Experiences from the Luxembourg Personalised Medicine Consortium
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Transcript of Experiences from the Luxembourg Personalised Medicine Consortium
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The Personalized Medicine Consortium of Luxembourg: Driving Innovation in
Healthcare for Luxembourg
Goal
Small is beautiful
• Luxembourg has the potential to be a world leader in testing and implementing new advances in personalized medicine into its health care system
• 5 hospitals, no medical school, 1 university
• Small, but excellent scientific community – very collegial and embraces partnerships
• Different Ministries work closely together on personalized medicine initiative
• Ministry of Health believes that research will improve health
• Introduction of new innovation involves only one level of government
• One of three most expensive healthcare systems in world
• September 2010 – agree to support a major coordinated initiative in personalized medicine focused on four priority research areas: – Cancer (lung, colon, and breast)
– Type 2 diabetes
– Parkinson’s disease
– Large population cohort
• Creation of Consortium to bring together all of the key stakeholders under one umbrella
• Goal: Establish Luxembourg as a leader in the adoption of new advances in personalized medicine
Evolution of Personalized Medicine Consortium (PMC)
Transition from Traditional Medicine to Personalized Medicine Will Require Radical Change
Hospital and
Pathology labs
Patient Doctor
Results
Diagnosis
Disease
Tissue
Examine
Treatment
Symptoms
Integrated
Information
Patient Doctor
Summary
Data
Tissue
Examine
Probable
Diagnoses
+
Recommended
Treatments
Molecular
Diagnostic lab
Best Treatment
Clinical
Data
Worldwide
Data
Informatics
Centre
eHealth
Record
1) How translate new knowledge into innovation?
Translational research and clinical trials do this step reasonably well
1) How transfer new innovation into a healthcare system?
Need new research process here – topic of Luxembourg Health Summit
Two Big Problems in Personalized Medicine
Problem: Introducing Innovation into Healthcare Often Fails
Discovery Research
Translational Research PMC
Healthcare System
Benefits for citizens of
Luxembourg
Very small
benefits
Research
Innovation
Successful research does not automatically lead to
successful innovation
• Patients/public – many effective interventions require behaviour change (smoking, diet, screening)
• Hard to change widely held beliefs – risk of vaccinations, genetically modified food, fluoridation of water, evolution
• Physicians – too many new guidelines for treatment; changes often may impact income; require new knowledge
• Hospitals – change requires radical redistribution of work
• Government – concern that radical change will cost too much and be too disruptive (making re-election difficult)
Barriers to Change
Missing Step in Innovation Process
Basic Discovery Research
Pilot Studies in Healthcare
System
Clinical Trials and Studies
Translational Research
Use in Healthcare
System
New Paradigm: Pilot studies followed by gradual introduction into the health care system
Discovery Research
Translational Research PMC
Healthcare System Benefits for all
citizens of Luxembourg
Small Pilot
Good benefit for few
Larger Pilot
Good benefit for
more
Proposed new approach for innovation in healthcare in Luxembourg
Healthcare System
Research Innovation
• Ten countries are working together to test health innovations in pilot studies in a real healthcare systems
• Develop process for introducing radical change into a healthcare system
• Test new approaches in pilot studies on groups with 5,000 to 1 million participants
• Jointly plan pilots to bring best practices to all countries
• Share successes and failures
• The PMC is working with the Ministry of Health to explore the possibility of joining this initiative
Maimonides Project – Introducing Innovation in Healthcare
Maimonides Strategy
Think Big • Luxembourg is leader in early
adoption of new advances in personalized healthcare
• Strive to:
– Prevent the preventable
– Cure the curable
– Manage chronic disease when necessary
Act Small
• Small projects that can be easily replicated anywhere
• Partner with the most innovative companies and research institutes
• Use best practices from other countries and share our experiences
(Big Dreams and Small Practical Projects)
May 2
• 40 Luxembourg opinion leaders will meet to discuss ways for Luxembourg to introduce innovation into its healthcare system. The goal will be to identify 3 or 4 projects that can be started this year.
Potential themes for projects:
• Healthcare Services
• Personalized Health
• Active Lifestyle for Health
• Diet and Stress Management
• Healthy and Aging Population
Luxembourg Health Summit
Questions and Comments
Organization of PMC
Cancer Diabetes
LNS
CRP-Santé CIEC
IBBL
LCSB
Parkinson’s Disease
Health Economics
Normal Cohort
PMC
Composition of PMC
• Leaders of each program in
personalized medicine
• Leaders from each major partner
• CIEC
• Health economics
• Laboratoire National de Santé
• IBBL accepts responsibility for the
administrative budget of PMC and
for coordination
• PMC meets monthly
• Decisions made by consensus
• Healthcare system not aligned with current health problems
• Most patients have chronic disease and system was created to meet acute needs
• Health system responds well to small innovations, e.g., new imaging technology, new laboratory tests
• System not ready for radical changes to align system with needs
Problems
• To make Luxembourg the healthiest country on earth
• To prevent diabetes
• To prevent heart disease
• To ensure the future health of your children and grandchildren
• To make Luxembourg’s health system efficient, innovative and user friendly
• To work closely with all groups striving to improve health
Opt-in:
• Smoking – largest risk factor for preventable disease - risks identified in 1938-1950; US Surgeon General warning in 1964; still have 15-40% of adult population smoking.
• Lumpectomy – never good data supporting radical mastectomy. When data confirming effectiveness of lumpectomy, still took 15 years to obtain wide-spread use.
• Overuse of antibiotics – described as problem over 30 years ago and still a problem
• Electronic Health Records
Solutions Difficult to Implement
Components of Personalized Medicine Initiative
1. Excellent, multidisciplinary research teams
a) focused on specific problems using systems biology
b) conduct the innovative research
c) coordinate the clinical testing of novel interventions.
2. Sophisticated technology platforms
a) collect high quality tissue and clinical data
b) high through-put technologies generate the large datasets
required by the teams.
3. State-of-the-art informatics
a) conduct informatics research
b) support the disease teams for data mining, data analysis and
model building.
• Tissue and data bank
• Technology hub
• Research
• Personalized Medicine Consortium (PMC)
IBBL – Integrated Concept
IBBL Vision: To be an international centre of
excellence in biobanking and to accelerate the
introduction of personalized healthcare for the benefit
of Luxembourg