2. Agenda
part 0 Orange Healthcare
part 1 the evolution of personalized medicine
part 2 down the road
part 3 a prediction
2
3. Orange Healthcare
joining up healthcare
Orange helps modernize the healthcare infrastructure as well as
healthcare systems as a whole, and equip healthcare facilities with
communications solutions
we are convinced that the medicine of tomorrow is connected
medicine in which the management of healthcare data and medical
information play an essential role
at Orange Healthcare, we are using our expertise in communications
to enable healthcare professionals to increase patient comfort and
peace of mind
3 Orange Healthcare - 2012
4. in 2012, Orange has solutions to offer in 3 areas
services for remote healthcare preventive
healthcare monitoring services
professionals services
professionals to professionals to patient
professionals patients
our services connect our services allow patients our tools allow individuals to
infrastructure to improve to keep in touch with improve prevention by
coordination, collaboration, healthcare professionals, managing their own health
and information flow among so professionals can and well-being on a day-to-
all the traditional players in provide high-quality care day basis
the healthcare profession
hosting and sharing of medical remote monitoring of cardiac drug authentication
imaging arrhythmia
4 Orange Healthcare – 2012
- 2012 Orange Healthcare
5. Our value chain is tightly linked with key partners:
medical device manufacturers, health apps editors...
Patients Partners Partners
Medical Orange Health Healthcare
Healthcare Applications ecosystem
Devices Value
Chain
Global
Health M2M, Integration Specific
“Computin Internation , developmen
g” al Helpdesk, ts (Security,
(hosting) backbones services to portals)
& Last mile end users
Consulting, Integration
Communication layer : voice and data transmission
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6. 1- The evolution of personalized medicine
Today, personalized medicine is mainly
about oncology
Stakeholder concerns:
Patients: more effective with fewer side effects
Pharmas: reduce drug failures in late clinical trials
Regulatory: value for money
Today : over 50% of cancer
drugs in development are targeted
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7. 1- The evolution of personalized medicine
The emergence of new technologies allows for a
larger view of personalized medicine
1 “Big Data” Prevention
2 Enabling access to information
Patient
empowerment
3 Monitoring patients anytime,
anywhere
New ways of
delivering care
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8. 2- Down the road
In a few years, DNA sequencing will be about $100
$100 000 000
Moore’s
$10 000 000 Complete DNA law
sequencing cost
$1 000 000
$100 000
$10 000
$1 000
Jul 2002 Jul 2004 Jul 2006 Jul 2008 Jul 2010 Oct. 2011
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9. 2- Down the road
Predictive medicine for everyone.
9
10. 2- Down the road
Personalized medicine in prevention:
What are the advantages? The downside ?
2003 Today Tomorrow
Human Genome Project
International team Disease likelihood,
$ 3 billion (US) adverse effects
Targeted drugs,
bespoke follow up
Risk for payers: Risk for patients:
“health dictatorships” What if I do not want to
Competition between know ?
countries. 57% of individuals at risk for Huntington’s
Disease indicated an interest in testing before
it was available. 16% took the test*
10
*Maat-Kievit et al. J Neurol Neurosurg Psychiatry 2000;69:579-583
11. 2- Down the road
Personalized medicine in prevention:
The downside……
How Super Bowl has made a $1,500 treatment (which
costs $200) popular without any proof of efficiency
11
12. 2- Down the road
Personalized medicine and patient empowerment
The possibilities exist. What are the advantages?
Medical imaging in general practice 2010
US: 68m X-rays, 42m MRI
Patients generate data
Fr: 50m (X-rays + MRI) with professionals, or alone
Patient record
The medical cloud
Veteran Health Administration: 5.5m
is up and running
France: dossier pharma > 15m
It is not just about
raw data, but also
corporate decision
making tools
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13. 2- Down the road
Personalized medicine
as new ways of delivering care
Asthma A better follow-up for
300M people worldwide (5% the patient
population),
You’ve been using your
what triggers asthma attack remains
unclear
inhaler twice as much as you
did last month - is everything
1985: asthma epidemic hits ok?
Barcelona.
All attacks occurred near the harbour, A better
when ships were unloading soya beans. understanding of the
external causes
You might want to avoid
2011: chips inside getting too close to that crop!
asthma inhalers
13
14. 2- Down the road
Personalized medicine:
consequences of “Big Data”
•Massive
amounts of
data
•New kind of
follow up, with
new medical
challenges
•New kind
of jobs
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15. 3- a prediction
Personalized medicine will require the end of two myths:
the omniscient physician,
and the patient-led revolution in healthcare
Data will be available
But does it fit an existing healthcare process ?
Is there someone to monitor & interpret this data?
Are physicians ready to use data collected by their patient?
We will be facing two challenges
Over-expectation: omniscient physician
Be sure that healthcare pros are leading the way ,
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presentation title presentation title presentation title Introducing the three pillars. Distribution: Two thirds: 20% to 10% Health management: list the diseases (diabetes, cardiovascular disease, kidney failure, etc.) En 2011: one billion euros; it is expected to double within five years.
presentation title
presentation title The X Prize. $10 million to the first team to rapidly, accurately and economically sequence 100 whole human genomes The complete sequence of the human genome occupies about 1Gb.
presentation title The complete sequence of the human genome occupies about 1Gb.
presentation title The X Prize. $10 million to the first team to rapidly, accurately and economically sequence 100 whole human genomes The complete sequence of the human genome occupies about 1Gb.
Left : Hines Ward, Right : Troy Polamalu Other eg : H1N1 in France, patients decided not to follow OMS recommandation, and to skip vaccination Conclusion : Patient community duty, physician must be part of the buzz, etc
presentation title Patients like me : 100 000 patients in 2011, more than 500 diseases.
presentation title In 1985 and 1986 an epidemic of asthma hit Barcelona. The city’s researchers first turned to the usual suspects, such as air pollution, pollen and mould. But a series of telephone interviews with the sufferers pointed to a much more precise cause. All the attacks had occurred by the harbour, and at times when ships were unloading soya beans. The cause was clear: soya-bean dust. So was the solution: the installation of filters on the harbour’s silos. Stories of success, like that of Barcelona, are rare. Part of the reason for that lack of clarity is inadequate data on where and when attacks happen. But David Van Sickle, an epidemiologist and medical anthropologist who once worked for America’s Centres for Disease Control and Prevention (CDC), has come up with a solution. This is to use the asthma inhalers carried around routinely by patients to record the time and location of symptoms as they happen. To develop his idea, Dr Van Sickle left CDC and founded a company, Asthmapolis, which is based in Madison, Wisconsin. The result is Spiroscout, an inhaler with a built-in Global Positioning System locator and (in advanced models) a wireless link to the internet. Whenever someone uses the inhaler, it broadcasts the location and time to a central computer. Asthmapolis plots and analyses the data, and sends weekly reports to participating patients and their doctors summarising the observations and making recommendations. Over the past three years Dr Van Sickle has run two pilot studies to test the new tool. Both of these showed useful improvements in patients’ management and understanding of their disease. They have also resulted in him questioning some longstanding theories about asthma, including the ideas that symptoms occur primarily at home and that the affliction is more prevalent in urban areas than rural ones. If those insights are confirmed, they will change the way asthma is managed. Commercialisation is planned for the autumn.
presentation title Just like MRI, it’s a new way for healthcare.