Technology is moving us, finally, towards the vision of personalised medicine

We attended this year’s SapphireNow event (SAP’s customer and partner conference) in Orlando and were very impressed with some of the advances SAP and their ecosystem are making in the field of healthcare.

Why is this important?

Healthcare for many decades now has been stagnant when it comes to technological disruption. Go to most hospitals today and you will still see doctors using paper and clipboards for their patient notes. Don’t just take our word for it, in her highly anticipated 2015 Internet Trends report Mary Meeker clearly identified that the impact of the Internet on healthcare is far behind most other sectors.

But this is changing, and changing rapidly. The changes coming to the healthcare sector will be profound, and will happen faster than anyone is prepared for.

DNA sequencing cost per genome

And one of the main catalysts of this change has been the collapse in the cost of gene sequencing in the last ten years. See that collapse charted in the graph to the right. And note that the y-axis showing the cost of sequencing is using a logarithmic scale. The costs of sequencing are falling far faster than the price of the processing power required to analyse the genetic data. This means the cost of sequencing is now more influenced by the cost of data analysis, than data collection. This has been a remarkable turn of events, especially given the first human genome was only published fourteen years ago, in 2001.

The advances in the data analytics picking up pace too. In memory databases, such as SAP’s HANA, and cognitive computing using devices like IBM’s Watson, are contributing enormously to this.

To get an idea just how much the analytics is advancing, watch the analysis of data from 100,000 patients by Prof Christof von Kalle, director of Heidelberg’s National Center for Tumor Diseases in the video below. Keep in mind that each of the 100,000 patients has 3bn base pairs in their genome, and he’s analysing them in realtime (Prof Von Kalle’s demo starts at 1:00:03 in the video, and lasts a little over 5 minutes).

As he says at the conclusion, two years ago a similar study conducted over several years by teams of scientists was published as a paper in the journal Nature. That’s an incredible rate of change.

IBM are also making huge advances in this field with their cognitive computing engine, Watson. In a recent announcement, IBM detailed how they have teamed up with fourteen North American cancer institutes to analyse the DNA of their patients to gain insights into the cancers involved, and to speed up the era of personalised medicine.

Personalised medicine is where a patient’s DNA is sequenced, as is the DNA of their tumour (in the case of cancer), and an individualised treatment, specific to the genotype of their cancer is designed and applied.

This differs from the precision medicine offerings being offered today by Molecular Health, and discussed by Dr Alexander Picker in the video at the top of this post.

Precision medicine is where existing treatments are analysed to see which is best equipped to tackle a patient’s tumour, given their genotype, and the genotype of their cancer. One thing I learned from talking to Dr Picker at Sapphirenow is that cancers used to be classified by their morphology (lung cancer, liver cancer, skin cancer, etc.) and treated accordingly. Now, cancers are starting to be classified according to their genotype, not their morphology, and tackling cancers this way is a far more effective form of therapy.

Finally, SAP and IBM are far from being alone in this space. Google, Microsoft and Apple are also starting to look seriously at this health.

With all this effort being pored into this personalised medicine, I think it is safe to say Ms. Meeker’s 2016 slide featuring health will look a little different.

UPDATE – Since publishing this post SAP have uploaded a video to YouTube showcasing their internal application of Molecular Health’s solution for employees of SAP who are diagnosed with cancer. You can see that below:

Full disclosure – SAP paid my travel and accommodation to attend their Sapphirenow event


Utilities and change – times are changing

I attended this year’s International SAP for Utilities event in Berlin and despite it’s being co-located with the SAP Oil and Gas conference which led to some unfortunate references in the keynotes, it was an interesting event.

Some of the numbers I learned at the event were that of SAP’s 5,800 utility customers, 65 are on HANA, and the first Suite on HANA customer (Snohomish County Public Utility District) will go live in September.

SAP also let it be known that it has 2 utilities customers who are on their new S4 platform. One is a net new customer, while the other is migrating so as to be a “Utility of the Future”.

Apart from that I had conversations with several SAP Utilities customers, and I was surprised at how utilities, who have traditionally been averse to change (65 out of 5,800 have moved to HANA), are starting to realise that technological change is inevitable, and so are starting to embrace it. Albeit slowly.

I spoke to Khalid Al Dossary from Saudi Electricity Company (see video above) and he told me of two projects they’ve recently rolled out. The first was a move to paper invoicing because they want to move completely away from paper. And the second, even more interesting was the rollout of SuccessFactors, for talent management (HR).

