Smart Grid For Medicine

Health Care

Billionaire Patrick Soon-Shiong On Health Care, Obama Kym McNicholas 08.25.09, 6:00 AM ET

Patrick Soon-Shiong, a self-made billionaire through injectable and breakthrough nanoparticle anticancer technology drug development, is now focusing his philanthropic efforts on creating a national highway for health care. He is donating $1 billion of the $3 billion he netted from the $5.6 billion sale of APP Pharmaceuticals to create the Bell Labs of Health Care. His goal is to build a smart grid for health care, which aims to not only provide greater transparency for doctors and patients to better identify ailments and treatments, but to also eliminate fraud and abuse in today's health care system. Patrick Soon-Shiong: The idea is to create a health grid that empowers the patient and the provider. This should be a public utility, basically what I call a U.S. public health grid. If you look at swine flu, for example--we just presented this at the Institute of Medicine. If you look at swine flu, the world came together very quickly, where we actually were able to share, very quickly, the genomic DNA and actually identify how to actually address this, in a global sense. We need to treat chronic disease as an epidemic like the swine flu. But the only way you can do that, whether it's diabetes, whether it's heart disease and whether it's cancer, is to have what you call a grid, a public utility that you can actually share information on a national scale. With the whole new era of molecular medicine, there's a whole new huge amount of information available today that can significantly impact the decision the doctor's making, that'll affect your life today. It's what I call actionable information. Which then set in motion for me a sense of urgency, that there is without question in my mind, the most important contribution that I can make, establish what I call an information highway. A public utility for information to be shared across the nation. To not only empower the doctor but empower the patient.

Kym McNicholas: It's the smart grid for medicine. And you're creating this, in part, through $1 billion that you had made the commitment for philanthropy, correct? Correct. The idea is to actually go across the country and bring scientists, mathematicians, computer scientists, engineers, biologists, clinicians, surgeons, oncologists, pathologists, all together. And really integrate, truly integrate, information from the basic science to the bench to the clinic. My view, we need to blur what I call translational scientific research with clinical practice because of exactly that, what it is today. That you as a patient would have better treatment with this next generation medicine that's ongoing as we speak than the old medicine that's been there for 20, 30 years, because of our molecular insights. But how do we make this information available to you right now? And so, we needed to create this public utility and this grid. So I've started funding and bringing together computer scientist to implement the grid, in an open architecture for the country. Now, isn't that what the Internet is good for? You share information around the world. Or is this a special, secure connection? Well, that's exactly the issue. So now, within medicine, there's this whole area of HIPA compliance, and also the complexity of medicine, because the Internet is not going to follow you as you go from your doctor. You then go to the specialists. You then go to the hospital. You go into the imaging agent, where you get your CAT-scan. You go to surgery, and you go home. How does anybody follow that trail of information and bring it together? Then how do you take that complex information, integrate it with new data that's happening on a daily basis across the country? So, for example, here's me, the patient, potentially I have cancer. All my information, my data, I go to specialists. It's all up there. Exactly. So basically, it's a cognitive support for medical decision making. So the problem right now is, you know, while I was in medical school, maybe 10 decisions as they examine you, because that's all they had. Listen to your chest and examine you, and that's all they had. Now, with molecular medicine, there may be 200, 300. Then they predict, in another five to 10 years, 1,000 facts that affect you, right now, of which I have to base a clinical decision. It's beyond the cognitive power. And those thousand facts need to come and integrate with you, particularly, in real time, at point of care. That's what we're developing.

That's a lot of information for any one mind. But how do you know what information should and shouldn't be shared over this health care highway? I am convinced that in order for you, as a patient, to be protected, it has to be transparent, evidence-based, objective information. Not self-serving information. Not pharma-driven information. Not ad-driven information. It is transparent, objective, evidence-based information. So how do you make that happen? By creating this public utility, and having transparency of where the knowledge comes from. And who's funding it, above and beyond your initial installments? So far it's just philanthropically, and that's where I need to partner with the government, because if we're going to get into these public options, and we're going to get into actually reducing health care costs. I think the whole issue is, look, there is no question that we need to address health care as it currently exists. There's no question that it's unsustainable. There's no question that this country is the most innovative country still in the world. What we have not done is integrated the goals of actually providing best care, quality of care, regardless of your social and economic status. We have now the opportunity to jump-start health care, straight into molecular world. Or having the integrated, open-source software system that allows access to the two 300 Legacy systems of software. So my great concern is, if we go ahead and implement a plan that just says, "OK, everybody just has an electronic medical record, with 200 proprietary systems, that don't talk to each other by its nature." We will then actually create even further concrete of absence of sharing of the information. And higher danger, not only to the patient but to our health care costs. So the only way to reduce health care costs and to wring out what I call waste and fraud and abuse, I hear that term coming up, but nobody's implemented it. We need a plan of action that actually can identify the waste, fraud and abuse, and act on it. And the only way to identify waste, fraud and abuse, you need an open, transparent information highway that can access fraud and abuse as it's happening in real time. Let me give you another example of a thing called medication adherence.

