Dr. Eric Topol, voted by Modern Healthcare as the most influential physician executive in the United States, shared his thoughts on why people should own and control their own data.

Dr. Topol, a world-renowned cardiologist, geneticist, digital medicine researcher, and prolific author, is a true pioneer in personalized medicine. In 1975, he wrote his baccalaureate thesis, “Prospects for Genetic Therapy in Man” earning him an undergraduate degree with highest distinction from the University of Virginia. His work in the genomics of heart attack has led to the discovery of key genes and resulted in recognition by the American Heart Association as one of the top 10 research advances of the year, twice. Topol is Founder and Director of the Scripps Translational Science Institute. In 2016, Topol was awarded a $207 million NIH grant to direct a large portion of All of Us (Precision Medicine Initiative), the one million American prospective research program). Read his full bio.

Dr. Topol will present and be honored at PMWC 2018 Michigan taking place June 6-7, 2018.

Q: Genomics, Digital Health, Big Data, and Artificial Intelligence (AI) are some of the newest technologies/fields that are reshaping medicine and healthcare. How and when will they impact healthcare?

A: Right now, we have extraordinary potential to understand the medical essence of human beings in an unprecedented fashion. Surrounding that, there is considerable hype, while we also see some real advances – so there is a mixture of substance and hyperbole. Yet, it is undeniable: sensors, genomics, imaging, advanced analytics and particularly deep learning, a major subtype of artificial intelligence, are all making big strides. They are clearly going to make an impact on the future of medicine.

The progress is quite heterogeneous, with respect to medical conditions, timing ,and who will be affected. If you look at the person, the consumer, these technologies will be able to help manage a condition like diabetes. But today, the algorithms are dumb and only inform a patient that their glucose is going up or down, and they don’t factor in anything else in their lives. We now have far better glucose sensors that are factory calibrated, that will eventually, at lower costs, will make finger-sticks obsolete with smart algorithms. These glucose data will be integrated with other data: your activity, your sleep, your levels of stress, your nutrition, your gut microbiome, and much more. That will help coach people to regulate their glycemic levels far better than what we do today, and we will transcend imprecise parameters like glycohemoglobin. This is just one example of a new data and analytic framework for diabetic patients, or even people simply at risk for diabetes. The same kind of example would apply for high blood pressure or any other common chronic conditions. Eventually, but this will take much longer, we will see this across a person’s health –the approaches will be holistic. This is all on the individual level, but there are obviously many other levels (for doctors, hospitals, etc) where big data, AI, and the digital genomic revolution are going to have a significant effect.

Q: Is it feasible to successfully implement individualized/precision medicine for everyone and what are the biggest challenges?

A: Yes, it is feasible. Our number one problem today is the inability for people to have all of their data. No one has all of their medical data from birth, or even prenatal, all the way through life. Every medical encounter, every lab, every scan – no one has all that data, unlike places like Estonia and other countries where patients have and own all that data. This is step number one and currently we are still far away from that, but eventually that has to occur to maximize the data’s impact and to help preserve one’s health. If we are going to work with very limited data it is going to be a serious impediment in the area of AI. Instead of health systems and doctors owning the data, people need to own their data– it is vital that this flip occurs. And patients will very happily share their data with specific health providers, doctors, and others. But they need to be the ones who are making that decision.

Q: Some of these approaches to personalized medicine require individuals to continuously monitor a range of personal readings, such as blood pressure, glucose levels and heart rate. In light of recent renewed concerns regarding data security and patient data privacy, how will people’s minds and the general culture be changed to trust the collection and sharing of personal data with providers, via wearables or smartphones?

A: This is the number one issue for me, which will hold us back–privacy and security of the data. The endless sea of data breaches – whether it is Facebook or MyFitnessPal – can’t be tolerated in the medical world. This is another reason why people have to own their data and on a secure platform, like Blockchain or a private cloud. We need to achieve the highest level of data security and personal ownership. If you ask any cyber security guru for the best strategy, in relation to avoidance of data breaches, the first step is getting the data out of massive servers and getting it into units of one or small family units. Massive data servers are incredibly attractive to cyber thieves and hackers and medical data sells for 5-fold more than personal financial data on the Dark Web. This is yet another reason why people must own their data and have it made fully secure.

Q: How can we accelerate the developments, and deliver on the promises of precision/individualized medicine?

A: Give people control over all their data and let them own it. But we are a long way from that. We are seeing some first instances with Apple enabling people to get their data from health systems that have a portal and are cooperating with Apple. This is a good start. And that happened quickly, so for example, I got some of my data from both Scripps Health and UCSD Health, so for the first time I have that and my sensor data in one place, at my fingertips. There’s plenty of missing data, like scans, and multiple providers, but it’s far better than trying to go to multiple, clunky health system portals. This is the beginning of a quiet revolution for people – not just having their data, but eventually also owning it. This is a new development that will continue to evolve and be built upon, and this is important. It’s a signal of what is to come. We can’t do deep learning AI for any individual optimally without all of their data.

