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Personalized Medicine: Real Opportunities And Real Challenges For Doctors

Greg McStravick

In the first of a three-part series on how technology is transforming healthcare, Greg McStravick, GM and global head, SAP Platform GTM, takes a look at the potential of personalized medicine. Technology has the potential to create real value, but short-term challenges are significant. Find out more about technology and healthcare challenges and opportunities in Parts 2 and 3:

  • Part 2: Personalized Medicine and Big Data–Opportunities and Pitfalls of IT Innovation
  • Part 3: The Risks, Challenges–and Rewards–of Ensuring Medical Data Privacy

As we observe National Heart Month (#NationalHeartMonth) this February, it is both encouraging and exciting that a new effort is underway to create tailor-made medicine and medical treatments by drawing on exceptionally detailed and extensive biomedical data. The effort is ambitious and challengingand possible. The goal: wide availability of personalized medical care (aka precision medicine) that can be customized based on an individual’s genetic makeup and other factors.

But collecting this level of personal health care information, while it holds the possibility of game-changing personalized drugs and treatments, is not without major challenges–including those in the realms of patient privacy and data storage. Highly individualized diagnosis and treatment available on a large scale requires collection and management of petabytes of data, including but not limited to patient histories, genetic data, data from wearable health monitors, and information on individual microbiomes (bacteria, fungi, and viruses in and on the body). Privacy is of utmost concern, and even current big data standards could be strained by massive amounts of genetic data.

The possibilities are compelling, and the upside is huge. But personalized medicine is a challenge with real, difficult, and perhaps intractable problems attached.

Are we there yet?

We’ve been able to sequence the human genome for about 15 years. In certain specialties, such as oncology, we’re already seeing tremendous advancements thanks to genometrics. Cancer used to be thought of in terms of a cell gone wrong that affected the tissue around it, with treatments based on affected area – for example, lung, breast, or skin. Now, researchers are looking to treat each mutation by responding to its genetic fingerprint. The same treatment might be applicable regardless of the organ or tissue affected, and, for example, one patient’s lung cancer treatment might differ from another’s due to genetic differences in each person’s mutation.

However, along with important breakthroughs and new therapies to treat formerly untreatable diseases, we’ve also seen the need for exponentially more complex understanding – from not just researchers but front-line doctors. Now that we can sequence the DNA, we must understand and transcribe epigenomes, proteomes, metabolomes, and more. This poses a huge challenge for on-the-ground medical personnel, including primary care providers and specialists whose focus is broadly defined quality care.

Friend or foe?

The majority of physicians believe that personalized medicine will eventually create real value for individuals as well as entire populations. But in the short term, what will the average family practitioner get for her efforts? Physicians are under stress, working more and seeing patients less. Many doctors have just completed mandatory transitions to electronic medical records (EMRs), which has required more work but yielded little in tangible results. Privacy laws, insurance paperwork, and the shift to value-based pricing are requiring more data input and creating more hoops to jump through, lengthening the workday but providing minimal tangible value for patients and doctors. The fear here is that personalized medicine could mean more of the same for the vast majority of providers. Would primary care doctors need to verify even more information when a person is sick, taking into account all the additional characteristics that drive a doctor toward different therapies? Will all the new inputs yield equivalent benefits?

Outside the office

I believe that in order for personalized medicine to take off, we’ll need to capture not just genomic information, but accurate information about individual patients that falls well outside current hospital or clinical settings. How do patients live in their homes? What do they eat, drink, and smoke? What’s their documented level of physical and social activity? And even more important, how do we engage patients, especially those with chronic illness, in ways that support real change of unhealthy habits? I believe that for personalized medicine to reach its full preventative potential, the medical profession will have to engage with patients in their homes.

Also, correlating such lifestyle data is critically important to understanding and applying genomic data when predicting risk factors for certain diseases. But how will this lifestyle data be captured and stored? What infrastructure will be needed, and how will it be funded? Before we can consistently, accurately, and cost-effectively collect this data, we need a technology infrastructure and payment model in place.

