Infrastructures use, requirements & prospect in ICT for health domain Karin Johansson ICT for Health DG Information Society & Media European Commission

ICT for Health research activities Relevant Grid-related activities Outline ICT for Health research activities Relevant Grid-related activities Where are we going in the short/medium term? Where do we go beyond FP7?

WHO ARE WE? ICT for Health (eHealth) Unit, European Commission Information Society and Media DG established in 1989 supported to date > 450 projects worth > € 1 Billion currently funds eHealth projects (€ 100 Million/year) The vision (since 1994): “eHealth-enabled citizen-centred care” or equivalently “eHealth-enabled continuity of care” Today’s focus R&D: Personal Health Systems Patient Safety Modelling and Simulation of Human Physiology and Disease (Virtual Physiological Human) Support to deployment: eHealth Action plan, Large Scale Pilots, Lead market initiative, Recommendation on Interoperability of EHRs, Communication on Telemedicine (2009) Wider than just research support: also includes implementation and deployment support through the CIP and policy activities to take research results further. 1994: start of FP5 Policy areas: Luba: Action Plan, Cross-Border Interoperability Christoph: Communication on Telemedicine Mike: Lead Market Initiative Flora: Large-scale pilots (CIP) PHS: Wearable, implantable, portable systems PS: IT systems for detecting trends in adverse events (treatments, drugs etc) VPH: Modelling and Simulation of Human Physiology and Disease

Budget for research supported by the ICT for Health unit in FP7 Overall € 340 M over 4 years (2007-2010) Personalisation of Healthcare Personal Health Systems (PHS) € 72 M in 2007 - € 63 M in 2009 Patient safety (PS) - avoiding medical errors € 30 M in 2007 - € 30 M in 2009 Predictive Medicine – Virtual Physiological Human (VPH) Modelling/simulation of human physiology and disease € 72 M in 2007 - € 5 M in 2009 - € 63 M in 2010 Next work programme will cover 2011-2012 and will be published on CORDIS in Oct-Nov 2010.

ICT for Health research activities Relevant Grid-related activities Outline ICT for Health research activities Relevant Grid-related activities Where are we going in the short/medium term? Where do we go beyond FP7?

Where are Grid activities most relevant? VPH Need for data capacity originates from biomedical informatics roots Huge demand on Data storage/management Computing power Patient Safety (PS) Early detection of public health events Re-use of EHR data for research purposes

The Virtual Physiological Human (VPH) concept Based on the ideas of the International Physiome project The Virtual Physiological Human is a methodological and technological framework that once established will enable the investigation of the human body as a single complex system. One of the 12 pioneer projects in FP6, The VPH research roadmap developed by project STEP in 2007: www.europhysiome.org The concepts have been elaborated through the physiome initiative and the field of biomedical informatics It is mainly the computational framework (infrastructure and tools) which could allow the modelling and simulation of the human physiology. The ultimate goal is to enable the move towards the personalised and predictive medicine. This is a quite ambitious goal which is certainly quite long-term. We are favouring a step wise approach towards this objectives. FP7 Calls 2, 4 and 6 are just first steps in this process. STEP roadmap: For different VPH areas: status and state-of-the-art identification of gaps in knowledge challenges to be addressed needs for research funding - Personalised (patient-specific) healthcare solutions - Early diagnostics & predictive medicine - Understanding diseases for the first time across several biological levels

Virtual Physiological Human: a schematic picture Computational resources Application Knowledge of biological and physiological pathways, processes etc Data management Modelling Construction and/or refinement of models on different temporal and spatial scales Integration of models Multiscale model verification Clinical validation Health care professionals Hospital Data access Data processing Patient Specific Data -omics imaging clinical pharma Patient Data management is continuously an issue in the modelling and simulation process. We fund in the middle boxes, not so much in data acquisition. Verification of models must be done using independent data sets. Prediction, Early Diagnosis, Treatment

First VPH Call: FP7 call 2 Technical focus: Patient-specific computational modelling and simulation of organs targeting specific clinical needs. Data integration and new knowledge extraction. Clinical focus: Simulation environments for surgery training, planning and intervention. Prediction of disease or early diagnosis. Simulation and assessment of the efficacy and safety of specific drugs.

