Pictures of the Future Spring 2005
Personalization – Healthcare
The Promise of Personalization
In the future, each of us will benefit individually from a vast, integrated and steadily improving knowledge base that includes genetic as well as traditional health information, provides access through health cards, and crystallizes our health needs in a personalized patient record.
Health cards can provide access to a patient’s online medical history, allowing doctors and pharmacists to see what medications a patient is already taking. Medications associated with allergies can be avoided, as can potentially dangerous drug interactions
Inside hospitals, digital systems that once stood alone in radiology departments, emergency rooms and operating theaters are being networked. In the most technologically integrated hospitals (see Hospital Applications) the resulting medical data is in turn being refined and combined with administrative information in the form of the electronic patient record — a personalized, real-time, on-demand document that represents an efficiency revolution in terms of the availability and accuracy of medical data.
As information technologies allow more and more data to be focused on understanding and managing individual health problems, treatment is becoming increasingly personalized. Personalization can take many forms. Today, it can mean that a pediatric cardiologist can analyze a fetal heart beat from a home PC in the middle of the night to help nurses tailor treatment for an expectant mother. Increasingly, it will mean that software will analyze prescriptions in terms of patients’ specific conditions and flag potential risks to physicians. And in years to come it will mean that a patient’s genetic data will be used to tailor preventive treatment for illnesses to which he or she is predisposed. "What personalization boils down to is a tailoring of the entire healthcare process to the individual patient’s needs," says Michael Mankopf, Director eHealth and Digital Hospitals at Siemens Medical Solutions.
Undoubtedly, the ultimate step in personalization through the networking of medical technologies will be the application of information on patients’ genetic and proteomic (protein-based) constitution to a range of preventive and medical treatments. This process will begin to take shape with the introduction of Siemens’ quicklab, a card-and-reader combination that will extract DNA or proteins from blood and compare them with an array of synthetic bio-molecules to pinpoint anomalies (see Molecular Imaging).
Radio frequency ID bracelets from Siemens provide access to medical records. The bracelets can replace name and bar code tags in hospitals
These and other fundamental issues are now being explored by a team of researchers headed by Dr. Dorin Comaniciu at Siemens Corporate Research (SCR) in Princeton, New Jersey. The team - as well as other groups at Siemens - is working with hospitals around the world, the U.S. National Institutes of Health and the European Union Commission’s e-Health action plan to understand how information from traditional imaging technologies can be combined with information about molecular processes on the cellular level.
"The vision," explains Mohammad Naraghi, M.D., head of Business Development at Siemens Medical Solutions, "is to detect and treat illnesses such as cancer, cardiovascular disease, Alzheimer’s, and others on the molecular level and refine traditional imaging technologies to manage and provide feedback on therapies."
Healthy Dividends
Millions of people in the northern Italian state of Lombardy are set to benefit from a new, universally available health card from a consortium of companies, including Siemens Informatica, a joint venture of Siemens Business Services and Telecom Italia. Medication errors - one of the major causes of morbidity and mortality among people undergoing medical treatment - could be significantly reduced thanks to the introduction of the card, eight million of which were in use throughout Lombardy by April 2005 - one year ahead of schedule. Required for visits to doctors, the card is used in conjunction with a PIN to identify users and their insurance providers. The card also contains data on the patient’s allergies, blood group, and medical history. Once scanned by a doctor’s reader, the card transmits prescription information to a database. The patient can then use the card at any pharmacy to fill the prescription. "But if a medication poses a threat, or if two doctors have prescribed medications that could cause an unwanted interaction, the system will alert the pharmacist," says Sales Manager Werner Braun from Siemens Communications, a major player in the development of the cards. The customer - Lombardia Informatica, which is associated with Lombardy’s Ministry of Health - expects to save about 100 mill. € per year, much of it as a result of the elimination of prescription abuse. In addition to what is happening in Italy, similar cards are being introduced in Austria, Slovenia and Spain, and plans are developing for their introduction in Germany and Switzerland.
In the mean time, healthcare’s information revolution is gathering speed as it focuses ever more intelligence on solving individual conditions. Scientists at Siemens Medical Solutions’ Computer-aided Diagnosis & Therapy (CAD) group in Malvern, Pennsylvania, for instance, are developing an array of database-guided decision support systems for lung, breast, colon and cardiac diagnostics that can sift through huge medical image sets and help physicians identify anomalies. Says Dr. Alok Gupta, Ph.D., head of the CAD group, "The goal is to provide the physician with decision support tools that combine relevant information from multiple sources at the point-of-care of a specific patient."
With a view to combining this information with genetic and proteomic data, Comaniciu’s team is developing advanced mathematical and software tools for robust information fusion and statistics, multiple hypothesis diagnostics, and indexing and retrieval of the resulting information.
The networking of digital technologies, the introduction of quicklab, the development of tools for the interpretation of quicklab-generated genetic and proteomic data, the funneling of such data into increasingly personalized electronic patient records, the development of health cards to access such information (see sidebar), and the development of a universal database that combines knowledge from traditional technologies with a new world of knowledge gleaned from genomic technologies - it all adds up to a vision of medical care in which each of us benefits individually from a vast, integrated and steadily improving knowledge base.
Arthur F. Pease