Abstract: Medicine has become an information business, driven by data from new technologies, especially genomics and imaging, as well as from new sources, like wearables and IoT. Accordingly, excellence in patient care, especially for complex diseases, requires integrating, processing and presenting these data to care-giver teams. Roche is aggressively entering this field, by leveraging its breadth and depth of medical and technical expertise, to develop and commercialize a Decision Support portfolio of workflow and decision support software products. The NAVIFY Tumor Board workflow solution, collects and combines patient data integrated from multiple silos of in treatment center, including EMR, PACS and pathology, and presents them in a single dashboard so cross-functional oncology care teams can review and agree on optimal treatment plan for patients. This presentation will give an overview of the new information challenges in clinical decision-making, and use the NAVIFY Tumor Board as an example of solutions that will become more prevalent across medicine.

Bio: Ketan is the VP of Diagnostics Information Solutions at Roche and his team is focused on harnessing the power of data, diagnostics and other critical information to support better clinical decisions. Prior to this role he was a Managing Director at Health2047 and General Manager of Life Sciences at Intel Corp. He has been a member of the US Health IT committee on Precision Medicine, and part of numerous taskforces at AAAS-FBI-UNICRI, ITU and WHO. He has an MBA and MS and is a certified Paramedic. 

Abstract: Healthcare in the USA consumes 18% ($3.5 Trillion) of the national GDP. As this cost has increased over the last half century, simultaneously there has been a massive shift in disease burden from episodic/acute to chronic disease (chronic disease now accounts for >80% of the healthcare spend). Yet the structure of medical school curricula/ongoing learning, as well as the structure of the health care system overall have only modestly adapted to these striking changes in the type of disease the country faces. In parallel, the digital revolution, remote monitoring, telemedicine, and an astounding growth in health data are edging into healthcare, but our “system” remains fragmented and siloed with poor incorporation of clinical data organization, interoperability, and data liquidity. The AMA has approached these problems by: developing and piloting the medical school and educational networks of tomorrow, creating new connected approaches to chronic disease, and defining how one can turn this non-system into more of a authentic system. Doing this requires rethinking the use of digital environments and, in particular, creating advances in the organization and liquidity of clinical data. Accomplishing this required the AMA to launch an independently operating Silicon Valley innovation company (Health2047.com) which has successfully launched companies with efforts ranging from clinical data liquidity (Akiri.com) to “uberization” of the approach to chronic disease (First Mile Care.com); while, at AMA headquarters in Chicago, producing new approaches to clinical data organization (https://www.ama-assn.org/amaone/integrated-health-model-initiative-ihmi ), a digital network to connect entrepreneurs with physicians having like interests (https://innovationmatch.ama-assn.org) , and a digital medicine advisory group (https://www.ama-assn.org/practice-management/digital/digital-medicine-payment-advisory-group) to provide a more disciplined approach to the digital space in medicine. 

Bio: James L. Madara, MD, is CEO of the American Medical Association. His career began with 20+ years at Harvard where he received clinical and research training, served as a tenured professor of pathology and was director of the NIH-sponsored Harvard Digestive Disease Center. After five years as chair of pathology (Emory), Madara served as the Thompson Distinguished Service Professor and dean of the University of Chicago Pritzker School of Medicine, and as CEO of the University of Chicago Hospitals. Along with his current position, Madara is chairman of Health2047 Inc. An independent C-corporation, Health2047 is a San Francisco-based design firm whose mission is to help advance the AMA’s goal of improving the health of the nation through innovative solutions.

Abstract: Recent advances in materials, mechanics and manufacturing establish the foundations for high performance classes of electronics and other microsystems technologies that have physical properties precisely matched those of the human epidermis. The resulting devices can integrate with the skin in a physically imperceptible fashion, to provide continuous, clinical-quality information on physiological status. This talk summarizes the key ideas and presents specific examples in wireless monitoring for neonatal intensive care, and in capture, storage and biomarker analysis of sweat.

