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
Healthcare is at a Pivotal Juncture in History
• 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
UPMC’s Global Academic Integrated Delivery
and Finance System (IDFS)
55,000 employees, $10B Revenue
Enterprise Services
Hospital and
Community Services
• 21+ hospitals
• 234,000 admissions
• >4.8M outpatient visits
Physician
Services
• 3,321 employed
• >5,500 total
Insurance
Services
• 2.0 M members
International and
Commercial Services
• Hospitals: Italy, Ireland
• and others
Oracle
Informatica
IDFS structure promotes high quality, low cost care and unleashes
innovation while others live “Life in the Gap”
The UPMC Strategic Framework
Smart Technology
Big Data
Good Science
Big Science
New Models of Care
Improved Outcomes - Cost Effective
New Models of Care: System Re-Design
Coordinated, Continuous, Patient-Centered Care
Care Pathways /
Analytics
Medical
Neighborhood
Specialty Care
Supporting Finance
Horizontal Analysis
Cost Accounting
Bundling
Personalized
Medicine
Patient
Self-management
Telehealth
Medical Home
Primary Care
Team
Hospital
Emergency
Department
ICU
Re-engineer
Discharge
Palliative /
Support Care
Skilled Nursing
Facilities
Hospice
Hospice
Smart Technology…
…Bringing Intelligence to Information
Enterprise Analytics
Delivering real-time data to the bedside
Enterprise-Level Data Warehouse
Advanced data mining
Harmonize structured data (db Motion)
and unstructured data (Nuance)
Aggregate data into central data warehouse:
Cerner, Epic, Peoplesoft, HealthPlaNET, etc.
Clinical Data
(Provider)
Financial
Population Data
(Payer)
Ask new questions
Make digital information usable
Ingest over 200 data sources
• Deliver better outcomes/optimize cost
• Develop new models of care
Genetics
Genomics
• Enable the center for innovative science
Big Data and Big Science for Appropriate
Variation in Care and Personalized Medicine
Big Data Analytics
Clinical Redesign
DECREASE variation in population care
Big Science “omics”
+
Systems Biology
Personalized Medicine
INCREASE variation in individual care
Go from “Syndrome” to precise individual network
Framework for Good Science –
Personalized Medicine
Environment
Diet, infection, smoking,
pathogens…
HOST
Genetics
Time: Growth and Development, Adult Aging
INDIVIDUAL DISEASE
Susceptibility, Course, Treatment response
Basic science, Drug discovery
Discover new treatment for
aggressive disease
Biomarkers
Individualized care, Prevent
OverDx/Rx
Prostate, Breast CA Examples
Better Personalized Medicine
Genomic Tests
DNA, RNA
Patient Samples
Proteomics Tests
Bioinformatics/
Systems Biology
Hyperplexed
Pathology
Patient Stratification,
Diagnostic/Prognostic Tests
& Companion Diagnostics
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 Fondazione Ri.MED Biomedical
Research and Biotechnology Center
• The Center of Advanced
Genetic/Genomic,
Computational Biology Research
• Leading to Personalized
Medicine at the Bedside
Oracle
Informatica
17
• Unleashing Unlimited
Commercial Opportunities and
Industry Partnerships around
Health IT, Personalized Drug
Therapy, and New products not
yet imagined
The General Process of Becoming
Affordable and Accessible
1. First bring the problem to the solution 2. Then bring the solution to the problem
Minicomputers
Desktops
Laptops
Smartphones
Copyright Clayton M. Christensen
The Decentralization That Follows Centralization
is Only the Beginning of Healthcare
1. First bring the problem to the solution 2. Then bring the solution to the problem
Imaging:
MRI, CT, PET Scanners
High-speed,
Multi-Channel Testers
Specialist Physicians
Clinics
Personal Physicians
Offices
Nurse Practitioners
Retail Clinic
Homes
Surgical Suites
Pharmacists
Family
Care
Center for Innovative Science
Design Update
Sept 2012
20
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