The Intellectual Property briefing by IBM on May 2 in Greenwich was extremely interesting and I hated to leave a bit early but there was an overlap with another briefing down the road in Stamford, Connecticut — this one about healthcare. IBM’s healthcare and life sciences business is huge with 4,000 employees and revenues in the U.S. alone that would put it well into the Fortune 500. The company counts as customers 8 of the top 12 hospitals and all of the top 30 pharmaceutical companies. What has really put IBM on the healthcare map is last year’s acquisition of Healthlink, which brought with it 400 top healthcare consultants. The insight of the consultants plus the smorgasbord of IBM technology has put the company on a mission — to be a major factor in creating “Transformed Healthcare“.
IBM’s vision is significant — to build patient-centric information systems, shared health and wellness management systems, and integrated networks to pull it all together among the payers, the providers, and the patients. Many of the benefits are obvious but some are more subtle. Payer insurance companies may be transformed from claims processors to wellness concierges. Smoother workflow and process optimization due to better integration and access to information can lead to improved quality, fewer errors and lower healthcare costs.
IBM has a vested interest in becoming the leader at these things because it has a half-million employees and retirees. Their Global Health and Wellness program is a partner in developing solutions for clients and may itself become a model. The company not only has a wealth of information at the intranet web portal but also enables an electronic health record into which employees enter their personal information which is then supplemented by automatic updating from claim and pharmacy data. The company also provides incentives to exercise and stay healthy. As a result, IBM’s labor cost is significantly lower than industry averages.
The conference was attended by several dozen healthcare software vendors and various industry experts, including more than a half-dozen physicians. Most of the discussions revolved around the notion of "Patient centric" — connecting healthcare information about patients with insurers and healthcare providers for the benefit of the patient. The key to make all this work is standards and they will evolve through Regional Health Information Organizations (RHIO) and a National Health Information Network now called HIEWatch (HIEWatch). The RHIO includes consumers, hospitals, labs, pharmacies, payers, public health offices, and physicians. Progress is being made. A presentation was made by John Blair, MD, who is CEO of Taconic Healthcare Information Network, a RHIO just west of the Hudson River. They have connected practices, hospitals, labs and payers and have developed standardized electronic health records, e-mail access to physicians, and e-prescriptions. The NHIN has asked four IT companies to work on interconnection of the RHIO’s. Part of IBM’s NHIN architecture will be based on royalty-free health care information systems patents (discussed in the IP meeting earlier that day) which give priority access to requests for patient information coming from emergency rooms vs. routine office requests.
From a purely heath point of view, the biggest transformation will come from information based medicine that bridges healthcare and life sciences. Molecular level understanding of disease is being made possible, in part by supercomputers such as BlueGene, and the result will be the development of targeted drugs. In other words, based on a DNA sample and genomic analysis, a diagnosis and treatment can be based on our individual medical history and genetic predispositions. Whole new fields are opening up including pre-emptive medicine, pharmacogenomics and clinical decision intelligence. A small device the size of a cell phone can take a sample of your  blood and determine your rate of metabolism which in turn affects how much of a drug you need to provide optimal results. It will soon be possible to predict the likelihood of a person getting something deadly but yet preventable.
Advanced analytics are beginning to provide the ability to run complex algorithms to answer complex questions. For example, there is a 100 page document that provides guidelines on how to perform a particular surgical procedure. It is based on the “average” person. Nobody is average so would it be nice to be able to have a system which can provide specific recommendations based on many variables that are particular to an individual — providing the surgeon with a “how to” guide unique to each patient.
Molecular Profiling Institute is creating tools for genomic and proteomic profiling and treatment of cancers. Seventy of our 40,000 genes can predict breast cancer accurately. Dr. Robert Penny showed incredible examples. A particular gene that is missing or not working can tell the cause of a particular disease and a drug that can attack that specific gene can fix it and the patient can be cured. This is called “jumping diseases” — using a cure for disease xyz to treat disease abc. Dr. Penny showed before and after images of a dying cancer patient. After the application of a drug that attacked the targeted gene, the cancer disappeared. It gave the audience a lump in their throats.
There are many new issues arising along with the breakthroughs. For example, being able to know you have high odds of getting xyz disease for which there is no prevention and no cure after getting it, is questionable. The trend from physician centric to payer centric to patient centric is accelerating. It is likely that what will be accomplished in the next ten years will be vastly more than what has been accomplished in the last one hundred.

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