Author Archive

Creating the regulatory framework we need

February 9, 2009

“In recent days, there have been misguided criticisms… [suggesting] that we can meet our enormous tests with half-steps and piecemeal measures… I reject these theories”

President Barack Obama, Washington Post, February 5th, 2009

The Obama Administration’s attempt to create the 21st century government “we want” has again confronted the 20th century government “we have”. The Washington Post reported on January 31st that in an attempt to add accountability to the recipients of Troubled Asset Relief Program resources the Obama team hit the brick wall of federal regulations. Turns out, the Paperwork Reduction Act of 1980 prohibits the Obama team from asking recipients what they did with the billions of dollars they received without Office of Management and Budget (OMB) clearance. As reported in The Post, this clearance process can take up to months and can only be waved when “lives are at risk”.

The Paperwork Reduction Act represents but one example of legislation whose good intention in one context blocks noble objectives in another. Biomedical researchers are all too familiar with the alphabet soup of regulations: FDAAA, 21 CFR Part 11, FISMA, HIPAA, to name a few. Moreover, these regulations are interpreted and enforced by a government that has been progressively hobbled for the past 20 years by bipartisan consensus (“government is the problem” – Ronald Reagan, “the era of big government is over” – Bill Clinton). The consequence is Lilliputian ropes binding the giant biomedical enterprise. These bindings impair natural synergies between research and care as well as foster a perverse set of misaligned incentives. For example, the Institute of Medicine’s Committee on Health Research and the Privacy of Health Information this week released a report in which it concludes: “the HIPAA Privacy Rule does not protect privacy as well as it should, and that, as currently implemented, it impedes important health research”.

The current economic crisis we face clearly indicates that the answer is not deregulation. When it comes to healthcare one can not count on altruism and organizational “better angels” to protect privacy, safety, security. Instead, what is needed is a holistic, systematic examination of the patchwork quilt of regulations in the context of 21st century biomedicine opportunities. A significant challenge confronting such an examination is that biomedicine is not currently constituted as a system but instead is a collection of highly fragmented, disconnected, silos.

The BIG Health Consortium™ represents a laboratory where such a systematic assessment could be performed. The BIG Health ecosystem contains the diverse stakeholders throughout biomedicine: consumers, care deliverers, researchers, government, academe, industry, non-governmental organizations. The consortium’s projects will represent real-world applications that demonstrate the regulatory challenges and in which solutions could be contemplated. Because of the diversity of the ecosystem it may be possible to anticipate “consequences” that would otherwise appear as “unanticipated”. The BIG Health Consortium™ inherits the caBIG® community’s pioneering work on data sharing, intellectual capital, and security. The framework created by this community represents solid foundational stones on which to build.

There are many additional natural partners to this endeavor. For example, I had the opportunity to present the BIG Health Consortium™ effort to a luncheon meeting of the American Health Lawyers Association Teaching Hospitals and Academic Medical Centers Practice Group. This group is on the frontlines of the day-to-day struggle of moving biomedicine forward. I invited them to join the BIG Health Consortium to help us create the necessary regulatory framework that balances private interest and public good and make 21st century biomedicine a reality.

Advertisements

Help me, Obi-Wan Kenobi; you’re my only hope.

January 26, 2009

“The question we ask today is not whether our government is too big or too small, but whether it works” President Barack Obama, Inauguration Speech, 2009

A wave of change is breaking over the United States. Whether that wave will sweep in a much needed change into a 21st century biomedical system or harden the silos of 20th century paradigms is yet to be determined. One thing is certain, the developing legislation – the American Recovery and Reinvestment Act of 2009 will change the landscape of biomedicine. Two provisions are noteworthy: the Act’s support for electronic health records and comparative effectiveness research. There is substantial investment in both areas. The devil will be in the details. How the noble ideas are translated into action will determine success or failure of the intentions.

The BIG Health Consortium™ represents a prototype of the 21st century health care “system”. Our ecosystem could serve as a model for the Learning Health Care System needed to inform and sustain a stable, knowledge-based system that focuses on quality and effectiveness. The BIG Health Consortium™ is in an ideal position support a 21st century model of comparative effectiveness – molecularly-informed comparative effectiveness. Traditionally comparative effectiveness studies examine average effectiveness based on broad populations. Such broad comparisons do not account for what we now know about the molecular characteristics of diseases and individuals, and the critical relevance of that knowledge in effectively preventing or treating disease. For example, molecular characterization has already elucidated cancer as a family of sub-types that can only be identified at the molecular level. There are a plethora of molecular tests now used in clinical practice that define subgroups and guide intervention and treatment. 21st century comparative effectiveness must include these stratifications to “do no harm”.

