IBM Leadership Seminars

IBM Research - Medical Informatics Day 2010
Translational Medicine: Is There A Translator Around?!
From Bench to Bedside — Developing an Ecosystem around Evidence Generation and Use at The Point of Care

An IBM Research Medical Informatics PIC sponsored event
October 31, 2010
IBM Haifa Research Lab
Haifa University Campus
Haifa, Israel

Abstracts

Welcome Remarks and Introduction

Uzia Galil
Uzia Galil, is the founder of the Galil Center for Medical Informatics, Telemedicine and Personal Medicine at the Technion's Bruce Rapaport Faculty of Medicine in Haifa.

Uzia Galil also founded Elron Electronic Industries in 1962 and through Elron founded more than 20 companies worldwide. Until 1999 he served as President/CEO and Chairman of Elron, Chairman of Elbit Systems Ltd. and Chairman or Board member of many of the subsidiaries or related companies. In 1999 he founded Uzia Initiatives and Management Ltd. that specializes in the promotion and nurturing of new businesses, primarily in the field of Information Technology for Personalized Medicine, mobile communication and electronic commerce and serves as its Chairman and CEO. He continues to be Chairman of the Board of Zoran Corp.

Uzia Galil has received Honorary Doctorate from the Technion, the Weizman Institute, Polytechnic University, Ben Gurion University, the Solomon Bublick Prize Laureate from the Hebrew University and the prestigious Israel Prize for his contribution to the development of the Israel hi-tech industry.

Oded Cohn
Oded Cohn the director of the IBM Research Lab in Haifa, first joined IBM in 1982, when he started with the IBM Haifa Scientific Center as a Research Fellow. Before assuming the role of lab director, Oded served as department group manager for software and services at the lab. Since joining IBM Haifa, he has been involved with research and product development in a variety of areas, including: storage subsystems, high availability and business continuity, network design, distributed and parallel systems, file systems, Java technology, medical information systems, along with solutions and software in support of services.

Oded was a member of the advanced R&D storage systems team in San Jose, CA from 1991 to 1992. Oded received his BSc (1979) and MSc (1982) in computer science from the Technion Institute of Technology in Israel. He is the author and co-author of over a dozen US patents and has been awarded IBM Outstanding Technical Achievement and Outstanding Invention Awards. Currently, Oded is an adjunct lecturer at the Computer Science Department of the Haifa University, teaching Computer Communication Networks.

Amnon Shabo
Amnon Shabo (Shvo), PhD, works at IBM Research Lab in Haifa as a research staff member specializing in health informatics and heads the Healthcare & Life Sciences Standards Program in IBM. He holds leading positions in HL7 (Health Level 7 - a major standards developing organization dedicated to health information):

* A co-chair of the Clinical Genomics Special Interest Group in HL7, as well as its modeling facilitator and primary contributor;

* A co-chair of the RIMBAA (RIM-Based Application Architecture Work Group);

* A co-editor of the HL7 CDA (Clinical Document Architecture) Release 2 standard and the CCD (Continuity of Care Document) Implementation Guide;

* A co-editor of the Family History Standard.

Amnon is leading the contribution of the Haifa Healthcare & Life Sciences group to the Hypergenes project (http://www.hypergenes.eu/) funded by the European Union to explore the genetic background of essential hypertension – a study conducted by a consortium of about twenty European partners.

Amnon also specializes in longitudinal and cross-institutional Electronic Health Records (EHR). A pioneer of the Independent Health Record Banks (IHRBs) vision, Amnon has promoted this idea for the past decade in various venues including the US Congress where he gave talk at a special briefing to Congressional Policy Stuff (2007) on the new legislation introduced on IHRB.

