Abernethy: EHR unstructured data: physician notes (PDFs), radiology reports, path, discharge notes, even condolence cards #PMWC17
11:08am January 24th 2017 via Hootsuite
Abernethy: Look at EHR structured data: demographic, Dx, visits, labs, e-Rx. Often missing NGS data/reports. #PMWC17
11:07am January 24th 2017 via Hootsuite
Abernethy: In the US: 258 cancer clinics, 2,4K cliniciants, 1.5M active cancer pts in network, aggregating EHR into 1 repository #PMWC17
11:06am January 24th 2017 via Hootsuite
Abernethy: Underlying the EMR, complex datasets. From demographics, metastatic sites, to diagnostic test results, etc etc #PMWC17
11:05am January 24th 2017 via Hootsuite
Abernethy: Thus from EMR's: aggregation, organization, completeness, quality/reliability, timeliness, access/security #PMWC17
11:04am January 24th 2017 via Hootsuite
Amy Abernethy (Flatiron Health) Unlocking real-world data. Outside of clinical trial data. 96% pts don't touch a clin trial #PMWC17
Simon: A reporter asks, 'what can you do in 9 mos?' 9 months can be half of someon'es life. #PMWC17
10:58am January 24th 2017 via Hootsuite
Simon: The Whitehouse Moonshot website 'is gone'. The effort lives on. https://t.co/CwyHv5TeMj #PMWC17
10:57am January 24th 2017 via Hootsuite
Simon: "It is why things change so slowly. Sharing data means something can happen. Hoarding data means nothing happens" #PMWC17
10:56am January 24th 2017 via Hootsuite
Simon: We need to change how we spend our money, most important: DATA. What happens to our data. Called the 'insider trading model' #PMWC17
10:55am January 24th 2017 via Hootsuite
Simon: Points to https://t.co/cN2BxtUsaT - there are >70 organizations carrying this work on #PMWC17
Simon: Howard Univ workshops, tying in another 2K participates remotely. 'a movement'. Moonshot had a 1y charter... $1.8B Cures Act #PMWC17
10:53am January 24th 2017 via Hootsuite
Simon: "You would not believe how many do not participate in clinical trials" due to practical transport, childcare, other concerns #PMWC17
10:52am January 24th 2017 via Hootsuite
Simon: Now just about every child is enrolled in a clinical trial. For cancer, a clinical trial is seen as a last-resort treatment. #PMWC17
Simon: Changing clinical trials: unethical to say 'enroll in this trial, it might help you'. It had to be altruistic before #PMWC17
10:51am January 24th 2017 via Hootsuite
Simon: Insurance and location determine cancer survivorship (!) more than any other variable - even family history #PMWC17
10:50am January 24th 2017 via Hootsuite
Simon: If you have Lynch - colonoscopy in your 20's, not 50's. 'Where you live determines how well you live w/cancer' #PMWC17
10:49am January 24th 2017 via Hootsuite
Simon: Lynch syndrome that goes undiagnosed: part of blue-ribbon panel, now screening 1st-degree relatives. Can save 1000's of lives #PMWC17
Simon: Early stage detection of cancer via blood testing: FDA wanted an atlas. 20 groups DOE, DOD, NCI, all working on this (ctDNA) #PMWC17
10:48am January 24th 2017 via Hootsuite
Simon: Deputy dir of VA: This is the most positive thing ever for the Dept of the VA (!) PMWC17
10:47am January 24th 2017 via Hootsuite
Simon: Walter Reed and VA for cancer NGS - another connection described. IBM Watson brought in 'for free' - brought all 3 together #PMWC17
Simon: GWU and CW connected for public health new-data initiatives. Advice: "Answer your phone, and speak with random people" #PMWC17
10:46am January 24th 2017 via Hootsuite
Gregory Simon (White House, Cancer Moonshot) An update on the Cancer Moonshot and BRAIN Government Intitiatives #PMWC17
10:42am January 24th 2017 via Hootsuite
Paz: Of $3T spend, 30% wasted. 60% admin waste, 40% clinical waste. 40% social determinants for health; 10% hospital, 50% genetics #PMWC17
7:47pm January 23rd 2017 via Hootsuite
Nadauld: Intermountain went away from a fee-for-service model to a value-based model, decreasing utilization w/incentives for health #PMWC17
7:39pm January 23rd 2017 via Hootsuite
