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"Tonight, I'm launching a new precision medicine initiative to bring us closer to curing diseases like cancer and diabetes – and to give all of us access to the personalized information we need to keep ourselves and our families healthier," said President Barack Obama during a 2015 State of the Union address.

Efforts in personalized medicine were underway prior to the President’s call to action with some technology companies and healthcare organizations teaming to move personalized medicine from idea to reality. However, President Obama’s initiative seeks to accelerate the transformation. 

At the SAP Personalized Medicine Symposium this October, leaders from Stanford Medical School, The American Society of Clinical Oncology (ASCO), Karolinska Institutet, and SAP joined to discuss advancements in digital healthcare, the fight against infectious diseases, genomics, and the benefits of personalized care.

Speaking with Dr. David Delaney

The day before the event, I spoke to SAP Chief Medical Officer, David Delaney. Delaney is an experienced physician with 14 years of practice as a critical care physician at Beth Israel Deaconess Medical Center in Boston where he also served as clinical faculty at Harvard Medical School.  In addition to his clinical responsibilities, he was also director of Web development and applied informatics.

In his current role at SAP, Dr. Delaney works with senior leaders from healthcare organizations across North America to discuss issues facing the industry, organizations, and patients.

During his tenure at Beth Israel Deaconess Medical Center, he not only created code for software programs and led teams of developers in complex solution creation, but also used the applications himself daily. He understands what works and what doesn’t in the healthcare industry, and he can identify the proper solution for a certain issue, or help innovate and create the type of programs that will positively change the field.

Although Dr. Delaney sometimes misses direct patient care, he is passionate about his ability to help create change on a larger scale in a transforming healthcare industry. During his years in critical care, he saw thousands of patients, but now he is able to impact the care of millions of patients.

By helping to connect healthcare organizations with the solutions needed to streamline patient health records, best treat cancer and other diseases, and optimize the way healthcare organizations are run, he is benefitting communities, states, and even countries.

What is Personalized Medicine?

The terms personalized medicine and precision medicine are very similar, yet nuance factors lay between them. Differing opinions exist around the definition of each term, and the discussion to explicitly define them is evolving. For the purpose of this article, I will use the term personalized medicine.

Personalized medicine is the practice of medicine specialized down to the finger-print level of an individual.  Personalized medicine focuses on analyzing a person’s genome, environmental, social, biometrical, and religious influencers, and determining a treatment for the individual based on that data.

Personalized medicine embodies the idea that by being more educated on the factors that influence outcomes, physicians can better gauge how patients will react to a certain treatment. It’s about moving from a one-size-fits-all approach to instead creating micro-buckets of patients by analyzing their medical records and genome sequences, and treating patients based on the research and records of how other patients in similar situations have reacted.

Organizations Leveraging Personalized Medicine

Molecular Health, with its end-to-end TreatmentMAPTM solution, translates the language of genes into actionable information that doctors and patients can use to make informed decisions.

The company has teamed with SAP to provide SAP employees diagnosed with cancer the Corporate Oncology Program for Employees (COPE).  COPE provides employees diagnosed with cancer free access to TreatmentMAPTM and a full genome sequence.

The German National Center for Tumor Diseases (NCT) is also using personalized medicine to help better treat cancer patients. The organization collects patient data from different sources, such as clinical information systems, tumor registries, biobank systems, and even text documents (like physicians’ notes), analyzes it, and puts it into actionable context.

The physicians at NCT are able to analyze the DNA mutation that caused a cancer tumor and then compare that mutation to how others with the same mutation reacted to certain treatments. They can also compare the DNA mutation to existing mutations in the field.

Now That’s BIG data

There’s six billion base pairs in human DNA.  Add that to years of medical research plus a lifetime of doctors’ notes.  Multiply that monstrous number by billions of patients all over the world.  The product is a volume of data so immense that it’s extremely difficult to extract complete and actionable insights. It’s estimated that 30% of all existing global data is healthcare related.

By addinghigh-speed in-memory computing capabilities to the equation, the result is the ability to comprehend and leverage data.  From there physicians can create personalized treatments based on research, DNA, and the experiences of others.

