Enhancement of study programs in Public Health Law, Health ERASMUS+ KA2 PROJECT: Enhancement of study programs in Public Health Law, Health Management, Health Economics and Health Informatics in Montenegro Festival of Medical Achievements 1st PH-ELIM National Conference: Modern Trends in Public Health: Experience and Practices, Research and Innovation 20 October 2017, Podgorica, Montenegro Project web site: www.ph-elim.net

Medical Informatics for Enabling Systems Medicine Petra Knaup University of Heidelberg, Germany Institute of Medical Biometry and Informatics Project web site: www.ph-elim.net

Institute of Medical Biometry and Informatics 12 departments /centers 11 institutes Heidelberg University Hospital 12,000 staff 1,500 physicians 1,900 beds 65,000 inpatients 1,000.000 outpatient visits p.a. Institute of Medical Biometry and Informatics 3,500 Medical students 200 PhD-theses p.a. 50 Habilitations p.a.

digitalisation personalized medicine big data Current Trends digitalisation personalized medicine big data

digital age computer-based processes digital agenda by: Wilgengebroed https://commons.wikimedia.org/wiki/File:Internet_of_Things.jpg Digitalisation digital age computer-based processes digital agenda Tim Reckmann  / pixelio.de https://blog.medtronic.de/koerperteile-aus-dem-3d-drucker/

Personalized Medicine therapy A prognosis: responder to therapy A therapy B diagnostic test prognosis: non-responder to therapy B therapy C prognosis: inacceptable side effects

Example Multiple Myeloma Heterogeneous survival times: from few months to more than 15 years Only 30 % of patients respond to the most effective therapies. About 40 % of patients, which are treated with an effective drug, develop a neuropathie.

Big Data traditional: driven by hypotheses Big Data: data-driven research question acquisition of data testing the hypotheses Big Data: data-driven data are available search for new knowledge in the data

digitalisation personalized medicine big data Trends digitalisation personalized medicine big data  new data  new information  new knowledge

Medical Informatics … is the science of systematic management, archiving, processing and presentation of Data, Information und Knowledge in medicine and healtcare. It is motivated by enabling high quality patient care. according to http://www.gmds.de/fachbereiche/informatik/wir_ueber_uns.php

System‘s Medicine „… is the application of systems biology approaches to medical research and medical practice. Its objective is to integrate a variety of biological / medical data … using the power of computational and mathematical modelling, to enable understanding of the pathophysiological mechanisms, prognosis, diagnosis and treatment of disease.“ Auffray C, Balling R, Benson M, Bertero M, Byrne H, Cascante M et al. From Systems Biology to Systems Medicine. Brussels , 2010.

patient generated data clinical data research data patient generated data knowledge results images reports … clinical trials registries biobanking genomics … nutrition lifestyle fitness wellness … publications case reports guidelines

Heterogeneity of Data harmonization – semantic level ETL-processes – syntactic level application system – user level

case base knowledge base rule base indi v idua l p atien t d a omi cs d a t G W A S (SNP) RNAseq GEP cy o g eneti indi v idua l p atien t d a individualized r the a py omi cs d a t c lini l case base knowledge base c lini a l d t i m agi n g s ide ef f ect Lab rule base litera- ture medical guide- lines systems biology models reasoning Systemmedizin Management Architektur Prototyp Diskussion

Information Management well-defined information management processes comprehensive information up-to-date information cyclic data management approach including knowledge-base dynamically updated ETL - procedures

Data Representation Decision Support User Interface IT-Architecture Data Representation Decision Support User Interface

IT Architecture preprocessing of data and knowledge from heterogeneous sources: harmonisation, transformation, storage application of knowledge-based procedures on data and knowledge: e.g. rule-based, case-based, systems biology models supporting the physician and scientist: transparent, timely and reproducible decisions Systemmedizin Management Architektur Prototyp Diskussion

Summary of our Approach Information and IT-management for systems medicine flexible approach heterogeneous data sources enable different knowledge-based concepts dynamic updates innovative user interfaces

Constitution of the World Health Organization: Principles physical Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. mental social well- being

Constitution of the World Health Organization: Principles The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. …

Big Data Personalized Medicine Digitalisation Take Home Message Big Data Personalized Medicine Digitalisation Smart Data Systems Medicine Application Systems