A Personal History within the Hypertension Saga: From Bench to Bedside
Daniele Cusi, University of Milan

Today, no-one actually knows how to handle the complexity of the interactions of the approximately 30,000 genes that make up the human genome - both interacting with themselves as well as with the environment - nor how to relate events at the molecular level with clinical phenotypes of patients affected by specific diseases. This problem dramatically influences every aspect of medical research and practice in the near future. Not only will it dominate predictive genetics and genetic counseling, but it will also be of major importance for clinical decision-making, as new diagnostic tools and treatments become available, not only when genetic manipulation is involved. Although mathematical modeling may solve some of these problems, careful analysis of the relationship between the molecular pathology of a certain disease and its inherent variation observed in the clinical phenotypes represented in large populations is always required.

The Hypergenes project proposes to use EH as a paradigm of a chronic complex disease, since its pathogenesis encompasses heterogeneous genetic, lifestyle and environmental factors. In spite of an exponential growth of genetic research in EH over the last two decades, up until now researchers have failed to identify common genes with large impact on EH in humans. The potential cause of this failure is that there have been no significant and coordinated efforts to overcome the classical formal genetic approach in the study of EH, a limitation that applies to virtually all genetic research on chronic complex diseases. The project aims at mapping the path from genotype to phenotype in complex traits, to reach the possibility of personalized medicine in a similar multidisciplinary scenario.

Daniele Cusi, MD
Chairman, Division of Nephrology, San Paolo Hospital, Milano
Director, Genomics and Bioinformatics Platform,
Fondazione Filarete, University of Milano

Daniele Cusi, MD, Professor of Nephrology and Chairman of the Graduate School of Nephrology of Milan University, with long-standing expertise in genetics and genetic epidemiology of hypertension and in pathogenetic mechanisms of hypertension.
His major research achievements have been the demonstration of increased renal Na reabsorption before the development of hypertension of some forms of human and rat hypertension; the demonstration of the role of adducin in the development of salt sensitive hypertension in humans and rats; the development of simplified tests for definition of salt sensitivity in humans.

High Throughput Screens Highlight Alternative Splicing Modulations in Alzheimer's and Parkinson's Disease
Hermona Soreq, Hebrew University of Jerusalem

In Alzheimer's and Parkinson's disease (AD, PD), synaptic functioning fails and cholinergic or dopaminergic neurons die due to as yet unclear mechanism(s). Here, we report the results of high throughput screens which suggest that changes in alternative splicing of brain and leukocyte mRNA transcripts are likely to be involved. In the AD brain, we observed massive changes in alternative splicing profiles. When experimentally tested, parallel manipulations caused synapse loss in primary neuronal cells and led to learning and memory impairments in treated mice. In PD patients' leukocytes, we found stimulus-induced changes in mRNA transcripts from nucleated blood cells compared to healthy controls. Distinct leukocyte alternative splicing profiles were further observed in the same individuals before and after sub-thalamic deep brain stimulation (DBS) neurosurgery, and in operated patients with or without electrical stimulus (ON-and OFF-stimulus). Using these profiles, we were able to differentiate pre-surgery from post-surgery patients. Furthermore, the observed changes were largely reversed following 1 hour OFF-stimulus, and the extent of changes correlated with the neurological efficacy of the DBS neurosurgery. Importantly, molecular expression level signatures of either 29 or 6 transcripts discriminated controls from both advanced and early PD patients or patients with other neurological diseases, pre- from post-surgery patients and ON-from OFF-stimulus conditions. Our findings present alternative splicing as a major player in both AD and PD, suggest new surrogate markers for early blood test diagnostics and propose novel target transcripts for intervention early in the process of these and other neuroinflammation-associated or DBS-treatable neurological diseases.

