dr. Andrew Litt : DELL Healthcare and Life Sciences, Chief Medical Officer

1. Powering the Possible
Genes, Clouds and Cancer

2. Dell Healthcare
& Life Sciences
by the numbers
#1 Worldwide
Healthcare IT
Services Vendor Gartner
13,000 employees
worldwide.
Serving >50% of US
hospitals that care to
90 million Americans
Serving 7 of top 10
pharmaceutical
companies
Serving 100
insurance
organizations with
65 million members
Managing over
6 Billion medical
images in cloud
based archive
Support for >500
software, medical
device & scientific
instrument providers
Leading IT provider
for 1st, 2nd and 3rd
generation gene
sequencing
Managing 14
billion security
events a day
Provide OEM services to
70+ Healthcare and Life
Sciences software, medical
device and scientific
instrument providers
2
300+ MDs, RNs and
PhDs
Sponsor of 1st FDA
Approved GenomicsBased Pediatric Cancer
Clinical Trial
Healthcare

3. Evidence based
medicine
Target population
Therapeutic option 1
A
Selection of representative
study cohort
Therapeutic option 1
30%
Response rate
Therapeutic option 2
Clinical trail
3
20%
Drug of choice for
EVERYONE in target
population
Option 2 is not
approved for this
indication
Response rate
Healthcare

4. Evidence based
medicine
Target population
Information enabled
medicine
Therapeutic
option 1
A
Therapeutic
option 2
B
Selection of representative
study cohort
Association of molecular feature
to phenotype/response
4
Healthcare

5. Information Enabled Medicine
Plavix
• Mutation in CYP2C19 causes 3 fold
increase in stent clotting
• Mutation is present in 30% of European,
40% of African and 50% of Asian
ancestries
5
Healthcare

6. Evidence based
medicine
N=1
Information –enabled
medicine
Precision
Medicine
100’s of options
Selection of an
individualized
option
Molecular
profiling
Individualized
Information
6
Intelligent
interpretation
(understanding)
The key question is:
How do we do that ?
Healthcare

7. Powering the Possible program
Finding cures and hope for Pediatric Cancer
• Cancer isn’t just one disease, it’s hundreds – and varies between individuals
• More effective cures can be “discovered” for each tumor and by attacking
the unique vulnerabilities of each child’s tumor directly
• Why Pediatric Oncology?
– Leading cause of disease-related death in children ages 1-14
– A child diagnosed with cancer every hour
– Cure rates have not improved in the last decade
– Pharmaceutical companies have thousands of new drugs in
development but very few target pediatric cancer
• Why Neuroblastoma?
– Worst clinical outcome of any pediatric cancer
– 5% chance of cure in children with advanced stages of the disease
– Even with remission, the cancer often returns and is untreatable
7
Healthcare

8. Panel of Genes
vs.Exomes
vs. Whole Genomes
Whole Genome
Sequencing
challenges:
–Cost vs.
Interpretable Data
–Informatics
Challenges
Healthcare

9. GEDI – Genomics Enabled Drug Inference
Genomic Compendium Report
Gene Drug Relationship Database
Heuristic Rules Algorithm
Healthcare

10. First ever clinical trial using Molecular guided
Individualized therapy in pediatric cancer
Biopsy
Molecular
profiling
Dell High Performance
Computing:
Faster and deeper
profiling for each child
10
Healthcare

11. DATA ANALYSIS
SEQUENCING
DAYS
LIBRARY PREP
STANDARD
GOAL
STRETCH
GOAL
SUPER
STRETCH
GOAL
Healthcare

12. Active Infrastructure for HPC Life Sciences
A complete, integrated genomic processing infrastructure
Designed to meet
the needs of genomic
research
Factory-integrated,
HPC infrastructure
• Includes all resources
required for complete
analysis workflow
• NGS output directly to
compute grid
• Compatible with extensive
genomics application
ecosystem
• Optimized for performance,
density, efficiency & power
Reduce turnaround times
from days to hours!
12
• Linux-based 512 node cluster
• Large memory node
• Lustre-based parallel file
system
• NAS-accessed output data
/user files
• Cluster and workload
management
• Rich standard development
tools
• Services and support
High performance computing
meets big data!
Healthcare