Why is this interesting? Well, SuccessFactors is cloud delivered and utilities have been seen as being cloud averse. I remember having conversations with utilities executives who said they’d never move to cloud only two years ago. It’s funny how time moves on.

I also spoke to Hydro Tasmania’s Rick Quarmby (see below) who talked about two projects Hydro Tasmania rolled out recently. One using OpenText for document management, and the other was a workforce productivity app (which you can see the employees rave about here).

I also recall, in the mid to late nineties, having conversations with people who said their business’ didn’t need to have a website. Or that they would rollout email and Internet access within the company, but only to certain employees who might need it.

Thankfully those days are long gone, and now it is unusual for organisations not to have a website, or to block internet access for their employees.

In a similar vein, with the increasing pace of technological change, I fully expect the vast majority of utilities to have moved fully to the cloud ten years from now, and any who haven’t will be viewed as laggards.


Big Data and analysis tools are facilitating huge advances in healthcare

SAP's Genomic Analyzer

As we noted recently here on GreenMonk, technology is revolutionising the healthcare industry, and the pace of change is astounding with new products and services being announced daily.

We were recently given a demonstration of two products currently being developed by SAP (Genomic Analyzer, and Medical Research Insights), and they are very impressive products.

The Genomic Analyzer (pictured above) can take large numbers of genomes and interrogate them for various traits. This may sound trivial, but this is a serious Big Data problem. In a talk at SAP’s Sapphirenow conference in June, Stanford’s Carlos Bustamante outlined the scale of the issue when he noted that in sample size of 2534 genomes takes up 1.2tb of RAM and consists of over 20bn records.

The industry standard for storing genomic data is in a variant call format (VCF) text file. This is then interrogated using either open source or some specialised commercial software analyse the genomic data. Researchers frequently have to write their own scripts to parse the data, and the parsing takes a considerable amount of time.

SAP's Genomic Analyzer results

On the other hand, SAP’s Genomic Analyzer, because it is based on SAP’s in-memory database technology, can take record sets of 2,500 genomes in its stride returning multi-variant results in seconds. This will allow previously impossible tests to be run on genomic datasets, which opens up the potential for disease biomarker identification, population genetics studies, and personalised medicine.

SAP are actively looking for research partners to work with them on the development of the Genomic Analyzer. Partners would typically be research institutions, and they would receive login access to the analyzer (it is cloud delivered), and the ability to create and run as many query sets as they wish.

SAP’s Medical Research Insights application again takes advantage of SAP’s Hana in-memory database to take in the vast swathes of medical data which would typically be housed in siloed data warehouses (EMR’s, scans, pathology reports, chemo info, radio info, biobank system, and so on). It can be used to quickly identify patients suitable for drug trials, for example or to surface new research when relevant to patients.

The Medical Research Insights solution is currently being developed as part of a co-innovation project with a large cancer institute in Germany, but will ultimately be applicable to any hospital or medical institution with large disparate data banks it needs to consolidate and query.

SAP are far from alone in this field. As well as developing innovative medical applications themselves, many in their Startup Focus program are also furiously innovating in this field, as previously noted.

Outside of the SAP ecosystem, IBM’s Watson cognitive computing engine is also tackling important healthcare issues. And like SAP, IBM have turned Watson onto a platform, opening it up to external developers, crowdsourcing the innovation, to see what they will develop.

The main difference between IBM’s cognitive computing approach, and SAP’s Hana in-memory database is that Watson analyses and interprets the results on behalf of the researchers, whereas Hana delivers just the data, leaving the evaluation in the hands of the doctors.

And news out today shows that Google is launching its Google X project, Baseline Study so as not to be left out of the running in this space.

There’s still a lot of work to be done, but the advances these technologies are starting to unlock with change the healthcare industry irreversibly for the good.


Sustainability and SAP?

SAP former CEO Dr Peter Graf

Dr Peter Graf, SAP’s Chief Sustainability Officer announced that he’s leaving SAP yesterday.

There has been a significant purge of executives re-organisation at SAP in the last few weeks since CTO Vishal Sikka resigned suddenly, and Co-CEO Jim Hagemann Snabe stepped back from his Co-CEO role leaving Bill McDermott as sole CEO.

Taken in isolation, the departure of Graf from SAP wouldn’t be too concerning, but SAP’s sustainability team has lost four of its most senior executives in the last few months. Jeremiah Stone was VP for SAP’s Sustainability Solutions. Scott Bolick was VP Sustainability. James Farrar was also VP of Sustainability for SAP, and Peter Graf was the Chief Sustainability Officer.

The loss of four such senior figures in such a short time leads to obvious questions about SAP’s ongoing commitment to sustainability.