During the symposium’s panel discussion, SAP CEO Bill McDermott heartfeltly expressed that SAP has an obligation to help the healthcare industry because SAP is the only company that has the technology to do so.  With SAP HANA, healthcare organizations can analyze and comprehend massive amounts of healthcare data in record speed and turn it into action. 

Will Genome Sequencing Become Mainstream?

Currently, in partnership with a South African health insurer, entrepreneur J. Craig Venter is offering consumers access to their DNA data sequence for $250. In addition to supplying consumers with their entire genetic blueprint, the data will be utilized by researchers.

In our discussion, Dr. Delaney outlined three main factors that will directly affect the wide adoption of personalized medicine.

1. Patients as consumers 

As patients increasingly grow aware of the benefits of personalized medicine including the power of genome sequencing, patients will begin to behave more like consumers creating demand.  Patients will strongly desire a more data-driven, personalized care delivery than has been the case in the past where decisions were often made on gut, intuition, and the experience of individual physicians. 

Additionally, patients will desire to be more actively engaged in shared decision-making and have visibility into their data and key health indicators. For example, the Accu-ChekView bundle by Roche Diagnostics helps diabetics take control of their disease and prevent type-2 diabetes from forming by helping them to change their lifestyle.  

Apps like the Accu-ChekView bundle, as well as gamification products like wearable fitness trackers, all help increase the education and understanding of one’s own health.  These change management agents are critical because even if a provider has access to genome sequencing, the best diagnostics, and personalized treatments, the outcome of care greatly depends on a patient’s ability to change their behavior when they leave the doctor’s office. 

A physician has no control over the patient’s ability to fill a prescription nor can they control the patient’s habits such as smoking, exercise, or healthy nutrition.

Education, gamification, and health trackers are imperative resources for helping patients become partners of their own health.

2. The Shift to Value-Based Care

Doctors are increasingly being compensated and measured by the value they provide instead of the number of patients they see or procedures they perform.  In order to have success in the era of value-based care, providers and organizations will need to improve the effectiveness and efficiency of their care delivery.  This will be a strong force in accelerating the adoption of personalized medicine. 

In addition to Roche Diagnostics, other companies have also teamed with SAP to create mobile apps that help facilitate patient engagement in their own healthcare. 

Heidelberg University Hospital  released an app that helps pregnant mothers connect with their doctors at all times, enabling the constant exchange of information and the ability to monitor the patient remotely and help catch early signs of prenatal depression.

3. Adoption of High-Speed, In-Memory Computing

Technologies like SAP HANA that can analyze massive data sets in near real time are needed to allow researchers and physicians to create insight. With the analytical power to decipher this information, we can transform it into actionable insight.

One Size DOES NOT Fit All

Delaney stressed that the historic ‘one size fits all’ or ‘T-shirt size’ approaches to health care (S, M, L, XL) is imprecise, working for some, ineffective for others, and even causing adverse outcomes for subsets of patients.

The path to improving outcomes and lowering costs is by necessity through personalization of care through precision diagnostics and therapeutics.  Not everyone fits well in a generic size, just like not all people fit into the large buckets of treatment that are currently leveraged.

With the research and information from DNA sequencing, the power of high-speed data analytics, and the will to constantly innovate, personalized medicine offers the potential to dramatically improve healthcare for all of us.The symposium guests and the President of the United States agree.

I’d like to thank Dr. David Delaney for speaking with me and assisting in the creation of this blog.

Follow me on Twitter @Cmdonato and on LinkedIn.

Top image: Dr. David Delaney presenting at the SAP Personalized Health Symposium

Bottom image (from left to right): Dr. David Delaney, Chief Medical Officer, SAP; Dr. Peter Paul Yu, MD, FACP, FASCO Immediate Past President, ASCO; Magnus Peterson, MD, Specialist In General Medicine And Pain Rehabilitation, PhD Department of Public Health and Caring Sciences, Uppsala University, Karolinska Institutet; SAP CEO Bill McDermott; and Carlos Bustamante, Professor of Genetics, Co-Founding Director of the Center for Computational, Evolutionary and Human Genomics (CEHG), and Inaugural Chair of the Biomedical Science Department at Stanford Medical School

(Photo by Paul Sakuma Photography)

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