13. Rapid results with maximum efficiency
Dell Active Infrastructure for HPC Life Sciences
A complete genome analysis in less than an 8 hr.
Up to 38 genomes processed per day
As low as 25 kilowatts per genome
Up to 9.4 Tflops, 1.5 TBs RAM, 520TBs in 42U chassis
Time to production reduced from months to weeks
One source for solution design, delivery, and support
13
Healthcare

14. First ever clinical trial using Molecular guided
Individualized therapy in pediatric cancer
Dell Genomics Cloud:
Improved clinical/scientific
communication and
collaboration
Biopsy
14
Molecular
profiling
Molecular
tumor
board
Healthcare

15. Accessing Networked Genomic Data:
Multiple Data Portals
Genomic Tumor Board
Clinical Trial Data Portal
Cancer Genome Data Portal
KIDS-CLOUDS
Unifying Precision Medical
Genomics Ecosystem
Knowledge Computing Research Portals
Public Facing Portals for Specific Trials
Healthcare

16. Collaborative Molecular Medicine
Video Conferencing & Scheduling Capabilities – Cisco Suite of WebEx and TelePresence Video
Interactive Dashboard for Presenting Multi-Media Files In Real Time – Lightbox App
Capturing Corollary Findings, Ideas and Side-Bar Conversations – Research Forum App
Searchable Back-end File and Knowledge Management Archive – Dell HIPAA HC Cloud
WebEx
Video
Data Sharing Portal
Apps Bin:
LightBox,
Research
Forum, etc
Searchable
Archive
Patient
Centric Files
Healthcare

17. First ever clinical trial using Molecular guided
Individualized therapy in pediatric cancer
Dell Genomics Cloud:
Improved clinical/scientific
communication and
collaboration
Biopsy
Molecular
profiling
Molecular
tumor
board
Personalized
Treatment
Dell High Performance
Computing:
Faster and deeper
profiling for each child
17
Healthcare

18. For Pediatric
Cancer, Cloud
technology helps
identify
personalized
treatment
strategies
for children with
neuroblastoma
Increases
computation and
collaboration capacity
by 1,200%
Reduces mapping
and analysis from
weeks to hours
Expands participation
from a few children to
hundreds and then
thousands
Healthcare

19. Powering the Possible for Pediatric Cancer
Case Study - Dramatic Response in all 4 tumor areas
June 6, 2012
Giselle Sholler, M.D. – Presentation, SIOP Conference
October 10, 2012
Healthcare

20. Shelby: A Medical Miracle
Healthcare

21. Big Data:
Security and
Privacy
Healthcare

22. It’s all about Trust
It’s all about Trust
2
Healthcare

23. Patient perspectives on sharing information
• 54% of patients would withhold information
• 38% would postpone seeking care
• 37% would travel substantial distances to avoid a
hospital they don’t trust with their privacy
• 73% said serious breaches of PHI would reduce
confidence in the quality of healthcare provided
• 97% said healthcare executives have a legal and
ethical responsibility to protect their privacy
• 87% think health executives should lose their jobs
over failure to act
23
Source: Fairwarning Report: Industry Best Practices for Patient Privacy
in Electronic Health Records, April 2011
Healthcare

24. 96%
Percentage of all healthcare
providers that had at least
one data breach in the past
two years
$27
18+ million
billion
Number of patients whose
protected health information was
breached between 2009 and 2011
Amount earmarked
between 2011 and 2015
for attesting to
meaningful use of EHR
60%
Proportion of healthcare
providers that have had 2 or
more breaches in the past 2
years
$50
Black market value of a
health record
65%
Proportion of breaches
reported involving
mobile devices
Healthcare

25. 25
Healthcare

26. Security strategy should support 4 critical areas
Data
visibility
Endpoint
access and
encryption
26
Mobile
device
strategy
Security
and risk
monitoring
Healthcare

27. Dell Healthcare:
Better information
Better healthcare
27
Healthcare