Report on Cal-(IT)2

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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
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DeGeM An Integrated Knowledge Environment
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The Biomedical Informatics Research Network
BIRN Test-beds Multiscale Mouse Models of
Disease, Human Brain Morphometrics, and FIRST
BIRN (10 site project for fMRIs of
Schizophrenics)
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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

UCLA
Harvard
UCSD
New Mexico
Stanford
Iowa
Minn.
UNC
Duke
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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
• PILarry Smarr Funded at 13.5M Over Five Years
• Start Date October 1, 2002

www.calit2.net/news/2002/9-25-optiputer.html
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Providing a 21st Century Internet Grid
Infrastructure
Wireless Sensor Nets, Personal Communicators
Routers
Tightly Coupled Optically-Connected OptIPuter Core
Routers
Loosely Coupled Peer-to-Peer Computing Storage
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The OptIPuter Project is Allowing UCSD to
Develop a Futuristic Optical Networking Fabric
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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

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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

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Exercise Was the First Wireless Monitoring
Application
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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

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Conceptual Framework for a Personal Medical
Assistant

WAN
PAN

• Personal Medical Assistant
• - Multi-Network Gateway
• Processor
• Sensor Data Analysis,
• Monitoring,
• Coding
• -Communicates With Monitoring Station

• Medical
• Monitoring
• Station
• Event Analysis
• Data Shaping
• Control Data

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

Source Sujit Dey. UCSD ECE
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Medical Monitoring Service
Source Sujit Dey. UCSD ECE
Medical Monitoring Center

• 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

Secure, reliable, private, preferential
communication over a heterogeneous network
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Adding Wireless Sensors to Systems-on-Chip Will
Create Brilliant Sensors
Critical New Role of Power Aware Systems
Source Sujit Dey, UCSD ECE
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The Navys Mobile Integrated Diagnostic and Data
Analysis System (MIDDAS)
Principal Investigator Lawrence
Hermansen Requirement 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.
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.
1. Developed a prototype MIDDAS demonstrator
system
2. Improve hardware and software. Test and
evaluate in mock battlefield environments
3. Refine overall system, include wireless and
prepare for Transition
Source PI Lawrence Hermansen, NHRC, San
Diego Sponsor Office of Naval Research
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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

Source PI Lawrence Hermansen, NHRC, San
Diego Sponsor Office of Naval Research
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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

Source PI Lawrence Hermansen, NHRC, San
Diego Sponsor Office of Naval Research
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The Data Acquisition Glove (DAG) is Used by the
Health Care Provider
Data Acquisition Glove (DAG)

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

Source PI Lawrence Hermansen, NHRC, San
Diego Sponsor Office of Naval Research
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MIDDAS Medical Operations Monitor (MOM) Located
At Field Hospital Displays Information
Source PI Lawrence Hermansen, NHRC, San
Diego Sponsor Office of Naval Research
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Clinical Trials Market Background

• Prescription Drug Expenditures - 125B 2001
• RD 50B 2001e - 40B/10B Pharma/Bio
• Pre-Clinical Studies - 10B
• Clinical Studies - 20B
• 3.5B - Patient Monitoring
• Number of Compounds in Clinical Studies - gt3500
• Avg. of Studies per New Molecular Entity (NME)
  68
• Avg. of Patients used in All Studies per NME -
  4200

• Legg Mason Feb. 2001 Presentation
• Parexel Pharmaceutical RD Statistical
  Sourcebook 2001

PhiloMetron Confidential
Source Darrel Drinan. CEO PhiloMetron
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Costs and Duration Estimates Per New Molecular
Entity
Duration (Yrs)
2.5 3 1 1.5 2 2.5 1.5
Clinical Development
FDA filing/approval launch preparation
Preclinical Development
Discovery
Basic Research
Phase 1
Phase 2
Phase 3
Discovery target
Leadcandidate
IND
NDAfiled
NDAapproval
Cost ( of total)
4 15 10 15 22 31 3
PhiloMetron Confidential
Source Darrel Drinan. CEO PhiloMetron

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

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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

PhiloMetron Confidential
Source Darrel Drinan. CEO PhiloMetron
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Advantages of Continuous Monitoring Measurement
Methodology

• Current - Single point manual measurements

Measurement Points

• PhiloMetron System (continuous monitoring)

Time and Cost Savings
PhiloMetron Confidential
Source Darrel Drinan. CEO PhiloMetron
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Non-Invasive Platform - Smart Band-AidCan Also
Link to Invasive Sensors

• Patent Pending

Source PhiloMetron