Coincidentally I’m at SAP’s customer and partner conference SapphireNow this week, so I look forward hearing SAP’s take on this.


Technology is completely revolutionising the healthcare industry

Healthcare is changing. Recent advances in technology are completely revolutionising how we approach the prevention, diagnosis and treatment of illness. And this is just the beginning of what will be a technological revolution in healthcare.

Smartphone use is growing at an enormous pace. They now account for 87% of the total mobile handsets in the US, for example. And with the smartphones has come hundreds of new apps related to health and fitness. These apps do everything from monitoring sleep and movement (steps), to keeping track of glucose levels, blood oxygen, and even ovulation.

Fitbit Dashboard

The relentless rise of wearable connected devices is also having a big effect on people tacking their health and fitness. These small devices (such as the Fitbit Force, the Jawbone Up, and the Withings Pulse) are light and easy to wear, and they communicate with apps on the smartphone to monitor and record health-related information.

The next evolution of wearables, where they are built-in to the clothes you wear, has already begun. If these devices become as ubiquitous as smartphones, they will help us make far better informed decisions about our health and fitness.

Then you have major players like Apple going on a hiring spree of medical technology executives to bolster its coming Healthbook application, as well as its rumoured iWatch wearable device. Samsung too have wearable fitness trackers and announced their own Healthcare platform “to track your every move” today.

Going further back the stack, and we see IBM using its artificial intelligence play Watson to make inroads into the health industry (see video above). IBM has been partnering with WellPoint Inc. and Memorial Sloan-Kettering Cancer Center to help clinicians better diagnose instances of cancer in patients.

And more recently IBM has announced that it is working with New York Genome Center to create a prototype that could suggest personalised treatment options for patients with glioblastoma, an aggressive brain cancer. From the announcement:

By analyzing gene sequence variations between normal and cancerous biopsies of brain tumors, Watson will then be used to review medical literature and clinical records to help clinicians consider a variety treatments options tailored to an individual’s specific type and personalized instance of the cancer.

And IBM aren’t stopping there. They announced last month that they were opening up Watson as a platform so developers can create apps that can utilise Watson’s cognitive computing engine to solve all kinds of difficult problems. And earlier this month IBM announced that several “powered by Watson” apps have been developed, including one to help dermatologists better diagnose skin cancer.

And IBM also announced the acquisition of Cognea. Cognea offers virtual assistants that relate to people using a wide variety of personalities—from suit-and-tie formal to kid-next-door friendly – think Siri, or better yet Cortana for Watson!

Then, newer in-memory database technologies such as SAP’s HANA, are being used to crunch through datasets so large they were previously to big to query. For example, SAP announced today a partnership with the Stanford School of Medicine to “achieve a better understanding of global human genome variation and its implications in disease, particularly cardiovascular disease”. From the release SAP goes on to say:

Researchers have already leveraged SAP HANA to corroborate the results of a study that discovered that the genetic risk of Type II Diabetes varies between populations. The study looked at 12 genetic variants previously associated with Type II Diabetes across 49 individuals. With SAP HANA, researchers in Dr. Butte’s lab were able to simultaneously query all 125 genetic variants previously associated with Type II Diabetes across 629 individuals. Using traditional methods, this analysis on this amount of data would have taken an unreasonable amount of time.

So, the changes which technology are bringing to the healthcare industry now are nothing short of revolutionary. And with the likes of SAP’s HANA, and IBM’s Watson, set up as platforms for 3rd party developers, the stage is set for far more innovation in the coming months and years. Exciting times for healthcare practitioners, patients and patients to-be.


SAP running six week online course on Sustainability and Business Innovation

Massive Open Online Courses, or MOOC’s as they are also known, are training courses delivered online, allowing for large numbers of students to enroll in the courses. When I signed up for an introductory data science course with Coursera last year I had over 50,000 ‘classmates’ taking the course with me. The network effect of haveing thousands of students taking the same course at the same time meant that the forums were actually useful places to interact and get questions answered.

I was interested then to hear from DJ Adams that SAP is running a MOOC on Sustainability and Business Innovation. The course is being given by SAP’s Chief Sustainability Officer, Dr. Peter Graf.

It is a six week course, commencing on April 29th (2014), with 4-6 hours of instruction per week, with a final exam on June 10-17th (2014).