Bio: Professor John A. Rogers is the Louis Simpson and Kimberly Querrey Professor of Materials Science and Engineering, Biomedical Engineering and Medicine, with affiliate appointments in Mechanical Engineering, Electrical and Computer Engineering and Chemistry, where he is also Director of the newly endowed Center for Bio-Integrated Electronics. He has published more than 650 papers, is a co-inventor on more than 100 patents and he has co-founded several successful technology companies. His research has been recognized by many awards, including a MacArthur Fellowship (2009), the Lemelson-MIT Prize (2011), and the Smithsonian Award for American Ingenuity in the Physical Sciences (2013) – and most recently the MRS Medal from the Materials Research Society (2018). He is a member of the National Academy of Engineering, the National Academy of Sciences, the National Academy of Inventors and the American Academy of Arts and Sciences.

Abstract: The burgeoning development of new technologies presents an interesting set of problems, especially in the health care arena. Federal regulatory agencies, industry, academia and constituency support groups are faced with the dilemma of providing the general population with the greatest and earliest exposure to technology without putting them at risk of premature product introduction – the tension between above all do no harm and rush to treat. It has become impossible to run clinical trials for long enough to identify rare, but potentially fatal events, and not impede technology transfer. Preclinical models are artificial and similarly constrained to consider only a subset of states. Only computational in silico models can embody the conceptual framework of device and drug interaction with pathology states, and in reasonable time simultaneously consider multiple permutations and combinations of anatomic structures, physiologic phenomena, pathologic states and possible interventions, device and drugs. 

Nowhere are these issues more acute than in the cardiovascular space – where diseases and dysfunction are responsible for the greatest causes of morbidity and mortality around the world. Innovation in every phase of live and medicine has reduced death from cardiovascular disease four-fold in the last 60 years. As we rush to sustain this momentum the balance of boldness and caution is increasingly threatened. At every stage computational modeling has played a role – critical to the understanding normal cardiac and vascular anatomy and physiology, characterization of the nature of disease, creation of innovative interventions, and delineation of response to these technologies.

The development, use and teaching of the discipline of modeling has evolved with insight into cardiovascular biology and medicine. Pioneers like Leonardo Da’Vinci helped make anatomy a scientific investigation simultaneous with development of quantitative methods; like his use of particle velocimetry tracking blades of grass flowing through fluid filled glass models of the heart and aorta. The last five centuries have seen what Howard Lord Florey noted was the concomitant synergistic development of science and technology. In this Florian paradigm new scientific insights advance our knowledge of disease, leading to development of new therapies and new devices which in turn require quantitative characterization of effect for full definition of their safety and efficacy.

Our obligation is to harness computational modeling to meld biology and engineering, medicine and science, for only then can we continue to advance health, educate communities and suggest lifestyle modification, produce novel medications based on deep insights and offer innovative interventions to improve the quality of life for all.

Bio: Elazer R. Edelman is Edward Poitras Professor Medical Engineering and Science MIT, Professor of Medicine Harvard Medical School, and Senior Attending Physician Brigham and Women’s Hospital. He directs MIT’s Institute for Medical Engineering and Sciences dedicated to applying physical sciences to biologic processes and disease mechanisms, and home to graduate and medical doctoral degrees programs. His research interests meld medical and scientific training leveraging pathophysiologic insight to improve clinical decision-making and device design.

Abstract: Joshua Gordon, M.D., Ph.D., Director of the National Institute of Mental Health, will provide an overview of challenges and opportunities in mental health research. Dr. Gordon will present emerging approaches and technologies, and future directions for this multidisciplinary field. In this era of unprecedented opportunity, Dr. Gordon will highlight the importance of cross-disciplinary, integrative approaches to address the vast complexities associated with mental illnesses as we move closer to our goal of finding effective treatments and therapies.