Besides data security the biggest problem are the deep learning algorithms that are so remarkable and can read scans, read slides, transform speech to text, etc. They all have to be validated, prospectively, in the clinical environment. What we have today is lots of in silico analysis and retrospective validation, but that is not good enough to change medicine. We need to see all of these things, whether it is retinal diagnosis, an EKG, or a heart arrhythmia, any type of medical scan, cancer pathology slides, or skin lesions—validated prospectively so that the medical community can accept it. None of this has been done to date. There isn’t one prospective clinical validation of these promising deep learning algorithms yet. At least nothing that has been published as of April 2018.

Interview with Gabriel Bien-Willner of Palmetto GBA

Q: What does your role entail as the director of the MolDX program at Palmetto GBA?

A: The job directing MolDX is multifaceted; first and foremost the MolDX program is responsible for assessing molecular diagnostic tests on the market and makes coverage and pricing determinations for such tests and technology. This is usually done through local coverage determination policies or technical assessments.

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Interview with Peter Marks of FDA

Q: The CBER’s Regenerative Medicine Advanced Therapy Designation program has been very successful, with about 100 requests for designation in the two years of its existence. Can you please tell us about the program and how it was put together?

A: The Regenerative Medicine Advanced Therapy (RMAT) Designation program came into being as part of the 21st Century Cures Act that was signed into law on December 13, 2016.

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Interview with Calum MacRae of Harvard Medical School

Q: What patient data do we need to better understand the underlying cause of disease and how to prevent it?

A: Medicine at present is highly underdetermined and data poor. To be precise, one must be comprehensive, so medicine (with our consent) will use not only what we currently conceive of as biomedical information, but also data from across our lives.

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Headlines from PMWC 2019 Silicon Valley

A big ‘Thank You’ to all of our presenters and attendees for celebrating 10 years of precision medicine progress with us! PMWC 2019 Silicon Valley was attended by 2000 participants from 35 countries, which included over 400 speakers in 5 parallel tracks!

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Interview with Ken Bloom of Ambry Genetics

Q: Tell us more about your organization/company. What patient population are you serving and which services are you specializing in?

A: Ambry Genetics is a recognized leader in high quality complex genetic testing. We seek to find the genomic cause or contributors to rare diseases, abnormal phenotypes and hereditary disorders.

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Interview with Lee Pierce of Sirius Computer Solutions

Q: What is the state of big data and analytics in healthcare, and how to best use the reams of data available?

A: More than ever, Healthcare organizations are achieving measurable value through use of their data and analytics assets. There is more raw material available than ever to create value. This raw material is the data flowing from internal systems and applications and also from devices and systems external to healthcare organizations.

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Interview with Anita Nelsen of PAREXEL

Q: There are various new, emerging technologies that bring us closer towards a cure for life-threatening disorders such as cancer, HIV, or Huntington’s disease. Prominent examples include the popular gene editing tool CRISPR or new and improved cell and gene therapies. By when can we expect these new technologies being part of routine clinical care?

A: Today’s emerging technologies are making the promise of individualized treatment a reality.

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Interview with Ilan Kirsch of Adaptive Biotechnologies

Q: The Nobel Prize in Medicine was awarded recently to James Allison and Tasuku Honjo for their work on unleashing the body’s immune system to attack cancer, a breakthrough that has led to an entirely new class of drugs and brought lasting remissions to many patients who had run out of options. The Nobel committee hailed their accomplishments as establishing “an entirely new principle for cancer therapy.” What is your first-hand experience the impact that those new drugs had on patients?

A: For decades cancer was viewed as solely a cell-autonomous condition.

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BMS buys Celgene | Lilly buys Loxo Oncology – Does this Signal a Return to Strong Deal-Making Activities in 2019?

Bristol-Myers Squibb’s blockbuster $74B deal to buy Celgene creates an oncology powerhouse amid industrywide excitement about the rapidly evolving science and explosive growth of the sector. The agreement could signal a return to deal-making for the pharmaceutical industry in the $133B global oncology therapeutics market.

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Interview with Gini Deshpande of NuMedii

Q: What need is NuMedii addressing?

A: NuMedii, has been pioneering the use of Big Data, artificial intelligence (AI) and systems biology since 2010 to accelerate the discovery of precision therapies to address high unmet medical needs. Artificial Intelligence approaches are a natural fit to harness Big Data as they provide a framework to ‘train’ computers to recognize patterns and sift through vast amounts of new and existing genomic

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Interview with Minnie Sarwal of UCSF

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend?

A: Completion of complete sequence data from the human genome project, and the advances in proteomic, microRNA and epigenetic assays added a layer of pathway biology to the understanding of human diseases.

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Interview with Shidong Jia of Predicine

Q: Once sequencing has been validated as a clinical solution via trusted workflows, and coinciding with the technological developments driving costs lower, we can expect accelerated human genome profiling for clinical Dx. How soon, do you think, will we see accelerated growth and what can we expect?