Best practices: A final challenge

It can be a major challenge for the medical profession to implement best practices. Even when best practices are proven in controlled, randomized trials, it has often taken up to 20 years for a practice to be consistently adopted. Given this challenge, for personalized medicine protocols to really work for–and be consistently adopted by–doctors, they must:

  • Be time-neutral
  • Integrate into current workflows
  • Drive clear value for both doctors and their patients

It’s only when we address all these challenges–both technological and human-based–that we will be able to truly take advantage of the benefits that personalized medicine can offer.

Learn more about the SAP Foundation for Health and Personalized Medicine

SAP is passionate about creating transformative technology that can advance healthcare. The SAP Foundation for Health includes a sophisticated platform and advanced analytic solutions that can help unlock the value of biomedical data–from genomes to electronic medical records to clinical trials. Supporting deeper insights and enabling collaboration, the SAP Foundation for Health helps connect data silos and bring together mission-critical biomedical data, advancing personalized medicine to new levels.

Visit SAP at #HIMSS16 Booth #5828 February 29-March 4 to learn more, or continue the discussion on Twitter @SAP_Healthcare.

 

 

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Greg McStravick

About Greg McStravick

Greg McStravick is the President of Database and Data Management at SAP, leading development and go-to-market teams for SAP’s core digital innovation platform, SAP HANA and Sybase databases (including ASE, and IQ), enterprise information management, middleware, and SAP HANA Vora. Formerly, Greg led the go-to-market teams and strategy for some of SAP’s largest and fastest growing businesses including the SAP HANA platform, analytics, database, and SAP HANA Cloud Platform. With more than 20 years of progressive experience as a leader in technology solution sales management and strategy, Greg has held senior leadership positions throughout SAP, including President (U.S.), where he was responsible for driving customer success and developing new opportunities for SAP to expand its business across the entire U.S. region.

IoT Can Keep You Healthy — Even When You Sleep [VIDEO]

Christine Donato

Today the Internet of Things is revamping technology. IoT image from American Geniuses.jpg

Smart devices speak to each other and work together to provide the end user with a better product experience.

Coinciding with this change in technology is a change in people. We’ve transitioned from a world of people who love processed foods and french fries to people who eat kale chips and Greek yogurt…and actually like it.

People are taking ownership of their well-being, and preventative care is at the forefront of focus for both physicians and patients. Fitness trackers alert wearers of the exact number of calories burned from walking a certain number of steps. Mobile apps calculate our perfect nutritional balance. And even while we sleep, people are realizing that it’s important to monitor vitals.

According to research conducted at Harvard University, proper sleep patterns bolster healthy side effects such as improved immune function, a faster metabolism, preserved memory, and reduced stress and depression.

Conversely, the Harvard study determined that lack of sleep can negatively affect judgement, mood, and the ability retain information, as well as increase the risk of obesity, diabetes, cardiovascular disease, and even premature death.

Through the Internet of Things, researchers can now explore sleep patterns without the usual sleep labs and movement-restricting electrode wires. And with connected devices, individuals can now easily monitor and positively influence their own health.

EarlySense, a startup credited with the creation of continuous patient monitoring solutions focused on early detection of patient deterioration, mid-sleep falls, and pressure ulcers, began with a mission to prevent premature and preventable deaths.

Without constant monitoring, patients with unexpected clinical deterioration may be accidentally neglected, and their conditions can easily escalate into emergency situations.

Motivated by many instances of patients who died from preventable post-elective surgery complications, EarlySense founders created a product that constantly monitors patients when hospital nurses can’t, alerting the main nurse station when a patient leaves his or her bed and could potentially fall, or when a patient’s vital signs drop or rise unexpectedly.

Now EarlySense technology has expanded outside of the hospital realm. The EarlySense wellness sensor, a device connected via the Internet of Things, mobile solutions, and supported by SAP HANA Cloud Platform, monitors all vital signs while a person sleeps. The device is completely wireless and lies subtly underneath one’s mattress. The sensor collects all mechanical vibrations that the patient’s body emits while sleeping, continuously monitoring heart and respiratory rates.