Bio: Joshua A. Gordon, M.D., Ph.D. is the Director of the National Institute of Mental Health (NIMH), the lead federal agency for research on mental disorders. He oversees an extensive research portfolio of basic and clinical research that seeks to transform the understanding and treatment of mental illnesses, paving the way for prevention, recovery, and cure. Dr. Gordon pursued a combined M.D.-Ph.D. degree at the University of California, San Francisco (UCSF). Medical school coursework in psychiatry and neuroscience convinced him that the greatest need, and greatest promise, for biomedical science was in these areas. During his Ph.D. thesis with Dr. Michael Stryker, Dr. Gordon pioneered the methods necessary to study brain plasticity in the mouse visual system. Upon completion of the dual degree program at UCSF, Dr. Gordon went to Columbia University for his psychiatry residency and research fellowship because of the breadth and depth of the research opportunities there. Working with Dr. Rene Hen, Dr. Gordon and colleagues studied the role of the hippocampus, a brain structure known to be important for memory and emotional processes associated with anxiety and depression. He joined the Columbia faculty in 2004 as an assistant professor in the Department of Psychiatry. Dr. Gordon’s research focuses on the analysis of neural activity in mice carrying mutations of relevance to psychiatric disease. His lab studied genetic models of these diseases from an integrative neuroscience perspective, focused on understanding how a given disease mutation leads to a behavioral phenotype across multiple levels of analysis. To this end, he employs a range of systems neuroscience techniques, including in vivo imaging, anesthetized and awake behavioral recordings, and optogenetics, which is the use of light to control neural activity. His research has direct relevance to schizophrenia, anxiety disorders, and depression. In addition to his research, Dr. Gordon was an associate director of the Columbia University/New York State Psychiatric Institute Adult Psychiatry Residency Program, where he directed the neuroscience curriculum and administered research training programs for residents. Dr. Gordon also maintained a general psychiatric practice, caring for patients who suffer from the illnesses he studied in his lab at Columbia. Dr. Gordon’s work has been recognized by several prestigious awards, including the Brain and Behavior Research Foundation – NARSAD Young Investigator Award, the Rising Star Award from the International Mental Health Research Organization, the A.E. Bennett Research Award from the Society of Biological Psychiatry, and the Daniel H. Efron Research Award from the American College of Neuropsychopharmacology.

Title: Advancing Genomics through Integrated Informatics

Abstract: Due to advances in nanofabrication, chemistry, protein engineering, and optical systems, we are generating volumes of genomic sequence data at a rate never seen before.  In fact, we have only begun to scratch the surface having sequenced less than 0.01% of all species on Earth, and less than 0.02% of the human population. These sequences can help us identify pathogenic species for health and food safety, rapidly diagnose babies with rare genetic diseases, inform therapeutic decisions for patients facing a cancer diagnosis, tell us about who we are, where we came from, and how we can better manage our own health. As incredible as these insights are, they are based on characterizations of less than 1% of the human genome. The complexity and volume of genomic information will require multiple sophisticated and scalable computational methods along the way from a tissue sample to a scientific breakthrough in order to achieve a more complete understanding of the contribution of the genome to biology. The integration of large-scale genomic sequencing power with advanced informatics, including a common data sharing framework and AI capabilities, is a critical next frontier in the mission to fully unlock the power of the genome to advance human health. 

Bio: Susan Tousi is Senior Vice President of Product Development at Illumina, Inc., a company on a mission to improve human health by unlocking the power of the genome through delivering market and technology leading DNA sequencers. Illumina is a global company headquartered in San Diego, California. Susan is responsible for Illumina’s global engineering, consumables, sequencing applications, software and informatics development efforts, ensuring Illumina’s scientists and engineers continue the culture of innovation and product excellence that has been a hallmark of Illumina.

Susan has more than 25-years of R&D and business leadership at Fortune 100 technology companies and within the life sciences industry. Formerly, Susan was as a Corporate Vice President and General Manager for Eastman Kodak’s Consumer Inkjet Systems organization. Prior to joining Kodak, Susan was an R&D program manager for Phogenix Imaging LLC, a joint venture start-up of Hewlett-Packard and Kodak. She previously spent 10 years with Hewlett-Packard in technical and management roles.

Susan holds an MBA degree from UCLA’s Anderson School of Management and a B.S. in Engineering Science and Mechanics from Pennsylvania State University. Along with many academic honors, in 2018, Susan was elected to the National Academy of Engineers, one of our nation’s “highest professional distinctions accorded to an engineer.”

Abstract: Our goal at Quanterix is to develop technologies to reliably measure molecular markers at extremely low concentrations in blood (and other fluids) that, in many cases, are undetectable using conventional technologies. These measurements provide unique insight into the role of biomarkers in human health, and has enabled researchers and clinicians to better characterize the continuum between health and disease. The resolution of single analyte molecules provides the ultimate analytical limit for a biomarker in blood, so we have focused on the development of robust single molecule detection technologies. In this presentation, we will describe the development of single molecule arrays (Simoa) for the detection of proteins at subfemtomolar concentrations, and their use in a number of research and clinical application areas. In particular, the use of Simoa to determine neurological health by profiling markers in blood, and the progress towards blood tests for diseases such as multiple sclerosis and Alzheimer’s disease will be discussed. The ultimate goal of these technologies is to rapidly provide accurate and precise molecular profiles directly to humans. To this end, we will discuss the technologies required to enable the measurement of single molecule biomarker profiles at the point of care and, ultimately, in a wearable device.

