Brian, speaking to the masses in Monty Python’s Life of Brian.
Finally, medicine is getting the message.
One of my school friends was part of the original genome project that kicked off in 1984, finally got underway in 1990, and reached completion in 2003. It was a $3B project (by the way, that’s about $1 per letter of our genetic code), which was expected to take 15 years. But thanks to being one of the most cooperative efforts in the world, it finished early. On June 26, 2000, the project team announced the first-ever available draft of the human genome, and declared the project complete on April 14, 2003.
Fast-forward 12 years: technology and innovation has driven down sequencing time to days—even hours—and a complete genome can be mapped for less than a $1,000. Cloud technology is further accelerating our ability to sequence genomes, offering access to incredible computing power at a fraction of the typical cost and enabling us to share that knowledge effectively.
Back in 2003, the data showed a little more than 20,500 human genes (about the same as found in mice), as well as many sections of repeated DNA. Our early insights even labeled 98 percent of the human genome as “junk DNA,” (aka non-coding DNA). But since then, our ability to comprehend the inner workings of DNA and how it codes for life has increased. We now know that more than 80 percent of the human genome has some form of biochemical activity, and our understanding of what might be going wrong in diseases is on an exponential curve of learning
Accelerating the sequencing and analyzing of genomic data opens the doors to using it in a clinical setting, enabling easy sharing of this data, which often comes in data sets too large for sending via email. This rapid speed also makes possible the collaboration between experts around the world, further accelerating the pace of scientific advancement.
One of the recent examples is our new-found appreciation for the human micro-biome. In the case of the human gut, bacteria outnumber human body cells 10 to 1, and we can now use these new tools to sequence the genome of bacteria in and on our bodies. Early studies and reports suggest some relationship to human diseases. There is also a suggestion that these bacteria, viruses, and fungi may even contribute to our moods. With accelerated sequencing, this field will advance rapidly and lead to new understanding of disease and perhaps a whole new branch of medicine centered on manipulating and managing the human microbiome.
But cloud technology offers so much more to healthcare—delivering easy access to clinical data and systems anywhere, anyplace and anytime. Doctors are now no longer tied to locally run, managed and installed systems. They are able to access powerful custom solutions on mobile platforms that travel with them to the bedside, their clinical office, home, and even out into the community, and the patient home. No longer bound by the chains of Ethernet cables and desktop hardware, physicians are now free to use systems without the burden of large-scale IT implementation and support. Even as the patient data set expands alongside our explosion of knowledge in clinical medicine, the cloud’s ability to offer near-instant access to data, information and collective wisdom will enhance real-time decision making at the point of care.
This changes things.
It changes everything for clinicians. Now, no longer limited to personal memory and individual decision-making, they have access to the broader collective hive mind of medical experts, researchers and more recently the “Artificial Intelligence” of computers. Personalized medicine is no longer the exclusive domain of high-end specialized centers. Easy access to the latest innovations and research in disease management are at the fingertips of every clinician. And as the researchers make advances, this innovation is shared and available to provide the best treatment guidance, based on the latest insights and the individual parameters of the patient.
A practical example of how genomics and collaboration have been enhanced by cloud technology is the Neuroblastoma and Medulloblastoma Translational Research Consortium (NMRTC), led by pediatric oncologist Giselle Sholler, MD. A partnership between T-Gen, Dell and Appistry developed new technology to provide rapid sequencing and collaboration tools that allow pediatric oncologists to personalize treatment for children with these two types of cancer.
It changes everything for patients too. Cloud technology is opening new resources, including telehealth, which allows patients to consult with physicians and other caregivers no matter their location or physical access to healthcare facilities. We are moving away from the days of paternalistic medicine characterized by controlled access and limited distribution of medical knowledge to the fully engaged and involved patient. Even if this were not good medicine, which I believe it is, the shortage of doctors would demand that we use this technology.
In the rural United States we have an average of 1 doctor per 3,500 people (and significantly lower in many other countries), and the situation is set to get worse. Aging populations and an increasing incidence of chronic disease will require a different approach, using technology to extend the limited resources. An essential part of cost-effective healthcare—which will soon be available worldwide—will be intelligent agents that can interact with patients, using their data and the collective knowledge of medicine in an automated self-service system. This will save the limited human clinical resources for broad oversight and intervention for the more complex cases.
As Eric Topol puts it – it is now time for the era of Open Medicine:
“There is a long history of medicine stymying public and consumer access, of keeping us in a closed cave, but the walls are starting to come down. Data is flowing more freely than ever before. The digital era has enabled open platforms, open access, and open science. It is now time to realize the benefits of open medicine.” —“The Patient Will See You Now: The Future of Medicine is in Your Hands” by Eric Topol
Information was the bottleneck, but no longer. I’m future ready. I’m willing to bet you are too, and excited by the dawning of a New Age of open and personalized medicine that by virtue of cloud infrastructure, is future-proofed and will continue to be for years to come.
For my readers in the UK: If you are attending the NHS Health and Care Innovation Expo 2015 on September 2 and 3, be sure to stop by Stand #3, where Dell will be offering presentations on a variety of healthcare technology subjects. I’ll be speaking from 2 p.m. to 2:15 p.m. on Wednesday, September 2, and my topic will be “The Digital Healthcare Trust of the Future: The strive toward mobility and security in healthcare.” I’ll repeat my presentation at noon on Thursday, September 3, for those who miss the Tuesday talk.
If you will be at the conference, be sure to drop by and say hello!