Watch this short video to learn more about how the EarlySense wellness sensor works:

The result is faster diagnoses with better treatments and outcomes. Sleep issues can be identified and addressed; individuals can use the data collected to make adjustments in diet or exercise habits; and those on heavy pain medications can monitor the way their bodies react to the medication. In addition, physicians can use the data collected from the sensor to identify patient health problems before they escalate into an emergency situation.

Connected care is opening the door for a new way to practice health. Through connected care apps that link people with their doctors, fitness trackers that measure daily activity, and sensors like the EarlySense wellness sensor, today’s technology enables people and physicians to work together to prevent sickness and accidents before they occur. Technology is forever changing the way we live, and in turn we are living longer, healthier lives.

To learn how SAP HANA Cloud Platform can affect your business, visit It&Me.

For more stories, join me on Twitter.

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Christine Donato

About Christine Donato

Christine Donato is a Senior Integrated Marketing Specialist at SAP. She is an accomplished project manager and leader of multiple marketing and sales enablement campaigns and events, that supported a multi million euro business.

Zhena’s Gypsy Tea Brews Sustainable Growth On Cloud ERP

David Trites

Recently I had the pleasure of hosting a podcast with Paula Muesse, COO and CFO of Zhena’s Gypsy Tea, a small, organic, fair-trade tea company based in California, and Ursula Ringham from SAP. We talked about some of the business challenges Zhena’s faces and how the company’s ERP solution helped spur growth and digital transformation.

Small but complex business

~ERP helped Zhena’s sustain growthZhena’s has grown from one person (Zhena Muzyka) selling hand-packed tea from a cart, into a thriving small business that puts quality, sustainability, and fair trade first. And although the company is small its business is complex.

For starters, tea isn’t grown in the United States, so Zhena’s has to maintain and import inventory from multiple warehouses around the world. Some of their tea blends have up to 14 ingredients, and each one has a different lead time. That makes demand-planning difficult. In addition, the FDA and US Customs require designated ingredients be traced and treated a certain way to comply with regulations.

Being organic and fair trade also makes things more complicated. Zhena’s has to pass an annual organic compliance audit for all products and processing facilities. And all products need to be traceable back to the farms where the tea was grown and picked to ensure the workers (mostly women) are paid fair wages.

Sustainable growth

Prior to implementing its new ERP system, Zhena’s was using a mix of tools like QuickBooks, Excel, and paper to manage the business. But to sustain growth and ensure future success, the company had to make some changes. Zhena’s needed an integrated software solution that could handle all facets of the business. It needed a tool that could help with cost control and profitability analysis and facilitate complex reporting and regulatory requirements.

The SAP Business ByDesign solution was the perfect choice. The cloud-based ERP solution reduced both business and IT costs, simplified processes from demand planning to accounting, and enabled mobile access and real-time reporting.

Check out the podcast to hear more about how Zhena’s successfully transformed its business by moving to SAP Business ByDesign.

 This article originally appeared on SAP Business Trends.

Building a successful company is hard work. SAP’s affordable solutions for small and midsize companies are designed to make it easier. Simple to install and use, SAP SME Solutions help you automate and integrate your business processes to give real-time, actionable insights. So you can make decisions on the spot. Find out how Run Simple can work for you. Visit sap.com/sme.

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David Trites

About David Trites

David Trites is a Director of SAP Global Marketing. He is responsible for producing interesting and compelling customer stories that will humanize the SAP brand, support sales and marketing teams across SAP, and increase the awareness of SAP in key markets.

Teaching Machines Right from Wrong

Dan Wellers

 

By 2018, smart machines will supervise over 3 million workers worldwide.
21% of consumers in an FTC study had confirmed errors on their credit reports.
2014: the first annual Fairness, Accountability, and Transparency in Machine Learning conference.
A private university encouraged 20-25 students to drop out based on AI predictions of
poor grades.

Real-world examples of misused AI algorithms abound. These are just a few:

  • Women who weren’t pregnant — or weren’t ready to reveal it — received special offers of baby products and “congratulatory” messages.
  • People with minority ethnic names received a disproportionate number of ads implying they had criminal records.
  • Guests at a party learned a ride-hailing company kept track of customers who stayed out all night and went home in the wee hours.