Nadauld: If we don't come up with standards ourselves (for actionable genes), CMS or others will do it for us. #PMWC17
7:35pm January 23rd 2017 via Hootsuite
Burd: Quality of assay 'a major concern for us' (she's a patient advocate). Need to separate actionable and useful for future use #PMWC17
7:34pm January 23rd 2017 via Hootsuite
Nadauld: And not only tests but annotation. Has heard 'WGS when you are born' to 'we don't know what any of it means'. Truth: midway #PMWC17
7:32pm January 23rd 2017 via Hootsuite
Krumholz: "It's the quality of the test that concerns me the most. Nadauld: Standardization is a 'must'. #PMWC17
7:31pm January 23rd 2017 via Hootsuite
Paz: So much quantity and quality of data provided to physicians, and then to patients. Some actionable, some not. Filters? #PMWC17
7:30pm January 23rd 2017 via Hootsuite
Krumholz: Lots of missing pieces - nothing is longitudinally linked. "The records exist." But held by different entities... #PMWC17
Paz: Blockchain? Krumholz: Public and private chains - private ones can be lost. Healthcare application - maybe down the line. #PMWC17
7:29pm January 23rd 2017 via Hootsuite
Krumholz: It has to be people first, not able to be de-identified and sold in secret, has to be convenient, from connected devices #PMWC17
7:28pm January 23rd 2017 via Hootsuite
Burd: Ideally, patients would carry it around in their smartphone. Nadauld: the next generation will demand that. #PMWC17
7:26pm January 23rd 2017 via Hootsuite
Nadauld: It is the empowerment of patients, to understand their own data. Paz: Are there platforms out there today? #PMWC17
7:24pm January 23rd 2017 via Hootsuite
Krumholz: ...and we won't know the value of a personalized approach. Nadauld: Your data no longer can be a black box. #PMWC17
Krumholz: Give people the power, and make 'the researchers beg for it'. A need for the data to move. #PMWC17
7:23pm January 23rd 2017 via Hootsuite
Krumholz: Such a separation between aspirations here at #PMWC17, and the realities of healthcare. What is the value to the individual?
7:22pm January 23rd 2017 via Hootsuite
Krumholz: Need to understand how health progresses. But the info gets 'mostly lost, and shielded from being useful clinically' #PMWC17
Round-table discussion - Krumholz "We need greater liquidity of patient data" - people owning their own data, being able to move it #PMWC16
7:21pm January 23rd 2017 via Hootsuite
Harold Paz Aetna Lincoln Nadauld Intermountain Amy Burd LLS Harland Krumholz (Yale) Moving Precision Medicine to Precision Health #PMWC17
7:18pm January 23rd 2017 via Hootsuite
Q: What's the next big thing? Rosenfeld: Highly sensitive that can pick up residual disease. Now more optimistic than before. #PMWC17
6:30pm January 23rd 2017 via Hootsuite
Q: have we met the limit of sensitivity? Rosenfeld: Can detect as few as three molecules; sample prep upfront is the work #PMWC16
6:28pm January 23rd 2017 via Hootsuite
Morris: (Here's the Clinical https://t.co/byUd2BT8MU website with the currently-enrolling Grail study https://t.co/7Qh02x1jm2 ) #PMWC17
6:21pm January 23rd 2017 via Hootsuite
Morris: ctDNA can aid early Dx, Grail is currently recruiting, and thus can widen scope of pts who can get intervention #PMWC17
6:19pm January 23rd 2017 via Hootsuite
Morris: Long list of profiling, monitoring, and early Dx companies for ctDNA. Stratification has already begun using ctDNA #PMWC17
6:12pm January 23rd 2017 via Hootsuite
Morris: Shows Piper Jaffray estimate of a $28B market opportunity. Sept 2015 to Sept 2016 $336M raised. #PMWC16
6:10pm January 23rd 2017 via Hootsuite
Govindan: Can detect down to 0.1%, many responders had low allele frequency. #PMWC17
6:09pm January 23rd 2017 via Hootsuite
Govindan: Current assays have limited sensitivity - Oxnard et al reports 58-77%. #PMWC17
6:04pm January 23rd 2017 via Hootsuite
Govindan: Plasma analysis tends to detect mutations shared between multiple tumor regions; can determine emerging areas of resist #PMWC17
