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

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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

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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