IT is pushing medical care to a new era, IBM exec says

The convergence of life sciences and IT, now in its early stages, means that we'll live longer, perhaps significantly so, as doctors have better access to data that will help them prevent, diagnose and treat diseases, Caroline Kovac, the general manager of IBM Corp.'s life sciences group, said Wednesday at the Bio-IT World Conference and Expo.

The profound changes in medical care won't initially happen in doctor's offices but at research facilities and large pharmaceutical companies, with collaborative projects that lead to massive databases of information about patients, she said, speaking on the second day of the conference. Those stores of data will be tapped into by those involved in health care, including pharmaceutical companies that will develop better, safer clinical drug trials.

IBM calls this future health-care system "information-based medicine." Some have suggested IBM prefers that tag over "specialized" or "personalized" medicine because its acronym is IBM, Kovac said, but then admitted that it took those in the company's life sciences group three weeks to realize that. They might be more on the ball, though, when it comes to insisting that, contrary to what some think, this new type of medicine "is going to happen sooner than we think," Kovac said.

Sequencing the human genome marked "the race to the starting line," and signaled the start of major new projects related to creating databases of information that, for example, track genealogies and can be used to figure out who is likely to come down with certain diseases. Kovac pointed to the work of Reykjavik-based deCODE Genetics Inc. to collect data on people in Iceland as a way to determine genetic causes of common diseases. Similar work is being done in Estonia, Kovac said.

"This whole issue of genealogy and population data is going to be very important," she said.

A ripple effect will occur as genetic causes of diseases are determined, with prevention becoming a cornerstone of medical care, but with issues arising such as how health-care providers will be paid for preventing a disease that could be years away from actually occurring in a patient. Despite issues such as these, the life sciences-IT convergence presents "tremendous opportunities" to vendors from both sides that seize those opportunities rather than shy away from them, Kovac said.

Before the opportunities are realized, however, the infrastructure must be put in place to build electronic-records databases. Those exist now in health care but are often used for billing and record keeping to track matters such as "who had surgery this morning," she said. The difference in what will occur in the future is that doctors will actually use such database systems, which eventually will be a combination of patient records and genomic records, to practice medicine.

Doctors, pharmaceutical companies and researchers will electronically mine databases of patient information. Doctors will use the databases to glean information that will help them make better diagnoses, rather than relying only on their past experiences with just their own patients and what little time they likely have to read current medical literature to stay up to date. Drug companies and researchers will plumb the data stores to develop clinical studies.

"What used to take weeks and weeks, to build a population for a study, now takes on the order of a matter of hours," Kovac said, referring to work already being done at the Mayo Clinic, in Rochester, Minnesota, an IBM customer. Mayo Clinic officials have told Kovac that their patient information database is the largest in the world. Researchers there, as well as in Japan, the U.K., and elsewhere around the globe, are using such information to identify genes and markers associated with predisposition to diseases.

However, that knowledge is useful only if doctors can then do something about it, offering effective treatment and drugs to stave off diseases. As part of that aspect of information-based medicine, work is under way to bring together medical images and molecular diagnostics. For example, studies are occurring to assess whether patients are at risk of aortic aneurysms. Using medical imaging, doctors can see if patients have places on their aortas that appear to be at risk for rupturing. They can then decide if the situation could be potentially life threatening and if surgery should be performed rather than risk a rupture happening.

Other research involves breast cancer risk and hormone receptors, "going from, 'Here's a woman who is high risk' to 'Here's one whose hormone receptors are moving in a direction that means six months from now this will be invasive breast cancer, so maybe she should be treated now." Such strides in medical care also mean that doctors will be able to decide which patients can be treated more effectively with drugs such as Tamoxifen, used for some breast cancer patients.

While the new approach to health care takes shape, issues must be addressed, such as standards for medical information including ones covering data sharing and interoperability, as well as diagnostic information management and security of information. Kovac isn't very worried about the security issue, which she said is a matter of proper implementation of regulations.

Along the way, medical devices will increasingly rely more on IT so that, for example, devices will predict that a person with Parkinson's disease is about to have a tremor and so will send an infusion of drugs into that person's brain to prevent the tremor.

Much of what Kovac outlined in her talk is in the early stages, but it all will lead to one thing, she said: "profound, profound change," including that big boost in life expectancy. In 1900, life expectancy was 45 to 47 years and in 2001 it was more than 77 years, she said, noting that the steepest curve upward, from 1910 to 1940, represented advances in knowledge about diseases. Now medicine is poised at a time "when we have every reason to expect this curve to increase significantly" in the future, she said.

The Bio-IT World Conference and Expo continues through Thursday at the Hynes Convention Center.

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