Bio: David C. Duffy, PhD, is Chief Technology Officer and Senior Vice President of Research and Development at Quanterix Corporation. Dr. Duffy joined Quanterix in 2007 and leads the team of scientists and engineers developing its Single Molecule Array (Simoa) technology. Dr. Duffy was previously at Surface Logix, Gamera Biosciences, and Unilever. Dr. Duffy was a postdoctoral fellow at Harvard University, and was the first Sir Alan Wilson Research Fellow of Emmanuel College, University of Cambridge. Dr. Duffy obtained his doctoral and bachelor degrees at the University of Cambridge. Dr. Duffy has 20 U.S. patents and more than 30 publications in the fields of surface chemistry, microfluidics, and single molecule diagnostics.

Title: Wearable Sensors, Smart Phones, and Machine Learning: Impact on Clinical Care and Clinical Trials

Abstract: Machine learning algorithms that use data streams captured from wearable sensors and smart phones have the potential to automatically detect disease symptoms and inform clinicians about the progression or regression of disease. We will discuss on how to design, implement clinical care or research with wearable sensors. The discussion will touch upon on choosing the number and type of sensors to place on an individual, which location on the human body is appropriate to detect symptoms in highly sensitive manner. Furthermore, we will talk about how much data is required or is sufficient to detect symptoms. Does increasing the amount of training data in each individual or adding more individuals lead to improved symptom detection? Which clinical tests or functional behaviors are best suited for symptom detection? We will discuss whether every data analysis requires advanced techniques like convolutional neural networks or other simpler statistical ensembles work to detect symptoms and its progression in each individual. Finally, we will talk about our smart phone technology can be used monitor disease and mobility at home and in the community and inform clinicians remotely the state of the individual under their care.

Bio: Dr. Arun Jayaraman’s work primarily focuses on developing and executing both investigator-initiated and industry-sponsored research in assistive and adaptive technologies to treat physical impairments. He conducts all of his outcomes research using advanced wearable patient monitoring wireless sensors and novel machine learning techniques, in addition to the traditional performance-based and patient-reported outcome measures. He collaborates both nationally and internationally with many academic and industrial organizations and is internationally recognized in the field of wearable technologies.

Abstract: Advances in stem cell engineering, omics technologies and data sciences offer a unique scope for deciphering the myriad ways molecular circuits dysfunction in pathologies of the brain. Recently, we have developed and explored iPSC-derived neurons from familial Alzheimer’s disease patients using a systems-level, multi-omics approach, identifying disease-related endotypes, which are commonly dysregulated in patient-derived neurons and patient brain tissue alike. By integrating RNA-Seq, ATAC-Seq, and ChIP-Seq approaches, we determined that the defining disease-causing mechanism of AD is de-differentiation of neurons, driven primarily through the REST-mediated repression of neuronal lineage specification gene programs and the activation of cell cycle reentry and non-specific germ layer precursor gene programs concomitant with modifications in chromatin accessibility. Strikingly, our reanalysis of previously-generated AD-patient brain tissue showed similar enrichment of neuronal repression and de-differentiation mechanisms. Surprisingly, our earlier work on glioblastoma also showed de-differentiation and initiation of some of the shared diseased endotypes as common features. We postulate that de-differentiation and reprogramming are hallmark mechanisms of numerous pathologies, arguably genetically evolved to serve as protection mechanisms.

Bio: Shankar Subramaniam is a Distinguished Professor of Bioengineering, Computer Science and Engineering, Cellular and Molecular Medicine, Chemistry and Biochemistry and Nano Engineering. He holds the inaugural Joan and Irwin Jacobs Endowed Chair in Bioengineering and Systems Biology. He is a Fellow of the AIMBE and AAAS and the current President of IEEE EMBS. He has numerous awards for this scientific contributions including the UCSD Faculty Excellence Award for Research, the Genome Technology All Star Award, the Association of Lab Automation Award, and the Smithsonian Foundation Innovation in Computing Award.