The Dahlem Centre for Genome Research and Medical Systems Biology

AIMS

• to develop the technology, the required infrastructure and the legal, regulatory and educational environment for a fully sustainable health care system that will offer truly personalised medicine, prevention and wellness for European citizens, providing a completely new Quality-of-Life.

• to develop novel -omics, imaging and multi-level advanced smart sensor technologies and big data/deep data analytics for problem solving in IoH/personalised health care.

• to address the full value chain of the virtual human at all multidisciplinary levels required, from -omics, imaging and sensor data to complex simulation models.

KEY BENEFITS for:

• EU citizens, through a radical improvement of their health care and a new quality of life.

• European economy, through new job and employment opportunities. Formation of a new vibrant economic ecosystem bridging traditional engineering, computer sciences and health care.

• European industry, stimulating the life sciences, pharmaceutical, health care, sensor and IT sectors, providing a large potential for innovation that can be further exploited in translational medicine.

• Public finances, by curbing the uncontrolled increase in health care spending (potential savings of hundreds of billions of euros) through a data and model driven truly personalised health care, improving continuously in a self-learning system, duplicating, in a sense, human evolution.

CHALLENGE & VISION

Our individual existence and well-being depend primarily on remaining healthy and during ill health, receiving the individualised, optimal therapy. The continuing ‘health’ of our societies is, in contrast, increasingly threatened by the enormous cost of providing appropriate healthcare (currently 4 billion euros PER DAY in Europe alone) in the rapidly ageing societies of Europe. When faced with similar challenges with harmful and/or expensive consequences in other areas we have followed a very simple principle: mistakes are unavoidable in dealing with highly complex processes. While we cannot avoid making these mistakes, we can avoid most or all of their consequences by making these mistakes in-silico. This change of strategy has been implemented in most areas of our existence, increasing efficiency, saving lives and reducing costs.

This enormous progress has, as yet, reached neither our health care system nor the way we develop new drugs. Drug based therapy and prevention is still statistical, with many patients receiving drugs, which are ineffective or, even worse, harmful. Unavoidable errors in drug development still cause the cost per drug reaching the market to remain in the multi-billion euro range and endanger patients participating in large, non-stratified clinical trials. In addition, our ‘health’ care system is still far too much a ‘disease’ care system. The majority of our efforts are focused on treating rather than preventing diseases; or at least diagnosing diseases (or their progression) early enough to be able to react.

Changing this will require nothing less than a revolution, based on technical developments in two general areas, but intimately linked to many other aspects of the organisation of health care and its legal and regulatory basis (see also www.healthcarecompacteurope.eu):

We need to know much more about the patient (or the potential patient), based on advanced -omics (e.g. genomics, proteomics, metabolomics) analyses, imaging techniques, and information from sensors deployed in various form factors. We will draw primarily on concepts developed under two separate Flagship proposals (both of which had reached the final stage of the last competition): IT Future of Medicine (ITFoM: www.itfom.eu), with a very strong -omics component, and ‘Guardian Angels for a Smarter Life’ (www.ga-project.eu/), with a particular focus on the development of novel autonomous sensors/low energy computing. In addition, we plan to incorporate a similarly strong imaging component, from the level of individual cells up to the entire organism.

Data is however not everything. We also need concepts to integrate this information and to predict the effects and side effects of possible therapies (or preventive measures) on every individual. Towards this we will build on the concept of the ‘virtual patient/virtual individual’, proposed in ITFoM. Such a ‘virtual twin’, updated intermittently by medical/omics/imaging information, and essentially continuously by a multitude of sensors could, in theory, accompany every European through life as a true ‘Guardian Angel’. These ‘Guardian Angel’ models will, to a large extent, be based on modelling the biology of every patient and the diseases mechanistically, providing by far the best chance to translate complex data sets into accurate predictions, complemented by machine learning/statistical techniques, whenever mechanistic models cannot be established due to insufficient knowledge, e.g. on disease mechanisms. Development in these areas will however also help to accelerate and de-risk the development of new drugs, based e.g. on virtual ‘clinical trials’, starting shortly after (and maybe even before) the synthesis of new candidate compounds, in a ‘virtualisation’ of drug development matching the enormous positive effects that a similar virtualisation has had on e.g. the car industry.

Technology is however only a part of the solution. We will, in addition, have to reconsider many aspects of our health care system, its legal basis, regulations and reimbursement mechanisms, to draw maximal benefits from the significant progress in technologies allowing us to truly personalise medicine and prevention. We propose a vision of a truly individualised health care and disease prevention system in Europe, based on a detailed characterisation (e.g. clinical, molecular, imaging and sensor based) of the patient/individual and their wellness, health and disease course, exploiting the most advanced molecular, imaging, sensing, computing and communication technologies, through an internet-of-humans, for truly personalised and preventive medicine.