Hermona Soreq, PhD
Professor, Faculty of Science
The Hebrew University of Jerusalem

Hermona Soreq is the The Charlotte Schlesinger Professor of Molecular Biology at the University's Alexander Silberman Institute of Life Sciences and is a member of the University's Edmond and Lily Safra Center for Brain Sciences. A leader in the field of cholinesterase activities and their functions in the CNS and periphery, Soreq has published over 240 peer-reviewed journal articles and seven books. She has served as head of the Silberman Institute of Life Sciences (1995-2000) and as the first elected woman Dean of the Hebrew University's Faculty of Science (2005-2008), then returned to devote most of her time to her own research and to leading her research team. She participates in several fundamental collaborative research projects with top scientists in Israel and around the world, consults the Israeli Ministers of Health, Commerce and Science, is a member of the European Community's top advisory committee on Health related issues and was the elected President of the Israeli Society of Biochemistry and Molecular Biology (2000-2002). Internationally recognized for her contributions to molecular neurobiology, Professor Soreq frequently lectures at universities around the world, including UC Berkeley, UCSD, MIT, the University of Chicago, the Max Planck Institutes in Berlin and Gottingen, Research centers in Japan, China and Korea and the College de France, among others. The recognition of her role has led to national and international awards including honorary PhD degrees in Chemistry from the University of Stockholm (1996), in Medicine from the University of Erlangen-Nuremberg (2007), in Science from the Ben-Gurion University in Beer-Sheva (2007) as well as National Prizes (an Israeli Ministry of Health Prize (2000), the Landau Prize for Biomedical Research (2005) and the Teva Prize for Molecular Medicine (2006)) and International ones (the Lise Meitner Alexander Humboldt Research Prize, 2009; and a Miller Fellowship at UC Berkeley, 2009). She is also an Adjunct Research professor at the Arizona State University BioDesign Institute, the inventor of 12 patents and has 3 different molecules (2 recombinant proteins, one DNA-based drug) at different stages of clinical trials.

Translational Infostructure: The Biomedical Information Infrastructure for Hypergenes & EuResist
Ariel Farkash, Haifa Research Lab

Healthcare & Life Sciences (HCLS) data and knowledge warehousing is a central component of the translational medicine (TM) infostructure, enabling semantic interoperability across the various stakeholders of the TM endeavor, from bench to bedside and on to community and policy making. By using HCLS worldwide accepted information standards, along with common HCLS terminologies, it is possible to deploy rich data models atop of a warehouse, allowing 'semantic warehousing' where all implicit semantics in the stakeholder source systems is made explicit and thus is subject to objective and independent analysis. Once data and knowledge from diverse data sources are integrated into the warehouse, the semantic richness of the warehouse model breaks the boundaries of information 'silos' which are so common in the HCLS world.

Nevertheless, the richness, heterogeneous and comprehensive nature of the warehouse data models makes it difficult to HCLS information consumers to utilize and analyze the data and knowledge in the warehouse. These consumers often prefer to use a much more focused data model that is tailored to their view and analysis requirements. The TM infostructure addresses this challenge by offering tools for generating data marts, which are persisted and optimized subsets of warehouse information, designed by the consumer's model and terminology. At same time, it is also possible to explore the entire warehouse using innovative technologies such as XML databases and their powerful query language XQUERY that allows the mixture of relational and XML queries in a single statement.

A prototype of such translational infostructure is the Biomedical Information Infrastructure (BII) serving the EC FP7 Hypergenes project by integrating clinical, environmental and genomic data on more than ten thousand subjects of case-control studies on essential hypertension, who have been genotyped for 1M SNPs using Illumina SNP array chip. The BII has also been tested for serving the EuResist (EC FP6) project, exploring the relationship between HIV viral genotypes and the best drug cocktail given to an HIV patient at the point of care.

Ariel Farkash
Healthcare & Life Sciences IT
IBM Haifa Research Lab

Ariel Farkash is a Research Staff Member and a member of the Healthcare IT group at IBM Research Haifa. He holds a B.Sc in Computer Science and another in Biology from the University of Tel-Aviv and a MA in Business Administration from the Technion institute of technology, both in Israel. Ariel is currently involved in Hypergenes, an FP7 EU Project researching Essential Hypertension.

