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

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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

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Big Data and analysis tools are facilitating huge advances in healthcare

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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.

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Technology is completely revolutionising the healthcare industry

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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.

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SAP’s Sustainability announcements at Sapphire Now

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SAP co-CEO Jim Hagemann Snabe at Sapphire Now 2012

SAP co-CEO Jim Hagemann Snabe at Sapphire Now 2012

Technology innovation plays a major part in creating a sustainable world tomorrow

So said SAP co-CEO Jim Hagemann Snabe at this year’s SAP Sapphire Now conference in Orlando. He then went on to predict three major trends in computing for the coming years – according to Jim, in the next five years everything will move to Cloud, everything will be in main memory and everything will be mobile.

This wasn’t just some off-the-cuff remark – these three developments are core to SAP’s product roadmap – even in the Sustainability space.

In the mobile space for example, at Sapphire Now SAP announced a new version of a mobile app for incident management. With this app, workers can now log issues from their mobile device with a photo or video, as well as an audio recording, and send it directly to an incident or safety manager for corrective action. This crowd-sourcing of safety information also has built-in tracking of the reported incident which is hugely empowering for workers who may previously have felt their voice wasn’t heard. And for the companies deploying this solution it leads to a safer work environment and a happier workforce.

This puts me in mind of an initiative IBM rolled out with the Los Angeles Unified School District (LAUSD) where they enabled students, teachers and staff to report issues like water leaks, broken aircon/heating, exposed cables and so on, by sending text messages and photos through their mobile phones. More please.

Also in the mobile sustainability space, SAP have their Electronic Medical Record app [SilverLight warning] – an app which gives doctors instant access to a patient’s electronic medical records.

In the Cloud space, SAP have made two major recent acquisitions – Successfactors and more recently Ariba at a cost of roughly $7.7bn. This is a clear indicator that while SAP maybe late to the party, it is serious about catching up.

And in the Sustainability space? Well SAP’s carbon management software, Carbon Impact OnDemand is already Cloud delivered. At SapphireNow SAP announced that they are going to rollout an on-demand service for product safety that the company is calling the SAP Product Stewardship and Safety Network. This will be a network where safety professionals can share safety information and best practices.

The irony of sustainability-related software being delivered via the Cloud, a technology which is not Green at all, is not lost on me. It does appear to be lost on SAP however – more on which in a follow-up post.

And finally in-memory computing – what is it? Well, you know how information held in RAM is much faster to access than information on disk, right? So HANA, SAP’s new in-memory database, is where the database is held in RAM for much faster data access. Also, in-memory databases can hold enormous quantities of data, and query them in milliseconds. This is a huge step forward in database technologies and according to SAP it will vastly simplify database maintenance as well because there should no longer be a need for large data warehouses.

Where do the HANA and Sustainability stories intersect? There are several examples – the first is in the area of Smart Grids and Smart meters. The volumes of information utility companies will be expected to handle after installing smart meters are orders of magnitude greater than anything they are used to. Realtime analysis of this firehose of information will allow for much better demand-side management, matching the demand curve to the supply curve, stabilising the grid and allowing for greater penetration of variable generators like wind and solar. Also, this availability of highly granular energy consumption data will facilitate the development of all kinds of new energy products and services that would have previously been impossible to offer. This is sorely needed by utilities who are in the uncomfortable position of currently (no pun) having to try to convince customers to buy less of their product.

Other use interesting cases are discussed in a great post on How Big Data Will Help Achieve Sustainability Goals by SAP’s Scott Bolick. And when you finish checking that out, head on over to Jennifer Lankheim’s post on SAP Situational Awareness for Public Sector where she discusses this new SAP Rapid Deployment Solution to help public safety and security organizations better anticipate, assess, and act on emergency situations.

We are only scratching the surface of what the implications of Big Data, Cloud, Mobility and in-memory computing are for sustainability. Expect to see far more announcements in this space in the near future.

Disclosure – SAP is a GreenMonk client and SAP paid my travel and expenses to attend Sapphire Now.