A: We will see accelerated human genome profiling for clinical Dx in 2019 and the coming years as more biomarker-based cancer drugs are gaining approval.

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Interview with Iya Khalil of GNS Healthcare

Q: Artificial intelligence (AI) techniques have sent vast waves across healthcare, even fueling an active discussion of whether AI doctors will eventually replace human physicians in the future. Do you believe that human physicians will be replaced by machines in the foreseeable future? What are your thoughts?

A: I think that there’s a lot of speculation and uncertainty around AI, but I don’t foresee a time when we won’t need physicians.

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Interview with Ilya Michael Rachman of Immix Biopharma Inc.

Q: The Nobel Price in Medicine was awarded recently to James Allison and Tasuku for their work on unleashing the body’s immune system to attack cancer, a breakthrough that has led to an entirely new class of drugs and brought lasting remissions to many patients who had run out of options. The Nobel committee hailed their accomplishments as establishing “an entirely new principle for cancer therapy.” Besides CAR T-cell therapy what do you think next generation immunotherapies will look like to successfully combat cancer?

A: The next generation of immunotherapies will build on the insights discovered by immunologists like James Allison and Tasuku Honjo and extend them to modify the body’s response to tumors.

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Join me to Kick off PMWC Silicon Valley in the Santa Clara Convention Center, Focusing on Every Element of Precision Medicine

My team worked in collaboration with Bill Dalton, Kim Blackwell, Atul Butte / India Hook Barnard, Nancy Davidson and Sharon Terry to create a program that touches every component of precision medicine while bringing together all of its key stakeholders. Leading participating institutions including Stanford Health Care, UCSF, Duke Health, Duke University, John Hopkins University, University of Michigan and more will share their learnings and experiences and their successes and challenges, as they make precision medicine the new standard of care for all.

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Johns Hopkins
University Of Michigan

The Precision Medicine World Conference (PMWC), in its 17th installment, will take place in the Santa Clara Convention Center (Silicon Valley) on January 21-24, 2020. The program will traverse innovative technologies, thriving initiatives, and clinical case studies that enable the translation of precision medicine into direct improvements in health care. Conference attendees will have an opportunity to learn first-hand about the latest developments and advancements in precision medicine and cutting-edge new strategies and solutions that are changing how patients are treated.

See 2019 Agenda highlights:

  • Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
    • AI & Data Science Showcase
    • Clinical & Research Tools Showcase
    • Clinical Dx Showcase
    • Creating Clinical Value with Liquid Biopsy ctDNA, etc.
    • Digital Health/Health and Wellness
    • Digital Phenotyping
    • Diversity in Precision Medicine
    • Drug Development (PPPs)
    • Early Days of Life Sequencing
    • Emerging Technologies in PM
    • Emerging Therapeutic Showcase
    • FDA Efforts to Accelerate PM
    • Gene Editing
    • Genomic Profiling Showcase
    • Immunotherapy Sessions & Showcase
    • Implementation into Health Care Delivery
    • Large Scale Bio-data Resources to Support Drug Development (PPPs)
    • Microbial Profiling Showcase
    • Microbiome
    • Neoantigens
    • Next-Gen. Workforce of PM
    • Non-Clinical Services Showcase
    • Pharmacogenomics
    • Point-of Care Dx Platform
    • Precision Public Health
    • Rare Disease Diagnosis
    • Resilience
    • Robust Clinical Decision Support Tools
    • Wellness and Aging Showcase

See 2019 Agenda highlights:

    • Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
      • AI & Data Science Showcase
      • Clinical & Research Tools Showcase
      • Clinical Dx Showcase
      • Creating Clinical Value with Liquid Biopsy ctDNA, etc.
      • Digital Health/Health and Wellness
      • Digital Phenotyping
      • Diversity in Precision Medicine
      • Drug Development (PPPs)
      • Early Days of Life Sequencing
      • Emerging Technologies in PM
      • Emerging Therapeutic Showcase
      • FDA Efforts to Accelerate PM
      • Gene Editing / CRISPR
      • Genomic Profiling Showcase
      • Immunotherapy Sessions & Showcase
      • Implementation into Health Care Delivery
      • Large Scale Bio-data Resources to Support Drug Development (PPPs)
      • Microbial Profiling Showcase
      • Microbiome
      • Neoantigens
      • Next-Gen. Workforce of PM
      • Non-Clinical Services Showcase
      • Pharmacogenomics
      • Point-of Care Dx Platform
      • Precision Public Health
      • Rare Disease Diagnosis
      • Resilience
      • Robust Clinical Decision Support Tools
      • Wellness and Aging Showcase
  • Luminary and Pioneer Awards, honoring individuals who contributed, and continue to contribute, to the field of Precision Medicine
  • 2000+ multidisciplinary attendees, from across the entire spectrum of healthcare, representing different types of companies, technologies, and medical centers with leadership roles in precision medicine
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