The Obama team squarely confronted the realties of the 20th century this week. The Washington Post reported the Obama team found itself in the “Technologic Dark Ages” as it moved into the White House and “encountered” the realities of federal information technology. Masters of the use of 21st century technology, they experienced first hand the labyrinth of policies, procedures, and interpretations that hobble national efforts. Most symbolic was the attempt to separate President Obama from his Blackberry. In what may be the first true victory for 21st century thinking in information technology in the executive branch, the President retained his Blackberry. Hope springs eternal that this enlightened approach to technology will similarly clear the Byzantine barriers that slow the deployment of an electronically-connected, 21st century ecosystem in biomedicine.

“General Kenobi: Years ago, you served my father in the Clone Wars; now he begs you to help him in his struggle against the Empire… This is our most desperate hour. Help me, Obi-Wan Kenobi; you’re my only hope.” Princess Leia – Star Wars.

Change we don’t need to fear…

November 24, 2008

Dr. Ken Buetow, BIG Health Catalyst

“The future is already here – it’s just not evenly distributed.”
– William Gibson, quoted in The Economist, December 4, 2003

There is an anxious excitement that change is on the horizon. There is little debate that change is needed. What produces the tension is the dilemma of ensuring that what is good is retained while fixing what is bad. My conservative Indiana “Hoosier” roots remind me that “If it ain’t broke, don’t fix it”. Change can cause damage as well as improvement.

The Biomedical Enterprise squarely faces this dilemma. The 21st century is commonly referenced as the “century of biomedicine”. A new generation of personalized medicine promises the delivery of the right intervention, to the right individual, at the right time. Unfortunately, tremendous barriers stand between the promise and delivery of personalized medicine. The cost of translation and development of next generation interventions is sky rocketing. Molecularly-targeted therapeutics are among the most expensive interventions available. An aging population threatens to expand the already 16% of Gross Domestic Product (GDP) spent on health care. Perverse misalignment of incentives blocks the adoption of the new paradigm.

Given the near universal recognition of the challenges faced by biomedicine why is it so difficult to adopt the practices that create solutions? Clayton Christensen of the Harvard Business School in “The Innovators Dilemma” suggests that this type of change is difficult because business practices by those successful in the current paradigm do not incentivize the necessary innovations. An example from another industry is illustrative.

In the early 1980’s “serious” computing was still performed on mainframe and mini computers. The market for these computers was small and they were sold at high price to a small numbers of institutions that could afford their high price tag, the special infrastructure need to house them, and the highly trained users who could master them. IBM was the unquestioned master of the mainframe computer world (its competitors were referred to as the “7 dwarfs”). Its approach to mainframes was common across the industry. New computers were designed by small, internal teams of highly specialized experts and composed entirely of components made within house, in this instance IBM. Mainframe and mini computers were high profit margin products.

At the time, the newly emerging personal computers (PC’s) were toys. They were sold through retail outlets and seen as consumer entertainment devices. Their most enthusiastic adopters were hobbyists and they were felt to have little practical application. They were relatively inexpensive and had low profit margins.

The “real” computer industry struggled with how to approach the PC. When projected against very well understood business models, they didn’t make sense. Existing mainframe customers had little interest in PC’s because they did not perform any functions of value. Their tiny profit could not justify investment in manufacturing or sales. The absolutely correct business analysis at the time suggested it was a distraction to invest in PCs.

Unique within the established computer industry, IBM recognized that to enter the personal computer market it would need to fundamentally alter its business strategy. First, it created a new business unit that was largely independent of existing management. This permitted the unit to explore approaches outside of “business as usual”. IBM had deep institutional knowledge of what was necessary to have a complete computing “system”. To achieve this system, it utilized a “network” model. Instead of creating all the components internally, it instead assembled “off the shelf” parts from different manufacturers. This permitted lower overhead as design and development costs were born by the external original equipment manufacturers (OEMs) and higher margins for the “orchestration” efforts performed by IBM. To make this approach work, IBM created an open architecture and defined interoperability standards for the components. It published these standards and described the “slots” available to plug components into its platform. The IBM PC transformed personal computers and the personal computer market.

