Report on Cal-(IT) 2 UCSD School of Medicine Research Council October 15, 2002 Dr. Larry Smarr Director, California Institute for Telecommunications and

Report on Cal-(IT)2

UCSD School of Medicine Research Council

October 15, 2002

Dr. Larry Smarr

Director, California Institute for Telecommunications and Information Technologies

Professor, Dept. of Computer Science and Engineering

Jacobs School of Engineering, UCSD

Systems BiologyIntegrating data and models

across scalesKnowledge and Data

Engineering Lab

Enabling querying,analysis, and creative exploration of large, integrated data sets

IntegratedInformation

An

alysis Sta

tist

ics

KnowledgeDiscovery

Biosystems InformaticsDevelop new informatics strategies to discover meaning of biological and biomedical data and processes

DeGeM: An Integrated Knowledge Environment

Molecular MedicineDeliver tools to enable personalized medicine

Wireless HealthCare Delivery

Create the Living Laboratoryfor Health Care Professional

Telescience &TelemedicineBuilding the Biomedical Grid

The Biomedical Informatics Research Network

BIRN Test-bedsBIRN Test-beds::Multiscale Mouse Models of Disease, Human Brain Morphometrics, and Multiscale Mouse Models of Disease, Human Brain Morphometrics, and

FIRST BIRN (FIRST BIRN (10 site project for fMRI’s of Schizophrenics)10 site project for fMRI’s of Schizophrenics)

FIRST BIRN: Functional Imaging Research in Schizophrenia Testbed

• Clinical Specific Aims– Is Frontal and Temporal Lobe Dysfunction the Cause of

Schizophrenia?– How can Treatment Reverse this Dysfunction?

• Technological Specific Aims– Integration of 4D Data from Multiple Sites - Acquired with

Different Non-Invasive Imaging Devices– Integration of Information Obtained with Different Brain

Activation Tasks

NSF Experimental Network Research Project The “OptIPuter”

• Driven by Large Neuroscience and Earth Science Data– NIH Biomedical Informatics Research Network – NSF EarthScope (UCSD SIO)

• Removing Bandwidth as a Constraint– Links Computing, Storage, Visualization and Networking– Software and Systems Integration Research Agenda

• NSF Large Information Technology Research Proposal– UCSD and UIC Lead Campuses– USC, UCI, SDSU, NW Partnering Campuses– Industrial Partners: IBM, Telcordia/SAIC, CENIC

• PI—Larry Smarr; Funded at $13.5M Over Five Years– Start Date October 1, 2002

www.calit2.net/news/2002/9-25-optiputer.html

Providing a 21st Century Internet Grid Infrastructure

Tightly Coupled Optically-Connected OptIPuter Core

Wireless Sensor Nets, Personal Communicators

Loosely Coupled Peer-to-Peer Computing & Storage

Routers

Routers

½ Mile

The OptIPuter Project is Allowing UCSD to Develop a Futuristic Optical Networking Fabric

SDSC

SIO

Medicine

Phase I, Fall 02

Physical Sciences

Arts

Engineeing

Preuss School

Sixth College

Phase II, Jan. 03

Cal-(IT)2

Phase III, Dec 04

Developing Training in New Biomedical Technologies

• Creating a Comprehensive, Campus Wide Training Program– Focus on Bioinformatics – UC Irvine Institute For Genomics And Bioinformatics – Awarded A $4.3 Million, Multiyear NIH Training Grant

• To Consolidate Current UCI Bioinformatics Training Programs– Department of Information & Computer Science (ICS), – the College of Medicine, – the School of Physical Sciences, – the School of Biological Sciences– the Institute for Genomics and Bioinformatics– 20 UCI Faculty Members

