Ralph-mullerThe last few decades have seen many exciting innovations in health care -- and Penn Medicine has regularly been at the forefront of these advances.

The latest area we’ve made an innovation priority is personalized medicine. Here we use technology to pinpoint the actual molecular makeup of patients. That’s right; we can develop fine-grained portraits of the very genes and proteins that make up our bodies -- one person at a time.

Then, armed with these remarkable data, we can customize health care decisions to fit the needs of each individual. This includes identifying patients at risk for certain diseases (so prevention plans can be introduced) and matching identified gene variations with particular medications to ensure that patients get the right drug at the right dose. Custom-made medicine is fast becoming a reality.

As you might imagine, such a high level of fine-tuning calls for sophisticated tools and procedures. Individualized data, decision-support software to help guide physicians, and fully integrated electronic health records are all necessary to make the most of personalized medicine.

At Penn Medicine we’re moving forward with three major projects that, taken together, will constitute a major step forward in our goal of achieving genuinely personalized medicine.

First, we’re working on two new data analysis programs. “Pennomics” takes all of the raw data we have on patients (for example, a patient’s blood-work, radiology results, and electronic medical record) and converts them into useful knowledge -- allowing physicians to tailor their care decisions to meet the precise needs of each patient. We might use the system to determine that a given patient could respond poorly to a specific blood pressure medication or blood thinner. We can also use the Pennomics platform to analyze populations of patients, such as those with mutations of the BRCA genes that raise the risk of breast cancer. A second tool, the Endeca platform from Oracle, was recently purchased to help us search all of the text in our electronic medical records, even the free form text typed in by clinicians. With this tool, our researchers or quality experts can identify, for example, all patients of a certain age, or those who “complain of persistent cough.”

Second, our new pathology initiative, the Center for Personalized Diagnostics, is a joint initiative between the Department of Pathology and Lab Medicine and the Abramson Cancer Center. Using lab and pathology specimens from patients, the Center uses DNA sequencing and advanced information technology to identify the genetic blueprint of individual cancers. Of the patients tested to date, the treatment has been changed in 75 percent of cases to a more suitable, personalized regimen.

Third, we’re unveiling an enormously important project that will merge our emergency-department and inpatient electronic medical records with our current outpatient (Epic) electronic medical record. This unifying process will mean that important patient data -- often locked away in one system and not easily retrievable by someone operating in another system -- will now be merged into a complete whole, resulting in better outcomes for patients. This is a substantial project that will be completed in stages over the course of several years, but will ultimately provide a much more coherent record of each patient -- a prerequisite for truly personalized care.

At Penn Medicine, our strength results from a dynamic interplay of innovation and continuity. New and fresh ideas such as these continue to come at a fast pace -- yet we retain what is best from our time-honored ways. By combining our legacy of excellence with our commitment to forward thinking, we can fully capitalize on the many potential benefits that personalized medicine holds for our patients.


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