The course content (below) looks to be quite comprehensive:

Week 1: The Business Case for Sustainability
The week contains the following units: Welcome; Root Causes; Sustainable Value Creation; Engaging Top Management; Organizational Setup for Sustainability & The Role of IT

Week 2: Sustainable Strategies
The week contains the following units: Crafting a Sustainable Strategy; Stakeholders and Materiality; Analysis and Target Setting; Examples of Environmentally Driven Initiatives; Examples of Socially Driven Initiatives & Examples of Transformational Innovation

Week 3: Sustainable Business Processes (Part 1)
The week contains the following units: Embedding Sustainability Into Business Processes; Sustainable Design; Sustainable Sourcing and Procurement; Sustainable Production & Sustainable Logistics

Week 4: Sustainable Business Processes (Part 2)
The week contains the following units: Sustainable Consumption; Sustainable End-of-Life Processes; Environmental and Social Capital Accounting; Sustainability in Finance and Administration; Sustainability in HR & Sustainability in IT, aka Green IT

Week 5: Stakeholder Engagement
The week contains the following units: Engaging Line of Business Leaders; Engaging Employees; Engaging Society – Corporate Social Responsibility; Engaging Business Partners, Authorities and Opinion Leaders & Engaging Investors

Week 6: Sustainability Reporting
The week contains the following units: Purpose, Audiences and Standards; Data Quality and Assurance; Integrated Reporting; Report Delivery; Rankings and Recognition & Recap of Key Course Learnings

Week 7: Final Exam

I’m particularly happy to see the data quality and assurance being covered. With the move towards an increasingly quantified and transparent world the importance of knowing how to measure and interpret data cannot be underestimated.

If you are interested in signing up, or simply knowing more about the course, head on over to the course site, preferably before the class commences this coming April 29th. Over 9,200 people have already registered, so it looks like it will be a lively few weeks for all involved.


Cloud computing companies ranked by their use of renewable energy

Cloud-Providers Renewables use updated

UPDATE: After publication of this post I was contacted by Rackspace who informed me that they do, in fact, publish their megawatt electricity consumption. it is contained in an investor report (PDF) published on their Investor Relations page. This shows Rackspace used just over 105mWh of electricity in 2013. This means that the 35% of Renewables figure corresponds to 36.8mWh (in fact it comes to 36,785kWh, or 0.037m kWh, as it is now represented in the chart above). Consequently, I adjusted the chart and moved Rackspace up a number of places in the rankings.

Cloud computing is booming. Cloud providers are investing billions in infrastructure to build out their data centers, but just how clean is cloud?

Given that this is the week that the IPCC’s 5th assessment report was released, I decided to do some research of my own into cloud providers. The table above is a list of the cloud computing providers I looked into, and what I found.

It is a real mixed bag but from the table you can see that Icelandic cloud provider Greenqloud comes out on top because they are using the electricity from the 100% renewable Icelandic electricity grid to power their infrastructure.

On the Windows Azure front, Microsoft announced in May of 2012 that it was going to go carbon neutral for its facilities and travel. Microsoft are now, according to the EPA, the second largest purchaser of renewable energy in the US. In 2013 they purchased 2,300m kWh which accounted for 80% of their electricity consumption. They made up the other 20% with Renewable Energy Certificates (RECs). And according to Microsoft’s TJ DiCaprio, they plan to increase their renewable energy purchases from 80% to 100% in the financial year 2014.

Google claim to have been carbon neutral since 2007. Of Google’s electricity, 32% came from renewables, while the other 68% came from the purchase of RECs.

SAP purchased 391m kWh of renewable energy in 2013. This made up 43% of its total electricity consumption. SAP have since announced that they will go to powering 100% of its facilities from renewable energy in 2014.

The most recent data from IBM dates from 2012 when they purchased 764m kWh of renewable energy. This accounted for just 15% of their total consumption. In the meantime IBM have purchased cloud company Softlayer for whom no data is available, so it is unclear in what way this will have affected IBM’s position in these rankings.

The most up-to-date data on Oracle’s website is from 2011, but more recent data about their renewable energy is to be found in their 2012 disclosure to the Carbon Disclosure Project (registration required). This shows that Oracle purchased 5.4m kWh of renewable energy making up a mere 0.7% of their total consumption of 746.9m kWh in 2012.

Rackspace have no data available on their site, but in email communications with me yesterday they claim that 35% of their electricity globally is from renewable sources. They declined to say exactly how much that was (in kWh) See update above.

Amazon discloses no information whatsoever about its infrastructure apart from a claim that its Oregon and GovCloud regions are using 100% carbon free power. However, they don’t back up this claim with any evidence, they don’t disclose to the Carbon Disclosure Project, nor do they produce an annual Corporate Responsibility report.

The other three cloud providers in the list, Softlayer, GoGrid, and Bluelock have no information on their websites (that I could find), and they didn’t respond to written inquiries.