We know that if you just were to take the drugs that you were supposed to take for diabetes or hypertension, just take it, as opposed to not take it, we could save $7,000, $3000 per patient per year. It'd be hard for you to believe that a drug like Gleevec, which is a drug for cancers. You would think that patients would take this drug every day. The compliance rate for Gleevec is only 70%, 75%. You'd believe that a patient with a hypertension, if you know you have hypertension or diabetes, you would take your drug every day. The compliance rate is more like 30% or 40%. Which means that 60% of patients don't take their drugs, and they actually go into these crises, end up in the hospital. But there's no mechanism today of knowing real time whether you're taking the drug or not. Yet now technology's being developed that wirelessly, we can monitor in real time whether the patient has actually opened the cap, taken the drug and light up the United States like air traffic control, to know that these patients have taken or not taken the drug. It's interesting, because I didn't realize that it was an issue. And I know this is getting away from your actual grander point. But I didn't realize it was an issue that people that are assigned drugs for a serious disease. They're not taking them. And that's become an issue. Correct. It's one of the most important issues that has not been addressed. So again, this is what we're talking with the Bell Labs of health care, in which the technology exists. The technology to create this health grid exists, right now. We can predict climate, weather. So that grid technology is actually used for weather prediction. But we're not even using it ever for health care. So we've taken that, transformed that, for the last five years, to convert that into systems that are what are called HIPA compliant for health care. And make this a public utility for the United States, so that we could treat chronic disease, going back, as if it was swine flu. So have you had a conversation with President Obama about your findings? Yeah ... I've had the opportunity to say hello to him. And he's aware of this. I've met with Secretary Sibelius, and I've met with David Blumenthal. And I've met with members of the National Library of Medicine and Dr. Don Lindberg. I presented this to the Institute of Medicine and the National Academy of Science. And what has been their reaction? What was President Obama's reaction? Well, I think his reaction was he believes this is important work, and he would introduce me to the right people to make sure this would happen was his statement to me in this. You know, I think he's clearly committed to health care

reform. And the difficulty, I believe, is that people are coming from all kinds of avenues to feed at this trough of stimulus money. It's just the nature of the game, right? This is above and beyond stimulus. We're talking about incorporating this into President Obama's health care plan? Correct. I think this is so important for the country. I think it's really more important for the country. I think important for the world, actually, because I'm also trying to actually bring this into Africa, India and Europe. Do you think that the United States will be the first country to implement it, or do you think that it will be implemented elsewhere first? I spent the last six months in Washington, and I've met with 10 or 15 governors. And the governors absolutely get this, absolutely get this, to the point that, at least in California now, we're going to create a health information network that's going to link 800, maybe 2,000 sites, up and down California, including the University of California system. I'm working with Arizona. We're also taking children's hospitals and doing a neuroblastoma clinical trial, which is been now implemented for three years. Forty children's hospitals are sharing CAT-scans and information right now, in real time. Real time. We also just launched, now, the largest colon cancer trial in the United States, the first colon cancer trial in which the eligibility criteria is based on your molecular marker. They couldn't really integrate the data, until they put it with our grid. And now it's about to be launched. MD Anderson, Northwestern and 700 cancer centers are participating. So we're doing this, and it's a little frustrating, because I'm spending a lot of time trying to sort of convince people that this is important for the nation. Just like I couldn't get anybody convinced that we should have 300 million pigs tagged for Heparin in 2005. And in 2008, just like I couldn't get anybody convinced that we need to develop a drug better than Taxol, because we can, and to this day, having literally a jumbo jet full of people die, women die, from anaphylaxis. Survive their breast cancer, but die from anaphylaxis. It's unconscionable. And yet approved in this country still. Unconscionable. So these are the kinds of things that, you know, after a while, you just say, "Well, the only way to do it is just to do it."