The echoes of mainframe computer manufacturing can be seen in today’s biomedical enterprise. Existing, successful organizations struggle to see why they should change. Like “IBM and the seven dwarfs”, even those groups who wish to be on the innovative edge struggle to see how to make it a sustainable activity. Absolutely correct business analysis does not show how a single organization or entity can address the challenges or grab the opportunities of 21st century biomedicine.

Through the BIG Health Consortium™ we strive to accomplish the 21st century biomedical equivalent of IBM’s personal computer model. First we are considering biomedicine as a “system”. This systems approach aims identify all the parts necessary to connect discovery, translation, and care. BIG Health also utilizes a network model. Instead of creating a new, monolithic organization that has all the parts, BIG Health is orchestrating “OEM contributions” from the multiple stakeholders within the biomedical ecosystem. This network model re-aligns incentives and balances contributions.

Like the IBM PC this ecosystem includes novel innovators in biomedicine. Who had ever heard of Microsoft before the IBM PC? For example, the BIG Health Consortium™ contains groups such as personal genomics companies that uniquely target consumers and are dismissed by some members of the biomedical establishment as “entertainment”. Sound familiar?

The BIG Health OEM network model is enabled by open architecture-based interoperable informatics capability – the “BIG” in BIG Health. BIG connectivity “unlocks” data. The BIG Health Consortium™ permits work to be performed through virtual, on-demand, “cloud” organizations.

Finally, while the BIG Health Consortium has the capacity to become a disruptive innovation, it is not by definition disruptive. Like the IBM PC effort it can be explored in parallel to the existing, successful paradigms in biomedicine. It cost efficiently recycles existing capabilities in novel ways. BIG Health is a way of living in the future without leaving the present.

Bows and flows of angel hair…

November 11, 2008

Dr. Ken Buetow, BIG Health Catalyst

And ice cream castles in the air, And feather canyons everywhere, I’ve looked at clouds that way. (Both Sides Now, Joni Mitchell 1967)
 
Clouds are all rage! The virtualization of computer resources – the shift from using storage, computing power, and applications on computers you can touch to accessing these resources through the internet has caught the attention of the lay press.  No longer the domain of arcane “geek-speak” PowerPoint presentations where we drew the internet as a cloud (the “cloud” in “cloud computing”), the cloud has spilled over into mainstream media such as Newsweek and The Economist.
 
The concept is not new and some of the cognoscenti (think Larry Ellison of Oracle) are asking what all the fuss is about.   Industry leaders such as IBM and Oracle have been talking about On Demand Computing and Grid computing for some time.  Much of this is the natural progression of what of Sun Microsystems meant when they adopted the motto: “The Network is the Computer™” two decades ago.   Pioneers of e-business such as CommerceNet have extended the concept to use virtualization to create new business models that have transformed much of industry.  If the concept is not new, why the excitement?  One reason may be that there is a major new player using “the cloud” – consumers.  As millions of consumers have become “wired” through high-speed internet connections and everyday devices such as cell phones, and PDAs connect to the internet a whole new market has opened.
 
A “new” Cambrian Explosion.
 
Irving Waldawsky-Berger, an IT thought leader from IBM, suggests that cloud computing may launch a new Cambrian Explosion and that it may be the “next Big Thing” in information technology.   The Cambrian Explosion refers to the period in evolution about 530million years ago where there is a sudden, rapid increase in the number and complexity of species.   Arguably, this occurred as evolution “mastered” the concept of multi-cellularity.  Two features are key to creating multi-cellular organisms.  First, to make the organism efficient evolution needed to figure out how to re-use components of the genome without duplicating them.  Second, it needed to master inter-cellular communications so that the organism could work together, as a whole.
 
The current day advantages of “multi-cellularity” have been recognized by economists for some time.  Adam Smith in his 18th century Wealth of Nations speculated that economic success was driven by greater productivity and that the greatest improvement of production came from the division of labor.  He further suggested that division of labor was limited primarily by the market of those consuming the specialized services. Through cloud computing organizations do not have to duplicate expensive functions that can be more efficient delivered on an industrial scale by others.  This permits a group to focus precious resources on core business aspects and cost-efficiently consume other capabilities at commodity prices.   Cloud computing is predicated on the availability of diverse resources that can be accessed from a multitude of appliances using common connection protocols.
 
BIG Health Consortium as Cloud
 
I will leave it to the “captains of industry” to debate whether cloud computing is new or whether it is an evolutionary concept in the commercial sector.   In biomedicine the cloud concept has the capacity to be revolutionary.  Biomedicine exists metaphorically in a Precambrian state.  Like low complexity organisms, each individual, organization, and institution carries the burden of having to do it all.  Biomedicine struggles to capture the synergy of specialization. 
 
The BIG Health Consortium™ seeks to create and leverage a novel biomedical “organism”.   The BIG Health market place offers up specialized capabilities that can be assembled in unique combinations. Underpinning BIG Health is BIG, the Biomedical Informatics Grid – a cloud that connects the diverse communities and their unique specialties.  Each participant can contribute their novel capabilities and consume of the capabilities of others.  BIG Health’s Web 2.0 approaches to community building offer a strategy for virtual organization coordination.
 
The BIG Health Consortium™ projects will demonstrate the power of this new model.  Like the Cambrian Explosion it is hoped that this new model will allow biomedicine to efficiently exploit resources and venture rapidly into new places – to address problems that are beyond the reach of current approaches and to demonstrate the reality of personalized medicine.

Complexity-squared

October 2, 2008

Dr. Ken Buetow, BIG Health Catalyst

The last couple of weeks have definitely brought to mind the ancient Chinese blessing/cure – “May you live in interesting times”. As the world churns around us, we are reminded of the complex interactive networks that tie together so many apparently disparate pieces of the world. Biomedicine represents one of these complex interactive networks. I participated in two fascinating conferences during the past 2 weeks that provided two synergistic views of the biomedical ecosystem with implications for BIG Health.

The first conference was the 5th European Conference on Complex Systems held this year in Jerusalem. Wikipedia defines a complex system as “a system composed of interconnected parts that as a whole exhibit one or more properties not obvious from the properties of the individual parts”. At the conference, complex systems in physics, biology, economics, art, and music were discussed and analyzed. Work was presented from ecology studying “real” ecosystems. As well summarized in the Wikipedia entry, complex systems share common properties. Key among these are that the systems boundaries are difficult to determine, that they may be systems of systems, they operate as networks, contain feedback loops, have non-linear effects, and demonstrate emergent properties.

The second conference was titled “Health Care Systems of the Future” sponsored by University of California San Francisco Center of Excellence for Breast Cancer Care and Physicians’ Education Resource. The conference brought together diverse stakeholders in health care and research representing academia, government, and industry. The goal of conference was to begin creating the high quality, coordinated systems of care that are linked to the research community to facilitate evidence based management in medicine. The conference explored many of the challenges facing health care. It also highlighted several examples of success. Common among the examples of success was the organizations recognition and leveraging of the systems nature of the problem they were addressing. In one example, Kaiser Permanente Health Care, the systems approach is accomplished implicitly because the group is an integrated deliverer of health care, acting as both payer and provider. They can therefore describe their boundaries, can formally control portions of the network and leverage the appropriate feedback loops to get non-linear effects. A second example was Geisinger Health Care. While geographically defined and having an integtrated component, Geisinger is an open system. It has a system within a system. It explicitly leverages its internal system to maximize the effectiveness of the larger, open portion of its network.

The insights obtained at the intersection of the two meetings provide important lessons for our emerging BIG Health Consortia. As BIG Health moves forward with its demonstration projects it becomes clear that broad engagement of the diverse biomedical stakeholders will be essential for success and necessary to create a self-supporting ecosystem. Moreover, by consciously considering the network of interactions we will be able to leverage the non-linear aspects of the complex system, amplifying the contributions of the consortia.

Making Personalized Medicine a Reality

September 13, 2008

Dr. Ken Buetow, BIG Health Catalyst

Existentialists posit that “Existence precedes essence…  reality is existence”.   A loose paraphrase would be “You are what you do”.  BIG Health took its first steps this week and in the process made Personalized Medicine that much closer to becoming a reality.

A core confederation of “do-ers”, individuals committed to actualizing the 21st Century Biomedical System necessary for Personalized Medicine, convened this week.   This novel collection of stakeholders representing the different dimensions of this new ecosystem – providers, consumers, government, academia, research, advocacy, industry – shared their needs and offered their capabilities.

What was truly impressive was the collection of “boots on the ground” activities and networks that the participants shared as potential resources that could be joined to create the ecosystem.  The energy was palpable and the enthusiasm was infectious.

Perhaps most important was the overall commitment to action.  The group rolled up its collective sleeves and began framing specific projects that it could undertake.  One key area for further exploration was centered on “virtual clinical research”.  There was much enthusiasm for assembling the unique components of the ecosystem to demonstrate new models for clinical research; models that connect the care delivery system with the research enterprise.  

The group also identified developing a “Learning Health Care System” as another focal point.  This project will explore how the primary observations that occur in clinical encounters could be repurposed to improve care outcomes and assess quality of care.

This initial meeting represents the first wave of the “pebble in the pond”.  The wave is already expanding to include more interested parties and these early participants are already reaching out to other constituencies that will join the expanding circle.  They will bring additional ideas and candidate projects.  Join us in our action-oriented, existential “leap of faith” in making Personalized Medicine a reality

The Need to do Something Different.

September 5, 2008

Dr. Ken Buetow, BIG Health Catalyst

One definition of insanity is doing the same thing over and over again and expecting different results. One may then fairly question the sanity of the biomedical enterprise – stuck by complex forces in existing paradigms we continue to hope for new outcomes such as personalized medicine.

Time Magazine has just published an article “He Won His Battle With Cancer” , outlining the challenges cancer presents to the biomedical community. It quotes Senator Kennedy from the June Senate hearings as saying “We need to integrate our current fragmented and piecemeal system of addressing cancer. Front and center in our current system are the troubling divisions that separate research, prevention and treatment”.

The Time article makes a strong call to do something different. It focuses on the new “Stand Up to Cancer” (SU2C) advocacy group that proposes supporting a model for research where cross-institutional, multi-disciplinary teams work on time delimited projects designed to produce specific deliverables.

The BIG Health Consortium will personify the “do something different” call as a “boots on the ground” group committed to exploring novel approaches. It will join the disconnected pieces observed by Senator Kennedy into a 21st Century Biomedical System. Like the approach of SU2C it will attempt to break down the barriers that slow the discovery process and translation to care by joining individuals, organizations, and institutions that want to demonstrate the reality of personalized medicine.

Crazy? No more than doing nothing.

The End of a Beginning in Personalized Medicine

September 4, 2008

Dr. Ken Buetow, BIG Health Catalyst

The first manuscript reporting results for The Cancer Genome Atlas (TCGA) was published today in the advanced, on-line addition of Nature.  TCGA is a 3-year pilot project of the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) whose goal is to increase our comprehensive understanding of the molecular basis of cancer.  The TCGA team describes the discovery of a complex collection of molecular alterations in glioblastoma multiforme (GBM) that have potential implications for the diagnosis and treatment.  GBM is the most common form of brain cancer in adults affecting 21,000 people annually.

The paper describes previously unknown high frequency mutations for NF1, ERBB2, and PIK3R1 and confirms previous mutational findings in PTEN, RB1, EGFR, and PIKC3A.  It implicates three pathways: the CDK/cyclin/CDK inhibitor/RB pathway, the p53 pathway, and the RTK/RAS/PI3K pathway as the target of molecular alterations in over 80% of GBMs.

These findings, whose true biologic and clinical significance will only be known over time, are of immediate significance in two ways.  First, this novel integration of multidimensional molecular data provides a rare systematic view of cancer.  It is breath taking to see the diversity of molecular mechanisms that generate this single cancer type.  Multiple genes, disrupted by multiple mechanisms (mutations, deletions, amplifications, and epigenetic alterations) interacting through multiple pathways.  However, through this team approach, in a matter of months the cancer community has learned what might have otherwise taken years. What would have been separate observations in different labs in separate papers measuring different molecular dimensions all requiring additional studies to understand the interactions are all seen in concert, simultaneously.  WOW!

Second, but perhaps of greater significance, this multidimensional information is available in an integrated fashion to biomedical community NOW!  By going to the caBIG Cancer Molecular Analysis Portal that integrates and shares the data – http://cma.nci.nih.gov, one can examine and judge for one’s self the assertions made in the manuscript.  Alternatively, a researcher can perform their own in-silico experiments.  This first manuscript will likely be the first of many significant finding drawn from this incredibly rich data resource

Of course the real challenge laid bare is how do we translate these findings into next generation interventions?  The BIG Health Consortium’s 21st Century platform for discovery and translation provides one possible solution.

BIG Health – A Consortium to Realize 21st Century Personalized Medicine

September 1, 2008

Dr. Ken Buetow, BIG Health Catalyst

In the spirit of full disclosure, it is important to let you know, up front – I’m a true believer! I believe, without equivocation, that our individual molecular topography holds the key to understanding disease and driving health. This belief today corresponds to many related health agendas – personalized medicine, molecular medicine, information based medicine. I don’t think it is worth getting hung up on the label.

 

I’ve spent 30 years in the trenches in pursuit of this vision. The seeds of my “faith” were planted when I encountered my first genetics class as an undergraduate. The die was cast for me when I took my senior internship with the Medical Genetics group at Indiana University. This group was making pioneering effort to create a genetic map of human chromosome 1. From the perspective of a completely sequenced human genome, it is difficult to grasp how audacious a goal that was at the time. My first “leap of faith” occurred later that year. I decided to pursue a career in human genetics. A genuinely concerned senior member of the experimental genetics community reacted in horror and told me in no uncertain terms I was throwing away my professional career – “Nothing of importance has ever come from human genetics, nothing ever will…”.

 

It was clear from the onset that the genetic endeavor in humans was very different from other genetics. It required big databases, powerful statistics, and fast computers. It also required a team of scientists from across all of biomedicine. No single individual could assemble the resources necessary to address all the challenges. All the disciplines contributed a novel insight. This was brought home to me as I traveled during my senior internship with a very talented clinician to the homes of study participants identified through his practice, collecting biospecimens for laboratory characterization and collecting family history information for statistical analysis using cutting edge computer technology.

 

The changes in laboratory, statistical, and computer technology that have occurred between that summer and now are breathtaking – cost-efficient, genome-wide genetic characterization, laptop computers with computational capacity that dwarfs the mainframe and mini-computers I used that summer, the internet, the world wide web – WOW! Biomedicine has embraced and exploited them all to give us a remarkable perspective of our molecular landscape. I am always thankful that I grew up with these emerging technologies. I’ve had 30 years to master them as they matured with me. I am amazed that today’s young scientists master these technologies in such short periods of time.

 

One place we have not seen this transformation is in how we as a community conduct biomedicine. We continue to apply existing organizational models. The conduct of studies is as labor intensive as it was 30 years ago. We have used computers to automate old business practices rather than enable completely new approaches. The information from individual health encounters is not accessible to providers or to those developing next generation prevention or treatment strategies. To quote the Secretary of Health and Human Services Michael Leavitt, we have a “health care sector, not a system”.

 

Progress in moving from bench to bedside has always been slower than we “true believers” have hoped and projected. Molecularly-based, personalized medicine is not a reality. We are seeing incremental change occurring by diffusion using tried and true practices that have weathered the test of time. The change will happen we are advised. We are the envy of the world in our US efforts in biomedicine. These things just take time. I am counseled patience.

 

It is hard to be patient. The urgency of the moment is particularly evident in my field, cancer, where over 1.3 million individuals will receive a diagnosis of cancer and over 500,000 will die of this disease this year. We have to try something different!

 

The BIG Health Consortium is that something different. BIG Health’s mission is to

demonstrate – in real settings, in real time – the essential unity of research and care and to model a 21st Century approach to biomedicine, one in which clinical care, clinical research, and scientific discovery are linked to achieve personalized medicine and improved clinical outcomes. It is a new biomedical ecosystem that joins the sectors of biomedicine into a synergistic whole. It leverages information technology as “electronic glue” (the BIG in BIG Health stands for Biomedical Informatics Grid – technology to interconnect the various parts of the biomedical community through semantic interoperable infrastructure).

 

BIG is just the tip of the iceberg. 21st Century medicine requires new organizational approaches that embrace our capacity to work digitally. As Nicholas Negroponte suggests in “Being Digital”, as we transition from atoms to bits the limitations of time and space disappear. Just as technology has permitted us the capacity to look inside a cancer cell, today’s new information technology permits us to reconsider traditional organizational structure and conventions. The BIG Health Consortium will leverage these new approaches as we set out creating our virtual community.

 

The BIG Health Consortium is a coalition of stakeholders who want to create a 21st Century biomedical ecosystem to address the challenges and opportunities of 21st Century personalized medicine. It will be exciting to see what happens when we bring together “true believers” from across all sectors of biomedicine. WATCH THIS SPACE!