I’ll be writing a follow-up post to this in the next few days where I look into the supply chain risks of utilising cloud platforms where there is no transparency around power sourcing.


Technology for Good – episode ten

Welcome to episode ten of the Technology for Good hangout. In this week’s show we had special guest Bill Higgins, who works on IBM’s Cloud & Smarter Infrastructure. Given the week that was in it with Google’s slashing of cloud computing pricing, and Facebook’s purchase of Oculus Rift, there were plenty of stories about cloud computing and social networks.

Here’s the stories that we discussed in the show:






Internet of Things



SAP to power its cloud computing infrastructure from 100% renewable energy

Wind turbine

Cloud computing is often incorrectly touted as being a green, more environmentally-friendly, computing option. This confusion occurs because people forget that while cloud computing may be more energy efficient (may be), the environmental friendliness is determined by how much carbon is produced in the generation of that energy. If a data centre is primarily powered by coal, it doesn’t matter how energy efficient it it, it will never be green.

We have mentioned that very often here on GreenMonk, as well as regularly bringing it up with cloud providers when talking to them.

One such cloud provider is SAP. Like most other cloud vendors, they’re constantly increasing their portfolio of cloud products. This has presented them with some challenges when they have to consider their carbon footprint. In its recently released 2013 Annual Report SAP admits

Energy usage in our data centers contributed to 6% of our total emissions in 2013, compared with 5% in 2012

This is going the wrong direction for a company whose stated aim is to reduce the greenhouse gas emissions from their operations to levels of the year 2000 by 2020.

To counter this SAP have just announced

that it will power all its data centers and facilities globally with 100 percent renewable electricity starting in 2014

This is good for SAP, obviously, as they will be reducing their environmental footprint, and also good for customers of SAP’s cloud solutions who will also get the benefit of SAP’s green investments. How are SAP achieving this goal of 100 per cent renewable energy for its data centers and facilities? A combination of generating its own electricity using solar panels in Germany and Palo Alto (<1%), purchasing renewable energy and high quality renewable energy certificates, and a €3m investment in the Livlihoods Fund.

So, how does SAP’s green credentials stack up against some of its rivals in the cloud computing space?

Well, since yesterday’s pricing announcements from Google they definitely have to be considered a contender in this space. And what are their green credentials like? Well, Google have been carbon neutral since 2007, and they have invested over $1bn in renewable energy projects. So Google are definitely out in front on this one.

Who else is there?

Well, Microsoft with its recently branded Microsoft Azure cloud offerings are also a contender, so how do they fare? Quite well actually. In May 2012, Microsoft made a commitment

to make our operations carbon neutral: to achieve net zero emissions for our data centers, software development labs, offices, and employee business air travel in over 100 countries around the world.

So by doing this 2 years ahead of SAP and by including employee air travel, as well as facilities, you’d have to say that Microsoft come out ahead of SAP.

However, SAP does come in well ahead of other cloud companies such as IBM, who reported that renewable electricity made up a mere 15% of its consumption in 2012. IBM reported emissions of 2.2m tons of CO2 in 2012.

But, at least that’s better than Oracle. In Oracle’s 2012 report (reporting on the year 2011 – the most recent report available on their site), Oracle state that they don’t even account for their scope 3 emissions:

Scope 3 GHG emissions are typically defined as indirect emissions from operations outside the direct control of the company, such as employee commutes, business travel, and supply chain operations. Oracle does not report on Scope 3 emissions

And then there’s Amazon. Amazon doesn’t release any kind of information about the carbon footprint of its facilities. None.

So kudos to SAP for taking this step to green its cloud computing fleet. Looking at the competition I’d have to say SAP comes in around middle-of-the road in terms of its green cloud credentials. If it wants to improve its ranking, it may be time to revisit that 2020 goal.


SAP Startup Focus in newly industrialised countries

Vishal Sikka, SAP CTO

As we have said before here, sustainability job number one is putting bread on the table. To that end, it was great to see SAP’s Startup Focus program take off so well, gaining over 1,000 companies signed up in less than two years.

We profiled the Startup Focus program here on GreenMonk earlier this year, talking to three of the participant companies about it. They were very enthusiastic about how it had helped them break into the enterprise software market, and said they wished they’d joined the program sooner.

More recently, we spotted news from TechEd Bangalore that SAP CTO Vishal Sikka announced there that of the over 1,000 companies who have joined the Startup Focus program, 158 of the come from India. I’d love to know what percentage of the Startup Focus companies overall come from newly industrialised countries, and what level of employment they are helping create.