Ethical-Edge Cases

Credit scoring algorithms designed to evaluate lending risk are now commonly used to gauge reliability and trustworthiness, determining whether someone should get a job or apartment.

Insurance underwriting algorithms determine the extent, price, and type of coverage someone can get, with little room for disagreement.

Healthcare algorithms could be used to penalize the currently healthy for their probability of future illness.

Algorithms often use zip codes as proxy for (illegal) racial profiling in major decisions, such as employment and law enforcement.

Self-driving cars will have to learn how to react in an accident situation when every possible outcome is bad.


What Should We Do About It?

All machine learning contains assumptions and biases of the humans who create it — unconscious or otherwise. To ensure fairness, business leaders must insist that AI be built on a strong ethical foundation.

We can:

  • Monitor algorithms for neutrality and positive outcomes.
  • Support academic research into making AI-driven decisions more fair, accountable, and transparent.
  • Create human-driven overrides, grievance procedures, and anti-bias laws.
  • Include ethics education in all employee training and development.

Above all, we must consider this a human issue, not a technological one. AI is only as unbiased a tool as we make it. It’s our responsibility to keep it on the ethical straight and narrow.


Download the executive brief Teaching Machines Right from Wrong.


Read the full article AI and Ethics: We Will Live What Machines Learn

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Dan Wellers

About Dan Wellers

Dan Wellers is the Global Lead of Digital Futures at SAP, which explores how organizations can anticipate the future impact of exponential technologies. Dan has extensive experience in technology marketing and business strategy, plus management, consulting, and sales.

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Why Millennials Quit: Understanding A New Workforce

Shelly Kramer

Millennials are like mobile devices: they’re everywhere. You can’t visit a coffee shop without encountering both in large numbers. But after all, who doesn’t like a little caffeine with their connectivity? The point is that you should be paying attention to millennials now more than ever because they have surpassed Boomers and Gen-Xers as the largest generation.

Unfortunately for the workforce, they’re also the generation most likely to quit. Let’s examine a new report that sheds some light on exactly why that is—and what you can do to keep millennial employees working for you longer.

New workforce, new values

Deloitte found that two out of three millennials are expected to leave their current jobs by 2020. The survey also found that a staggering one in four would probably move on in the next year alone.

If you’re a business owner, consider putting four of your millennial employees in a room. Take a look around—one of them will be gone next year. Besides their skills and contributions, you’ve also lost time and resources spent by onboarding and training those employees—a very costly process. According to a new report from XYZ University, turnover costs U.S. companies a whopping $30.5 billion annually.

Let’s take a step back and look at this new workforce with new priorities and values.

Everything about millennials is different, from how to market to them as consumers to how you treat them as employees. The catalyst for this shift is the difference in what they value most. Millennials grew up with technology at their fingertips and are the most highly educated generation to date. Many have delayed marriage and/or parenthood in favor of pursuing their careers, which aren’t always about having a great paycheck (although that helps). Instead, it may be more that the core values of your business (like sustainability, for example) or its mission are the reasons that millennials stick around at the same job or look for opportunities elsewhere. Consider this: How invested are they in their work? Are they bored? What does their work/life balance look like? Do they have advancement opportunities?

Ping-pong tables and bringing your dog to work might be trendy, but they aren’t the solution to retaining a millennial workforce. So why exactly are they quitting? Let’s take a look at the data.