Ariel's expertise lies in semantics and interoperability of clinical, genomic and environmental data. A large part of his work involves adoption of standards such as HL7v3 Reference Information Model, Clinical Document Architecture and Clinical Genomics Genetic Variation. In previous projects Ariel was involved in building an infrastructure for medical imaging interoperability involving the DICOM standard and several IHE integration profiles such as XDS-i. Past work also includes bioinformatics and biological sequence analysis. Mostly however, Ariel is a husband to Keren and a father to four children.

Aiding Clinical Decisions with Knowledge Extracted from the Literature, Images and Knowledge Bases, and Translated to Actionable Information
Henning Müller, University of Geneva and U. of Applied Sciences in Sierre

The presentation will mainly deal with research projects and their outcomes in the field of visual information retrieval and how to use visual information to complement text in finding relevant medical information, for example form the medical scientific literature.

The just started Khresmoi project and its goals will be explained in more detail, for example about retrieving information from the medical literature using text and visual information. The use cases of the project targeting radiologists, general practitioners and the general public will be explained. The main technologies covered include multilingual data access and multimodal data access.

Henning Müller, PhD
Professor, University of Applied Sciences in Sierre, and University of Geneva, Switzerland

Henning Müller obtained his Masters degree in medical informatics from Heidelberg University, Germany in 1997 and his PhD on multimedia information retrieval from Geneva University, Switzerland in 2002.
During this time he also worked for Daimler Benz research and technology North America in Portland, Oregon, USA, and at Monash University in Melbourne, Australia. After his PhD Henning has worked in the medical informatics service of the University and University hospitals of Geneva, Switzerland, where he finished his habilitation in 2008. Since 2007 he has been a professor at the University of Applied Sciences Western Switzerland in Sierre, Switzerland.
Henning leads the ImageCLEF benchmark on multilingual and multimodal information retrieval. Henning has published over 250 scientific articles and is currently in the editorial board of five journals. He has participated in several EU projects and has initiated several national projects. Currently, Henning is coordinator of the Khresmoi EU project on medical information retrieval.

The Path from the Anti-Parkinsonian Drug Rasagiline to Multifunctional Neuroprotective Anti-Alzheimer Drugs, Ladostigil and M30
Orly Weinreb, Technion

The beneficial use of enzyme inhibitors in the treatment of neurodegenerative diseases has its origin in the anti-Parkinsonian action of the selective monoamine oxidase (MAO) B inhibitor, l-deprenyl. This led to further development of various MAO- A and -B, catechol-O-methyltansferase and cholinestrerase inhibitors, as anti- Parkinsonian and anti-Alzheimer drugs. One of the main reasons for the cognitive deficit in dementia of the Alzheimer type and in dementia with Lewy bodies (DLB) is the degeneration of cholinergic cortical neurons and synaptic plasticity. Similar to Parkinson's disease (PD) therapy, cholinesterase inhibitors (ChEI) have been implicated in Alzheimer's disease (AD) therapy. However, the current available ChEI/ anti-AD drugs have a limited symptomatic activity and devoid of neuroprotective property, needed for disease modifying action. It is becoming clear that there is no "magic drug" for neurodegenerative disorders, while polypharmacology therapy or drugs with pluripotential activity, at different target sites in the central nervous system (CNS), are essential. The complex pathology of AD, as well as the cascade of events that leads to the neurodegenerative process, have directed us to develop several multifunctional neuroprotective drugs possessing possible disease modifying activity, with several CNS targets. Employing the pharamcophore of our anti-Parkinsonian drug rasagiline (Azilect, N-propagrgyl-1R-aminoindan), we have developed a novel pluripotential neuroprotective drug, ladostigil [TV-3326 (N-propargyl-3R-aminoindan-5yl)-ethyl methylcarbamate)], with both cholinesterase-butyrylesterase and brain selective MAO-A and -B inhibitory activities, possessing the neuroprotective-neurorescue propargyl moiety, as potential treatment of AD, DLB and PD with dementias. Since brain MAO and iron are increased in AD, PD and ageing, resulting in iron-dependent oxidative stress neurodegeneration, we further designed another series of multifunctional drugs (M30, HLA20 series), which are brain permeable, non-toxic, iron chelators-brain selective MAO inhibitors, also possess the propargyl neuroprotective moiety. These series of drugs were demonstrated to acquire a wide range of pharmacological activities in cell culture and animal models of AD, including regulatory effects on neuronal differentiation and neurite outgrowth, down-regulation of membrane-associated holo-amyloid precursor protein levels and reduction of the amyloid beta deposition and plaques, accompanied with a decline of progressive cognitive impairments.