Current and Potential Markets for Remote Patient Monitoring

• Wellness– Fitness Monitoring– Obesity Epidemic

• Ambulatory Hospital Patients• Cardiac Out Patients• Elder Care

– Global Population of People Over 65, Will Increase 88% by 2025

• Clinical Trials– New Drug Discovery

• Emergency Response– Natural Disasters– Homeland Security

Exercise Was the First Wireless Monitoring Application

Research and Development Requiredfor Remote Patient Monitoring

• Systems Integration of Sensing, Computing, Data, Communication – Wireless Communications– Sensor Platform– Sensors– Data Systems– Monitoring Station Software

• Simultaneously With Work On:– Legal Issues– Privacy and Security– Patient Safety Liability– Reimbursement Regulations

BP

Blood Glucose

Heart Rate

Temp

Personal Medical AssistantPersonal Medical Assistant- Multi-Network Gateway - Processor:

-Sensor Data Analysis,-Monitoring, -Coding

-Communicates With Monitoring Station

MedicalMonitoring

Station-Event Analysis-Data Shaping-Control Data

Sensors-Sensor Data-Control Data -Local-area networking

Conceptual Framework for a Personal Medical Assistant

Source: Sujit Dey. UCSD ECE

Medical Monitoring Service

- Multiple Physicians

- Heterogeneous Appliances

- Multiple Networks/Conditions

- Patient Data & Reference Data From Monitoring Center

- Client Data Interpretation

- Physician Identification/Location

- Set-up Of End-End Connection Between Patient Sensor Network & Physician

Adaptive Data Collection

Image/Video/Bio-Sensors

Secure, reliable, private, preferential communication over a heterogeneous network

Event-triggered Data Filtering/Aggregation

Medical Monitoring

Center

Content/Data Shaping

Source: Sujit Dey. UCSD ECE

Adding Wireless Sensors to Systems-on-Chip Will Create Brilliant Sensors

Applications

Memory

Protocol Processors

ProcessorsProcessors DSP

EmbeddedSoftware

Sensors

Source: Sujit Dey, UCSD ECE

Radio

Critical New Role of Power Aware Systems

Internet

The Navy’s Mobile Integrated Diagnostic and Data Analysis System (MIDDAS)

Description:MIDDAS has three major components – Data Acquisition Glove (DAG), Patient Sensor Unit (PSU), and Medical Operations Monitor (MOM). The DAG is used to obtain vital signs during initial triage. The PSU stays with patient and continuously transmits vital sign data to the MOM where the data are stored and monitored.Status: Project is in second year of development. This year will focus on hardware and software improvements as well as testing and evaluation in mock battlefield environments.

Principal Investigator: Lawrence HermansenRequirement: The Casualty Care and Mgmt Transition Summary (MED 217 – ORD/MNS) sponsored by N93/USMC requires the development of non-invasive methods for forward casualty diagnosis and treatment.

Approach: Develop, test, and evaluate a Mobile Integrated Diagnosis and Data Analysis System (MIDDAS) for improved combat casualty care.

1. Developed a prototype MIDDAS demonstrator system

3. Refine overall system, include wireless and prepare for Transition

2. Improve hardware and software. Test and evaluate in mock battlefield environments

Schedule FY02 FY03FY01

Source: PI Lawrence Hermansen, NHRC, San DiegoSponsor: Office of Naval Research

MIDDAS Requirements Issues

• Fundamental Issue:– Enhanced Battlefield Trauma Management

• Derive Non-invasive Methods for Forward Casualty Diagnosis and Treatment

• Utilization of Commercial-Off-The-Shelf (COTS) Products with New Technologies

• Provide Rapid Triage of Multiple Patients• Continuous and Simultaneous Monitoring of Multiple

Patients• Users: Navy And Marine Corps Health Care Providers


MIDDAS Has Three Major Components

• Data Acquisition Glove (DAG) That Contains Sensors For Body Temperature, Blood Pressure, Electrocardiogram, Oxygen Saturation And Heart Rate– Used To Obtain Vital Signs During Initial Triage

• Patient Sensor Unit (PSU), Continuously Monitors Heart Rate, Heart Rate Variability, Blood Pressure, Temperature, Ecg, Respiration Rate, sPO2 (Oxygen Saturation) Rate, And CO2 (End-Tidal) Levels– The PSU Stays With Patient And Continuously