Results of the 1st VPH call: 15 FP7 projects                    Results of the 1st VPH call: 15 FP7 projects Industry Parallel VPH projects Grid access CA CV/ Atheroschlerosis IP Liver surgery STREP Breast cancer/ diagnosis STREP Heart/ LVD surgery STREP Osteoporosis IP Oral cancer/ BM D&T STREP Cancer STREP Networking NoE Heart /CV disease STREP The Virtual Physiological Human is at the heart of the VPH projects. Overview of all the projects funded under Call 2, with a brief explanation of their main field of activity. Vascular/ AVF & haemodialysis STREP Liver cancer/RFA therapy STREP Alzheimer's/ BM & diagnosis STREP Heart /CV disease STREP Reproduction from VPH NoE Security and Privacy in VPH CA Clinics

Results of the 1st VPH call: 15 FP7 projects                    Results of the 1st VPH call: 15 FP7 projects Industry Parallel VPH projects Grid access CA CV/ Atheroschlerosis IP Liver surgery STREP Breast cancer/ diagnosis STREP Heart/ LVD surgery STREP Osteoporosis IP Oral cancer/ BM D&T STREP Cancer STREP Networking NoE Heart /CV disease STREP Some areas are better developed than others: Red – cardiovascular projects euHeart ARCH preDICT ARTreat VPH2 Green – cancer projects ContraCancrum Imppact NeoMark Vascular/ AVF & haemodialysis STREP Liver cancer/RFA therapy STREP Alzheimer's/ BM & diagnosis STREP Heart /CV disease STREP Reproduction from VPH NoE Security and Privacy in VPH CA Clinics

Second VPH call: FP7 call 4 International Cooperation on VPH Focus: Interoperability (interfaces databases, web services, mark-up languages, meta-data, ontologies) Tools and services for global cooperation (for modelling/simulation, curated models, interconnected libraries) International validation environment (joint verification of clinical relevance of models) Budget: 5M€ Results: 5 proposals selected, all of which include international partners. Focused on increasing international cooperation between existing VPH-related projects and similar international projects or initiatives. Retained proposals are currently under negotiation and will hopefully start early 2010.

ICT for Patient safety Results: 9 retained (2 IPs, 6 STREPs, 1 SA) Focus of Call: ICT for safer surgery ICT for integration of clinical research and clinical care ICT-enabled early detection of public health events Budget: 30M€ Results: 9 retained (2 IPs, 6 STREPs, 1 SA) But: Public health policy is mainly the responsibility of Directorate General Health and Consumer (DG SANCO) projects Retained proposals are currently under negotiation and will hopefully start early 2010. 13

eInfrastructure: the European HPC Service PRACE National DEISA and EGI National/Regional We are an application domain so we are not funding infrastructure, just the applications and interfaces on top of existing infrastructures. But we are closely cooperating with the research infrastructure funded under the Capacity programme. That the reason I would like to give this overview on Infrastructure. Best path: a bottom-up approach. Start with the local resource; if not sufficient, cluster with local network (such a universities etc). If not sufficient, seek to cluster on a national or regional level with supercomputers (DEISA) or EGI If still not sufficient, and if you are looking for best in the world machine, go for PRACE. EGI: European Grid Initiative EGEE: Enabling Grids for E-sciencE Local DEISA/PRACE Symposium – Amsterdam, NL ••• 14 14

DEISA: ‘virtual’ HPC services 12 sites in 7 countries connected at 10 Gb/s Over 22,000 CPUs with an aggregated peak performance of close to 1 Peta flops Running larger parallel applications in individual sites Enabling workflow applications with grid technologies (UNICORE) Providing a global data management service Extreme Computing Initiative DEISA is an aggregation of National resources. DEISA resources are accessible through 2 mechanisms: Bid for research through national scheme Bid at EU level through Call on DEISA Extreme Computing initiative – this is new!! There are 12 DEISA machines in Europe DEISA is for highly coupled applications. Where parallelism is possible then EGI might be more relevant. DEISA/PRACE Symposium – Amsterdam, NL ••• 15 15

establishing new organisational model for sustainable grid service provisioning EGI_DS (Design study) NGI- Nordic States Coordinating entity (EGI) NGI-UK NGI-IRL Key elements of new scheme: Coordination/pooling of National and European funding for sustainable service provision and for more efficient planning of investments Service provisioning beyond project cycles One-stop-shop service provisioning (including training) to users who want to access grid-based resources NGI-NL NGI-B NGI-PO NGI-D NGI-F NGI-CZ NGI-SK NGI-A EGI: European Grid Initiative EGEE: Enabling Grids for E-sciencE EGI is an aggregation of resources. It could be seen as the next step to EGEE but with a quite different approach. EGI will have the following features: Resource provisioning (this is where the focus of EGI lies) EGI will also be middleware neutral (compatible with Glite, UNICORE…). It will also involve the user community to influence the services offered Compared to EGEE it is much more structured with nodes at national level called National Grid Initiative. These nodes are in the process of creation. In this domain of eInfrastructures, a Call is currently open with a deadline of November 24th 2009. FP7-INFRASTRUCTURES-2010-2 Contact information for people working on this call will be shown at the end of the presentation. NGI-E NGI-I NGI-P NGI-GR

PRACE: preparatory phase Late 2009: 1PF in the top 5 Late 2010: 2 PF in the top 5; 1PF in the top 10 2011: 3 PF in the top 5; 2 PF in the top 10 2020: an exaflop in the top 5 PRACE aims at building EU super computer top of the range. It could link national super computers but also aim at developing new computers. It aims to release 1 or 2 machines per year. Here you see the aims in terms of performance which the they are aiming for. DEISA/PRACE Symposium – Amsterdam, NL ••• 17 17

ICT for Health research activities Relevant Grid-related activities Outline ICT for Health research activities Relevant Grid-related activities Where are we going in the short/medium term? Where do we go beyond FP7?