Photo Credit Tom Raftery

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Logica and SAP in exclusive joint bid for UK Smart Meter data provisioning

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Smart meter

The UK has an interesting Smart Meter infrastructure model. Data from all the country’s Smart Meters will flow to a centralised data repository (called the DCC), from where, energy retailers will pull the data for billing purposes. The beauty of this system is that consumers dictate who has access to their data, and so switching energy providers, is not held up by data ownership issues.

The build-out of this system is still at very early stages with RFP’s expected towards the end of the year but SAP and Logica have come out of the blocks early with an announcement that they are going to put in a joint bid to become the data service provider for the DCC.

Logica and SAP are both heavily involved in the utilities sector in the UK, so it makes sense for them to bid for this – the interesting aspect is that they agreed to bid together and that their joint bid is exclusive.

The six main suppliers in the UK are all either involved in trials, or in the process of starting to trial smart meters. All six are using Logica’s head-end system for their trials, so if Logica and SAP win the bid, the transition to the DCC system should be relatively painless.

Talking to Tara McGeehan, Logica’s Head of Utilities UK on Monday, she said that the idea behind the bid was to move the debate away from technology and comms, onto the power of the data to affect things like micro-generation, energy efficiency and smart grids.

Having seen Centrica’s Smart Meter Analytics application, which runs on SAP’s HANA, earlier this year, the proposition that there is gold in them thar data, certainly rings true.

Photo credit Tom Raftery

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Centrica’s Smart Meter Analytics application could make energy management compelling

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As I have mentioned here previously, Smart Meters are going to bring a flood of data to utility companies which will need to be properly managed and which can be a source of intelligence for the utility, if they mine it well.

At the recent SAP Sapphire Now conference, UK Energy retailer Centrica showcased their Smart Meter Analytics application running on SAP’s HANA. HANA is SAP’s in-memory computing solution (In-memory computing moves data off traditional storage on servers and into RAM, providing a performance boost over having to read the data off disks).

Centrica are the largest single instance utility on an SAP system with 18 million residential accounts for and one million business accounts. Right now they are billing residential accounts every three months and they are managing 75 million meter reads per annum.

With the move to smart meters, Centrica will take electricity reads every 30 minutes and gas reads once per day. This means a shift from 75 million meter reads per annum to 120 billion meter reads a year. 120 billion – that’s billion with a b. That’s a phenomenal amount of data to have to deal with. Doing any kind of traditional analytics on a data set that large would very quickly get totally bogged down. One of the interesting things about HANA however is that the performance scales linearly with the hardware. If it’s starting to slow a bit with 120 billion meter reads, throw a couple of extra terabytes of ram and servers at it and hey presto you are back in business, or so the theory goes!

In the demo above, Centrica are using the analytics to examine their customer segmentation. They can look at the energy profile of similar businesses in a specific area and where there are anomalies, they can work with those businesses to help them cut their energy consumption until it is more in line with their peers. Increasing pressures to be energy-efficient and to reduce carbon footprints are being looked on by Centrica as an opportunity to open an energy services business, going to customers to help them to become more energy-efficient. The Smart Meter Analytics application is going to be crucial for this new practice within Centrica.

Centrica's Energy Efficiency Scorecard

Centrica's Energy Efficiency Scorecard

In the residential market the Smart Meter Analytics app presents householders with an Energy Efficiency Scorecard. This facilitates charting actual usage patterns against the various tariffs Centrica offers to find the optimal rate plan. The score card also allows home-owners to compare their energy efficiency with similar households in the same area.

This is an impressive use of Smart Meter analytics and it presents hugely useful information but to avoid a short MTKD (Mean Time To Kitchen Drawer – the time it takes for people to get bored with this app and metaphorically stuff it in the kitchen drawer), the scorecard has to keep homeowners engaged. There are several ways of doing this. One of main ones would be to bring in some gamification – make a game of it. The Scorecard could set energy reduction targets for people to meet in the next set period, allot points or awards for achieving reduction targets, build social media in for sharing achievements and put up a leaderboard to add some real competition to the game.

Energy management applications to-date have suffered from the fact that they were working with estimated data a lot of the time, from lack of a significant networked dataset and from a lack of a usable analytics engine. Large energy retailers, like Centrica, have the opportunity now to change that and to make energy management in the home compelling. Let’s hope they make it so.

Disclosure – SAP paid my travel and expenses to attend Sapphire Now.