The Big Deal About Data

Saturday, August 20, 2016

Rush playing a key role in progress toward precision medicine

The promise of precision medicine — preventing and treating disease based on an person’s genetics, lifestyle and environment — is that, in the not-so-distant future, health care practitioners will be treating individuals instead of diseases. The present challenge is how to gather and harness the massive amounts of data that will form the foundation of this new approach to health care. 

Bala Hota, MD, Rush University Medical Center’s chief research informatics officer, likens the colossal bioinformatics project underway, both nationwide and at Rush, to the one that brought the sophisticated GPS network to the dashboard of cars, where it now helps people find their way to their daily destinations.

“First, somebody had to map out every street in the world. They had to gather all that data to build a GPS system,” Hota says. “You need that same approach for genomics — collecting and mapping our genomic data to disease and health. Those databases have to be built.” 

Building a national health database

Hota and his colleagues are making plans to do just that, collaborating with other health care institutions to advance these efforts in Chicago. Rush is part of a consortium of Chicago academic medical centers that has been awarded $45 million in funding from the National Institutes of Health to help build a diverse, voluntary national research cohort of 1 million Americans whose data will be gathered and shared. The plan is to enroll at least 150,000 individuals in Chicago alone.

The effort complements Rush’s work as a participant in the Chicago Area Patient-Centered Outcomes Research Network, or CAPriCORN, under which some of those same academic medical centers, government-funded hospitals and other partners pool data and other resources with a goal of improving care for all the area’s residents.

“Context is critical. The end goal of bioinformatics isn’t just to create and digest huge amounts of data. It’s to provide patients and their doctors with relevant information at the time of care,” Hota says.

Using data to improve outcomes

While these collaborations represent the future of bioinformatics in Chicago, precision medicine is already bearing fruit at Rush, Hota says. Genetic tests discern differences in how patients metabolize drugs, for example. Other advances are individualizing the treatment of cancer. 

With node-negative breast cancer, for example, only about four of 100 patients whose tumors are fed by estrogen will benefit from chemotherapy. Melody Cobleigh, MD, Rush’s director of medical oncology, says her team developed protocols to identify those four patients, “so we could spare the others the use of chemotherapy.”

“We’ve been able to take the information we have and personalize treatment for our patients,” Cobleigh says. “We helped develop a test that allows us to identify patients who actually need chemotherapy. This test has been ordered by more than 20,000 physicians in 70 different countries, with about a quarter of a million women benefitting thus far.”

A national focus on precision medicine

The Affordable Care Act and other federal mandates have pushed precision medicine forward, making electronic health records ubiquitous and requiring the data in those records to be available to clinicians and researchers. President Obama made precision medicine a topic in his State of the Union address in 2015.

In terms of how precision medicine will affect “the total cost of care,” Hota says the answers aren’t yet obvious, in part because new technology can initially be very expensive, but becomes exponentially cheaper over time. 

“The big opportunity,” he said, “is to use information to give the treatment best suited for each unique patient, thereby providing the best, most efficient care.”

For media inquiries, please contact kevin_mckeough@rush.edu.