Transmits Vital Sign Data To The MOM• Medical Operations Monitor (MOM) Located At Field

Hospital Stores Data And Allows For Telecommunication– The Data Are Stored And Monitored


Data Acquisition Glove (DAG)

Sensors:•Heart Rate•Oxygen Saturation•Body Temperature•Electrocardiogram•Blood Pressure

The Data Acquisition Glove (DAG) is Used by the Health Care Provider


ECG

HR & SpO2NIBP

Temp.

To Sensor To Sensor ProcessingProcessing

Quick Quick DisconnectDisconnect

ECG

HR & SpO2NIBP

Temp.

To Sensor To Sensor ProcessingProcessing

Quick Quick DisconnectDisconnect

MIDDAS Medical Operations Monitor (MOM) Located At Field Hospital Displays Information


Karl Van OrdenCommander647-90-4444Field HospitalFair

Karl Van OrdenCommander647-90-4444Field HospitalFair

Clinical Trials Market Background

• Prescription Drug Expenditures - $125B 2001• R&D $50B – 2001e - $40B/$10B Pharma/Bio

– Pre-Clinical Studies - $10B– Clinical Studies - $20B

– $3.5B - Patient Monitoring

• Number of Compounds in Clinical Studies - >3500• Avg. # of Studies per New Molecular Entity (NME) – 68• Avg. # of Patients used in All Studies per NME - 4200

• Legg Mason – Feb. 2001 PresentationLegg Mason – Feb. 2001 Presentation

• Parexel Pharmaceutical R&D Statistical Sourcebook 2001Parexel Pharmaceutical R&D Statistical Sourcebook 2001

Source: Darrel Drinan. CEO PhiloMetron

PhiloMetronConfidential

Costs and Duration Estimates Per New Molecular Entity

Basic Research DiscoveryPreclinical Development

Clinical Development

Phase 1 Phase 2 Phase 3

FDA filing/approval & launch preparation

Discovery Discovery targettarget

LeadLeadcandidatecandidate

INDINDNDANDAfiledfiled

NDANDAapprovalapproval

4%4% 15%15% 10%10% 15%15% 22%22% 31%31% 3%3%

•McKinsey & Co., Lehman Brothers, PhRMA, FDA.

CostCost (% of total) (% of total)

2.52.5 33 11 1.51.5 22 2.52.5 1.51.5Duration Duration

(Yrs)(Yrs)

PhiloMetron Market FocusPhiloMetron Market Focus(78% of Total Expenditures)(78% of Total Expenditures) PhiloMetron

Confidential


Wireless Clinical Trial In-Vivo Drug Monitoring

• Accelerates Drug Development Time

• Basic Physiological Monitoring

• Detects ADME - Toxicity Events – “Fail Fast”

• Remote Data Analysis for Pharmacokinetics



Time

Time

• Current - Single point manual measurements

• PhiloMetron System (continuous monitoring) Statistically Valid

Sample

Time Time and and Cost SavingsCost Savings

Advantages of Continuous Monitoring Measurement Methodology

T1T1 T2T2 T3T3 T4T4 T5T5 T6T6 T7T7Measurement PointsMeasurement PointsMeasurement PointsMeasurement Points



Non-Invasive Platform - Smart Band-Aid®Can Also Link to Invasive Sensors

SkinSkin

Sensors:Sensors:- Physical- Physical- Chemical- Chemical- Biological- Biological

BatteryBattery

Transdermal Patch Transdermal Patch “Smart Band-Aid“Smart Band-Aid®®””

• Patent PendingPatent Pending

AntennaAntenna

CPU/Comm ChipCPU/Comm Chip

Source: PhiloMetron

Documents

Report on Cal-(IT) 2 UCSD School of Medicine Research Council October 15, 2002 Dr. Larry Smarr Director, California Institute for Telecommunications and