Virtual Physiological Human future activities Keep the overall VPH goals: Early diagnostics & Predictive medicine Personalised (Patient-specific) healthcare solution By means of: Modelling & simulation of human physiology and disease-related processes Add emphasis on tools/infrastructure for biomedical researchers VPH in 2010 Call 6 expected to open November 2009 and to close in April 2010 Budget 63M€

VPH infrastructure needs Demand for: Data management Computing power Requirements (coupling research activities with applications) No longer sufficient to make technological advances within the GRID research Engage users Usability/user accessibility Routinely used in applied research in other domains (VPH and others) Develop culture of sharing No infrastructure developments can be done in isolation from the application side. This means that a coupling of infrastructure with research activities is essential. Users to us are BMI and/or VPH researchers! This means that it must be easy to access and use grid resources without needing to be an expert on how grid technologies work. Only by showing that the funds which have already been invested in infrastructure are being of benefit to the research community and sociely as a whole can we justify further funding in this field. Sharing of information with other researchers is essential – will come back to this point.

VPH Call 6 Focus a): Patient-specific computer based models and simulation Multiscale models & simulation of organs/systems targeting specific clinical needs. Better understanding of the functioning of the organs and their pathologies aiming at prediction/early diagnosis. Emphasis on: Integration of existing models Clinical benefits demonstrated Data acquisition, medical, clinical, bio research (if needed) < 25% Access to external computing facilities supported More or less same as Call 4, but: Requirement of multiscale models (i.e. integration of anatomical and physiological data from multiple levels: molecular, cell, tissue, organs or systems) Explicit support to HPC access

VPH call 6 Focus b): ICT tools, services and infrastructures for bio-medical researchers to support at least 2 of the 3 activities: Share data and knowledge Jointly develop and share models/simulators Create collaborative environments Interface to access to resources like Grid/HPC infrastructures Ability to interface with existing medical research infrastructure Complement/compatible with existing methods/standards to be suggested by VPH-NoE Theme of this focus: to develop a culture of sharing Focus on tools, services for BMI researchers sharing of data & results joint developments of models collaborative enviroments

VPH Call 6 Focus c) & d) Evaluation and assessment of VPH Projects w.r.t. optimal use and contribution of Shared tools/infrastructure Clinical achievements Market potential/ penetration Observatory on achievements and evolution of the broader BMI field (e.g. bioinformatics, Medical informatics, neuro-informatics): Facilitate communication between projects Dissemination and training Aim at: Sustaining cross collaboration among different fields Build on related NoEs. Important that all stakeholders interested in contributing to these either apply to participate in one of these consortia or provide their point of view to the selected consortia at the appropriate time.

ICT for Health research activities Relevant Grid-related activities Outline ICT for Health research activities Relevant Grid-related activities Where are we going in the short/medium term? Where do we go beyond FP7?

Support projects cutting across research, innovation and deployment As part of COM(2009)116 on « A strategy for ICT R&D Innovation in Europe », the Commission proposed Limited set of project cases that cut across the innovation chain Each project focused on specific characteristics of a pan-European service infrastructures addressing a specific societal goal To speed up the achievement of results there is a need to orchestrate efforts across research, innovation and deployment e.g. multi-financed large-scale initiatives in FP and CIP and national and regional actions including procurement of R&D and innovation Vision for large-scale action which combines all aspects of innovation funding: policy research implementation deployment

Example projects cutting across research, innovation and deployment European Large Scale Action in ICT for Health ICT service infrastructure for personal healthcare Specific societal goal: better integrated care and management of chronic diseases at the point of need; continuous and personalised care … Specific characteristics: accuracy of measurements, remote control by health professionals, self-monitoring … eHealth has been identified as 1 of 4 potential topics for such a large-scale action. On September 29th there was a consultation meeting held in Brussels to clarify the direction such an eHealth project could take. The report is currently being finalised, and further discussions on the topic will be held on a meeting organised by the Swedish presidency on November 10th-11th in Visby, Sweden.

Contact persons DG Information Society and Media Unit “ICT for Health” http://ec.europa.eu/information_society/ehealth Virtual Physiological Human team: Joël Bacquet (joel.bacquet@ec.europa.eu) Karin Johansson (karin.johansson1@ec.europa.eu) Amalia Vlad (amalia-irina.vlad@ec.europa.eu) eInfrastructure team: Enric Mitjana (enric.mitjana@ec.europa.eu) Maria Ramalho (maria.ramalho@ec.europa.eu) Bernhard Fabianek (bernhard.fabianek@ec.europa.eu) Contact person for EGI-related part of FP7-INFRASTRUCTURES-2010-2: Monika Kacik (monika.kacik@ec.europa.eu)