Orly Weinreb, PhD
Senior investigator
Faculty of Medicine at the Technion

Dr. Orly Weinreb is a senior investigator at the Eve Topf Centers of Excellence for Neurodegenerative Diseases research in the Faculty of Medicine at the Technion, for the last 10 years. Her major research disciplines and interests are the molecular and cellular characteristics of neurological and psychiatric disorders and neuropharmacology. Dr. Weinreb got an award for Excellency from the Zalman Shazar Center in Israel for Academic Education. Following her PhD studies, she was awarded for Post Doctorate study in Holland, by the European Commission, Marie Curie Biotechnology Research. Dr. Weinreb has extensive experience in various areas of neuroscience research, in particular Parkinson's and Alzheimer's diseases. Her research on the novel anti-Parkinson's/Alzheimer's drugs contribute to the understanding of the mechanism of action of these drugs and thus, she was honored by the International Federation of Parkinson's disease Foundation; Melvin Yahr award. Dr Weinreb is invited to present her work in international conferences, and her studies are published in highly quoted scientific journals.
Recently, she was nominated as an executive committee member in the international brain research association/ woman in world neuroscience (IBRO/WWN).

Cli-G: Deep Biomedical Analytics Platform – a Round Trip from Bedside to Bench and Back
Boaz Carmeli, Haifa Research Lab

The proliferation of 'omic' data (such as genomic, proteomic, metabolomic and more) and the transition towards preventive medicine and early detection are key drivers in the healthcare transformation towards an evidence-centric ecosystem. These drivers accelerate the development of deep analytics of multi-dimensional data for clinical-genomics evidence generation where human 'omic' data might play a role in optimizing therapies and selecting strategies to manage a disease. Typically, genomic data differs much from one organism to another and thus the challenge of analyzing the influence of genetic factors on therapies' success can be met only if a large-scale dataset of patients is available for exploration. Thus, it is crucial to have an innovative multi-phase platform that enables the integration of extensively large data arriving from different resources, the analysis of this data and the generation of consumable evidences. One of the key applications that use such platforms is a Clinical Genomics Decision Support application that consumes the newly generated evidences and use them for delivering evidence based treatment.

Cli-G is a forward-looking initiative at IBM Research – Haifa to develop a deep biomedical analytics platform for data-driven clinical-genomics decision support at the point of care. The platform is designed to integrate clinical and genomics data with external evidence, and analyze the results to provide insight into the best possible choices for patients' diagnosis and treatment.

The long term vision for Cli-G is to provide a two-part framework for i) data-driven evidence generation and ii) evidence-based decision support to be used at point of care.

Boaz Carmeli
Cli-G Seed
IBM Haifa Research Lab

Mr Carmeli is Research Staff Member and the manager of the Clinical Genomics IT group at IBM Research - Haifa. He holds a B.Sc in computer science from the Technion in Israel. Mr Carmeli is involved in the definition, design and implementation of IT solutions for Healthcare and Life Sciences, such as Clinical Genomics Analytics (Cli-G), Health Information Exchange, the Public Health Information Affinity Domain, and the Hypergenes and EuResist EU projects. During his scientific career at IBM Research, Mr. Carmeli made contributions to several other computer science fields such as wireless networks for hand held devices, high throughput data networks and multicast protocols. Mr. Carmeli is also actively involved in various standard organizations and was a member of the IEEE 802.15 personal wireless network group.

