EuroBioForum 2013 2nd Annual Conference 27-28 May 2013 - Hilton Munich City, Munich, Germany http://www.eurobioforum.eu/2013 ======================================= # REGIONAL PERSPECTIVES # Rotterdam Delta, The Netherlands: What’s keeping medicine from becoming personalised? Dr Menno Kok, Advisor Research Strategies Erasmus MC and sector manager Medical Delta ======================================= http://www.eurobioforum.eu

1. 27-28 May 2013, Munich, Germany
EuroBioForum 2013 2nd Annual Conference
What’s keeping medicine…
from becoming personalized?
Menno Kok

2. • Appr. 14.000 employees, of which > 1500 medical and scientific staff
• > 40.000 patients admitted
• > 500.000 visits to outpatient clinics
• 27,700 operations (incl. day treatment)
• Appr. 3000 medical students
• 28 medical specialty training courses
• > 1000 PhD students
• > 400 transplantations/y
• 400-450 new clinical trials/y
• Budget € 1.3 billion
Erasmus University Medical Center, Rotterdam

3. Top Reference and Top Clinical Care:
Cardio-Vascular (Thorax Centre)
Clinical Genetics
Gastero-Enterology
Infectious Diseases, Virology
Oncology (Daniel den Hoed Clinic)
Pediatrics (Sophia Children’s Hospital)
Transplantation (Liver, Kidney, Heart,
Lung, Bone Marrow)
Traumatology
Research:
Cardiovascular
Oncology
Cell Biology & Genetics
Immunology & Haematology
Neurosciences
Pediatrics
Medical Technology/Imaging
Epidemiology and Public Health
Health Policy and Management*
Erasmus University Medical Center, Rotterdam

4. Personalized Medicine
Personalized medicine generates and uses all the relevant information
available on the individual patient to make informed choices between
treatment options and fine-tune these subsequently.
Main activities of Erasmus MC:
- Cancer (breast, colon, lung, prostate, skin, brain, leukemia);
- Cardiovascular dis.;
- Medical Informatics (phase IV); Bio-informatics
- Imaging, -omics
- HTA
Collaborative efforts:
- All strategic research in national and mostly international collaboration;
- Epidemiological research (coupled cohorts);
- String of pearls 8  13 disease area’s, connection to electronic patient files.

5. Personalized Medicine
Personalized medicine generates and uses all the relevant information
available on the individual patient to make informed choices between
treatment options and fine-tune these subsequently.
is it really all about genetics?

6. Personalized Medicine
Genetic variation
Epigenetic variation
Age (life stage)
Food intake
Circadian clock
Stress
Impaired organ function
Other confounding conditions
Body sizeMicrobiome
Previous exposure
Physical and mental activity

7. Function
Personalized Health
Life phase: I II III IV

8. Function
Annual cost
Personalized Health
Inclusion in
clinical trials
Life phase: I II III IV

9. Personalized Health
Personalized Health generates and uses all the relevant information
available on the individual citizen to provide him/her with advice on health
issues, life style, work-life management, physical and socio-psychological
capacity building and (other) preventive options.
Main hurdles:
At research level: evidence base
At implementation level: reimbursement models
At execution level: acceptance and adherence
Personalized Medicine generates and uses all the relevant information
available on the individual patient to make informed choices between
treatment options and fine-tune these subsequently.

10. Personal perspective
Empirical (genetic) data changes the way individuals perceive themselves and
their families, and change the way others see them (Taylor, 2008)
Self management: personalized health shifts the responsibility for good health
from government and collectives to the individual, who becomes responsible
for his/her own health or disease (Savond, 2013).
Patient centered medicine requires patient centered decision-making, health
literacy, trusted information sources, and better communication to start with.

11. 1. Innovation in clinical trials;
2. Develop point of care devices and technologies;
3. Promote personalized health.
TOP 3 recommendations: