IBM doesn’t refer to its newest life science initiative as “information-based medicine” for nothing. Speaking at a biotech investors’ conference in New York earlier this month, IBM’s worldwide operations manager for life sciences, Joe Jasinski, quipped that it would be just fine with Big Blue if the term’s acronym —which is (ahem) IBM — happens to find its way into common parlance. After all, his company is planning to provide the IT infrastructure that would make such a vision possible.
“We’re IT plumbers,” Jasinski said, stressing that IBM’s business is not on the medical side of the equation. However, he noted, the company does intend to play a vital supporting role in the “end game” of genomics-based biomedical research: personalized molecular medicine. Eventually, Jasinski said, healthcare firms, insurance providers, physicians, and consumers will require ready access to a broad swath of digital patient information, from genotype data to diagnostic test results, family medical histories, lab notes, images, and other documents — a scenario that appears at first glance to be the mother of all data integration projects. “It’s very heavily information technology-based,” Jasinski told BioInform after his talk. “Otherwise, we probably wouldn’t be as interested in it as we are.”
The days of cradle-to-grave data capture may be a decade or more away, but Jasinski said that preliminary versions of such an infrastructure might be only three to four years off. If information-based medicine is a jigsaw puzzle, scattered efforts around the world are just now beginning to fit the corner pieces together, and IBM has a hand in several of them: The company is working with the Mayo Clinic to integrate three clinical trial databases; with Iceland’s DeCode Genetics to correlate genetic markers with disease; with the Translational Genomics Research Institute to map genetic markers for cancer; and with Canada’s iCapture to relate the genetic susceptibility of patients with cardiovascular and respiratory diseases to environmental influences.
In addition, Jasinski said, IBM is “very engaged” with the FDA as the agency evaluates ways to streamline the drug approval process via information technology. In one example, he said, IBM is participating in an FDA project dubbed “Marconi” to demonstrate a standards-based electronic model for automatic transmission of adverse event data to the FDA.
“We’re doing infrastructure for clinical genomics, we’re doing infrastructure for transcriptome analysis, we’re doing projects to integrate medical records data,” Jasinski said, pointing out that despite the breadth of these projects, “there’s no one place where we’re doing all of those yet.”
What will it take to help these dispersed efforts meet in the middle? According to Jasinski, a number of factors are at play, and most of them are economic rather than technological. “Who’s going to pay for it, who wants to pay for it, how much does it cost?” he asked, positing two possible scenarios for advancing the vision. “One is that a major national government like the UK or Singapore or Canada backs this vision and really makes it work and shows efficiency and efficacy. If that would happen, then consumerism [will be] a very strong driving force.”
The alternative, he said, “is that a major medical research center like the Mayo Clinic would put together this kind of system and demonstrate greatly improved patient outcomes.”
In either case, the effort will be complex, decentralized, and consumer driven, making an international research collaboration like the Human Genome Project look like a walk in the park by comparison. “Talking about revolutionizing health care in all the developed nations in the world is an astronomical sum of money. Getting it all moving in the same direction would be many orders of magnitude more difficult than it was to get all the human genome participants moving in the same direction,” Jasinski observed.
Ultimately, Jasinski said, IBM and others working toward the goal of personalized medicine will have to demonstrate measurable results, and deliver them as quickly as possible. “If it’s not better somehow — where ‘better’ can be the same health care cheaper or, preferably, better health care cheaper — then it’s not going to happen,” he said. “Just like if the human genome does not ultimately lead to better drugs faster and more cost-effectively, the interest and the research to mine it and to develop drugs will go away.”
According to Jasinski, IBM is ready for the long haul when it comes to information-based medicine. “If your view of this is, ‘How do I make money short term?’ then this is the wrong business,” he said. “But that’s never been IBM’s view and that’s not most of our customers’ view.” However, in a climate where investors began questioning the value of the Human Genome Project even before its completion, it remains to be seen whether the primary stakeholders in personalized medicine — consumers — will have the same kind of patience.