AALIM - The Use of Similar-Patient Cohorts for Biomarker Identification and Effectiveness
Tanveer Syeda-Mahmood, Almaden Research Center

With the rising cost of healthcare, more and more physicians and hospital networks are looking towards comparative effectiveness research studies to learn the impact of different options in medications, procedures and interventions that are applicable to their patients. Several methodological and logistic challenges currently have made large-scale conduction of such studies infeasible both in terms of cost and time. Much of the existing work in this area has exploited structured data when in fact multimodal data from reports, lab tests, echocardiograms, electrocardiograms, etc. contains important diagnostic, treatment and outcome information. In the AALIM (Advanced Analytics for Information Management) project at IBM Research Alamden, we have been investigating methods for automatically discovering the correlation between diagnoses, medications, and diagnostic exams using multimodal mining of structured and unstructured cardiovascular data sources.

Besides offering comparative diagnoses and medications using a multimodal search of similar patients, AALIM constructs a longitudinal history of conditions, treatments, and exams, using advanced analytics to extract disease and treatment-specific information from health records. Fast distributed computing architectures such as Map-Reduce have been used to implement multimodal analytics that extract disease-specific clinical information from the data. Our current explorations have so far been restricted to a set of cardiovascular diseases but the results are potentially generalizable to other diseases such as diabetes or finding associations between diabetes and cardiovascular diseases. Our primary application for demonstrating the value has been in clinical decision support. Future work will show the utility of AALIM as a multimodal CER platform for clinical trial research studies by investigators, and in translating such research to bedside clinical practices for improvement in clinical outcomes.

Tanveer Syeda-Mahmood, PhD
Research Manager
IBM Almaden Research Center

Dr. Syeda-Mahmood,Tanveer is a research manager in the Health care Informatics department at the IBM Almaden Research Center. She currently leads the AALIM project on multimodal mining for healthcare. Dr. Syeda-Mahmood graduated from the MIT AI Lab in 1993 with a Ph.D in Computer Science. Prior to IBM, she worked as a Research Staff Member at Xerox Webster Research Center, Webster, NY. She joined IBM Almaden Research Center in 1998.

Prior to coming to IBM, Dr. Syeda-Mahmood led the image indexing program at Xerox Research and was one of the early originators of the field of content-based image and video retrieval. Currently, she is working on applications of content-based retrieval in healthcare. Over the past 25 years, her research interests have been in a variety of areas relating to artificial intelligence including computer vision, image and video databases, medical image analysis, bioinformatics, signal processing, document analysis, and distributed computing frameworks. She has over 100 refereed publications and over 40 issued patents.

Dr. Syeda-Mahmood was the program co-chair of CVPR 2008 recently. She is a senior member of IEEE.

Antidepressant Response Biomarkers: Starting the Journey with Human Lymphoblastoid Cell Lines
David Gurwitz, Tel Aviv University

Major depression is among the most common human diseases. Although several antidepressant drug classes are available, none works for all patients, and typical non-response rates are above 30% contributing to the high societal costs of depression. Our studies present a genome-wide transcriptome-based approach for identifying putative biomarkers for predicting the clinical response to SSRI antidepressants. The method is based on phenotypic screening followed by microarray transcriptomics analysis in human lymphoblastoid cell lines from healthy individuals. Putative biomarker genes identified in our project (to be presented) include genes reportedly expressed in the brain and implicated in synaptogenesis and the maintenance of correct brain circuitry, attesting to the value of this genome-wide approach, which in further studies will be tested in clinical samples. The method is easily applicable as preliminary research phase for other diseases and drugs.