Millennials’ common reasons for quitting

In order to gain more insight into the problem of millennial turnover, XYZ University surveyed more than 500 respondents between the ages of 21 and 34 years old. There was a good mix of men and women, college grads versus high school grads, and entry-level employees versus managers. We’re all dying to know: Why did they quit? Here are the most popular reasons, some in their own words:

  • Millennials are risk-takers. XYZ University attributes this affection for risk taking with the fact that millennials essentially came of age during the recession. Surveyed millennials reported this experience made them wary of spending decades working at one company only to be potentially laid off.
  • They are focused on education. More than one-third of millennials hold college degrees. Those seeking advanced degrees can find themselves struggling to finish school while holding down a job, necessitating odd hours or more than one part-time gig. As a whole, this generation is entering the job market later, with higher degrees and higher debt.
  • They don’t want just any job—they want one that fits. In an age where both startups and seasoned companies are enjoying success, there is no shortage of job opportunities. As such, they’re often looking for one that suits their identity and their goals, not just the one that comes up first in an online search. Interestingly, job fit is often prioritized over job pay for millennials. Don’t forget, if they have to start their own company, they will—the average age for millennial entrepreneurs is 27.
  • They want skills that make them competitive. Many millennials enjoy the challenge that accompanies competition, so wearing many hats at a position is actually a good thing. One millennial journalist who used to work at Forbes reported that millennials want to learn by “being in the trenches, and doing it alongside the people who do it best.”
  • They want to do something that matters. Millennials have grown up with change, both good and bad, so they’re unafraid of making changes in their own lives to pursue careers that align with their desire to make a difference.
  • They prefer flexibility. Technology today means it’s possible to work from essentially anywhere that has an Internet connection, so many millennials expect at least some level of flexibility when it comes to their employer. Working remotely all of the time isn’t feasible for every situation, of course, but millennials expect companies to be flexible enough to allow them to occasionally dictate their own schedules. If they have no say in their workday, that’s a red flag.
  • They’ve got skills—and they want to use them. In the words of a 24-year-old designer, millennials “don’t need to print copies all day.” Many have paid (or are in the midst of paying) for their own education, and they’re ready and willing to put it to work. Most would prefer you leave the smaller tasks to the interns.
  • They got a better offer. Thirty-five percent of respondents to XYZ’s survey said they quit a previous job because they received a better opportunity. That makes sense, especially as recruiting is made simpler by technology. (Hello, LinkedIn.)
  • They seek mentors. Millennials are used to being supervised, as many were raised by what have been dubbed as “helicopter parents.” Receiving support from those in charge is the norm, not the anomaly, for this generation, and they expect that in the workplace, too.

Note that it’s not just XYZ University making this final point about the importance of mentoring. Consider Figures 1 and 2 from Deloitte, proving that millennials with worthwhile mentors report high satisfaction rates in other areas, such as personal development. As you can see, this can trickle down into employee satisfaction and ultimately result in higher retention numbers.

Millennials and Mentors
Figure 1. Source: Deloitte


Figure 2. Source: Deloitte

Failure to . . .

No, not communicate—I would say “engage.” On second thought, communication plays a role in that, too. (Who would have thought “Cool Hand Luke” would be applicable to this conversation?)

Data from a recent Gallup poll reiterates that millennials are “job-hoppers,” also pointing out that most of them—71 percent, to be exact—are either not engaged in or are actively disengaged from the workplace. That’s a striking number, but businesses aren’t without hope. That same Gallup poll found that millennials who reported they are engaged at work were 26 percent less likely than their disengaged counterparts to consider switching jobs, even with a raise of up to 20 percent. That’s huge. Furthermore, if the market improves in the next year, those engaged millennial employees are 64 percent less likely to job-hop than those who report feeling actively disengaged.

What’s next?

I’ve covered a lot in this discussion, but here’s what I hope you will take away: Millennials comprise a majority of the workforce, but they’re changing how you should look at hiring, recruiting, and retention as a whole. What matters to millennials matters to your other generations of employees, too. Mentoring, compensation, flexibility, and engagement have always been important, but thanks to the vocal millennial generation, we’re just now learning exactly how much.

What has been your experience with millennials and turnover? Are you a millennial who has recently left a job or are currently looking for a new position? If so, what are you missing from your current employer, and what are you looking for in a prospective one? Alternatively, if you’re reading this from a company perspective, how do you think your organization stacks up in the hearts and minds of your millennial employees? Do you have plans to do anything differently? I’d love to hear your thoughts.

For more insight on millennials and the workforce, see Multigenerational Workforce? Collaboration Tech Is The Key To Success.

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