the  use  of  social  media  for  biomedical   research.    •  We  believe  that  the  synergy  between  Health  Informa$cs  and  the   broadband  network  in  the  context  of  mul$disciplinary  collabora$on   and  innova$on  offered  by  Carlton  Connect  will  contribute  to   accelerate  the  advent  of  personalised  medicine.      
  • 22. Thank  you   www.healthinforma$   Twiqer:  @ibeshbir