David Gurwitz, PhD
Department of Human Molecular Genetics and Biochemistry
Sackler Faculty of Medicine
Tel Aviv University

Dr. David Gurwitz directs the National Laboratory for the Genetics of Israeli Populations (NLGIP) at the Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel-Aviv University, since its founding in 1995 (http://nlgip.tau.ac.il/). He earned a PhD in Biochemistry from Tel-Aviv University (1986) and conducted post-graduate studies at the University of California, Irvine. From 1989-1994 he led the biochemistry team developing Cevimeline at the Israel Institute for Biological Research. Dr. Gurwitz teaches pharmacogenomics at the Tel-Aviv University School of Medicine since 2001. His research is focused on searching biomarkers for drug response (safety and efficacy) and on societal and ethical aspects of personal genomics. He is affiliate member of the NIH Pharmacogenetics Research Network (PGRN) and several international biobanking organizations (P3G; BBMRI; EBB). In 2006 he co-authored the EC report on "The Socio-Economic Impact of Pharmacogenetics in the EU". He is senior editor of Pharmacogenomics and serves on the editorial boards of several journals including Genome Medicine.

Integrated Information Systems for Translational Medicine
Alfred Winter, University of Leipzig

Translational medicine deals with the integration of bed and bench, i.e. the integration of health care and medical research. Hence an information highway is needed connecting health information systems and research information systems in both directions fast, conveniently and safely. This information highway will be part of an infrastructure provided by the encompassing trans-institutional information system and therefore needs an encompassing information system architecture.

This architecture has to meet some major requirements:

• Handling of Mass Data: In healthcare, the emerging concept of personalized care involves taking into account especially the genetic makeup of the individual. This results in petabytes of data each year and at each site and storage costs will exceed the costs for genome sequencing.
• Technical integration: Integration has to be achieved at different levels. Data integration means that data which have to be recorded for example for clinical documentation or during a sequencing process are available wherever they are needed, without having to be reentered. Semantic integration requires to use the same system of concepts, i.e. to interpret data the same way e.g. in application systems of health care or during statistical analysis in a clinical trial. Semantic integration is guaranteed if different application components use the same system of concepts, i.e. they interpret data the same way. Process integration is needed which provides smooth execution of business processes even if sets of interacting application systems have to be used e.g. at a clinical workplace. Especially switching between healthcare and research documentation systems and respective double data entry have to be avoided. At all of these levels privacy has to be ensured e.g. by anonymization or pseudonymization of patient related data before they enter the research context.
• Social integration: Since information systems are socio-technical systems, integration has social and especially economic aspects as well. Without appropriate financial solutions, technical integration will neither be achievable nor can a resulting integrated information system be operated. Differentiation between research and care related costs and funding is one of the challenges here.

At the Institute for Medical Informatics, Statistics and Epidemiology of the University of Leipzig we are running a Coordination Centre for Clinical Trials (CCCT) and are in charge of information management at the University Hospital and of providing appropriate information system architectures for two so called "integrated research and treatment centers". One is located in Leipzig and one in the city of Jena. These integrated research and treatment centers need an information system providing the information highway from the University Hospitals in Leipzig and Jena to the CCCT. We are applying our enterprise architecture modeling method 3LGM² in order to develop the respective information system architecture. This architecture shall be generic for other settings in translational medicine as well. The architecture will include electronic data capture, biobanks and pseudonymization services. Additionally we are developing a minimum basic data set for supporting feasibility studies, and a meta data repository supporting semantic integration. Data warehouses will be used as a basis for data as well as semantic integration.

Alfred Winter, PhD
Deputy Director, Institute of Medical Informatics, Statistics, and Epidemiology (IMISE)
The University of Leipzig

Prof. Dr. Alfred Winter is a professor for medical informatics at the Institute of Medical Informatics, Statistics, and Epidemiology of the University of Leipzig, Germany. He studied informatics at the Technical University in Aachen, Germany, and received his Ph.D. and a license for lecturing (German "Habilitation") for medical informatics from the Faculty of Theoretical Medicine at the University of Heidelberg.
His research focuses on methods and modeling tools for the management of health information systems. He teaches information management in health care in a medical informatics course at Leipzig University. He works as a consultant and is responsible for coordinated strategic information management at Leipzig University Hospital and Leipzig University Medical Faculty. He is member of the board of the joint medical informatics division of the German Association of Medical Informatics, Biometry and Epidemiology (GMDS) and the German Association of Informatics (GI) and chair of their working group "Methods and tools for the management of hospital information systems".

Simulation of Evidence-Based Incentives in Healthcare
Ching-Hua Chen-Ritzo, Watson Research Center

In this talk, we describe a simulation framework for modeling the impact of alternative physician incentives on healthcare service utilization. Additionally, using an example from the management science literature, we show how our framework can be used to aid in the design of evidence-based incentive mechanisms. Finally, we provide a demonstration of the current capabilities of an implementation of our framework in the Agent Building and Learning Environment (ABLE), a software technology developed at IBM Research that has been delivered in IBM products since 2002.

Ching-hua Chen-ritzo, PhD
Research Staff Member
IBM Watson Research Center

Prof. Dr. Alfred Winter is a professor for medical informatics at the Institute of Medical Informatics, Statistics, and Epidemiology of the University of Leipzig, Germany. He studied informatics at the Technical University in Aachen, Germany, and received his Ph.D. and a license for lecturing (German "Habilitation") for medical informatics from the Faculty of Theoretical Medicine at the University of Heidelberg.
His research focuses on methods and modeling tools for the management of health information systems. He teaches information management in health care in a medical informatics course at Leipzig University. He works as a consultant and is responsible for coordinated strategic information management at Leipzig University Hospital and Leipzig University Medical Faculty. He is member of the board of the joint medical informatics division of the German Association of Medical Informatics, Biometry and Epidemiology (GMDS) and the German Association of Informatics (GI) and chair of their working group "Methods and tools for the management of hospital information systems".

Translational Medicine – A Patient Perspective
Yardena Peres, Haifa Research Lab

Translational medicine focuses on applying the value of clinical research "at the bench" to routine medical practice "at the bedside". Research insights help discover and develop new diagnostics and therapeutic approaches that can be incorporated systematically in clinical care. This is a fundamental change, since traditionally clinical research and clinical practice functioned as separated endeavors; they didn't even use the same vocabulary.

Translational medicine begins and ends with patients; it is about patients and for patients, therefore it is only natural to expect the patients to play an active role in the bench-to-bedside loop. The days when patients passively commended their health to experts are soon to be remembered as an outrageous curiosity. Patients are the main stakeholders of their well being, they have the time, the motivation and the technological know-how to invest in finding and managing relevant information about their condition. Collecting, displaying and analyzing Family History; self-managing health information and processes thru PHRs and Social Medical Discovery tools; using and developing Ambient Assisted Living services to help elderly and/or disabled people to live longer independently; all these activities are powerful examples of how pro-active patients are transforming medicine.

Yardena Peres
Manager – IT for Healthcare & Life Science
IBM Research – Haifa

Yardena Peres is a senior research staff member of the IBM Research Lab in Haifa. She manages the IT for Healthcare & Life Science group. Mrs. Peres joined IBM in 1992, she holds B.A. and M.Sc. in Computer Sciences from the Technion Institute of Technology in Israel.

Mrs. Peres is a contributor to universAAL, an EU FP7 project in the Ambient Assisted Living domain. She led the FP6 EuResist integrated dataset efforts, integrating viral genomics with clinical data to develop the largest European integrated system for clinical management of antiretroviral drug resistance. Mrs. Peres is a key contributor to BioMIMS, a first-of-a-kind SOA platform for the research of rare hereditary diseases. BioMIMS is based on the IBM Healthcare and Life Sciences Content Management Offering (CMO). This offering provides healthcare institutions with a smart, standards-based, medical data management system that allows for easy integration and automation of storage usage. She also contributed to IBM's design and implementation of IHE XDS, XUA and QED profiles. During her scientific career at IBM Research, Mrs. Peres has made contributions to several fields ranging from business process integration, management of distributed applications, search technologies and user interface frameworks.