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“Adding Consumer-Generated and Microbiome Data
to the Electronic Medical Record”

Using Big Data to Advance Healthcare Panel
National Health Policy Conference
Washington, DC
February 4, 2014
Dr. Larry Smarr
Director, California Institute for Telecommunications and Information Technology
Harry E. Gruber Professor,
Dept. of Computer Science and Engineering
Jacobs School of Engineering, UCSD
http://lsmarr.calit2.net
Consumer Self Measurement is Exploding
Totally Outside of the Medical Complex
From the First San Francisco QS Meetup in 2008
To 116 Cities in 37 Countries in Four Years
I Arrived in La Jolla in 2000of My Body andin the Midwest
By Measuring the State After 20 Years “Tuning” It
Using Nutrition and Exercise, Ithe Obesity Trend
and Decided to Move Against Became Healthier
Age
41

Age
51

Age
61

1999
2000

1999

1989

I Reversed My Body’s Decline By
Quantifying and Altering Nutrition and Exercise
http://lsmarr.calit2.net/repository/LS_reading_recommendations_FiRe_2011.pdf

2010
I Used a Variety of Emerging Personal Sensors
To Quantify My Body & Drive Behavioral Change
Withings/iPhoneBlood Pressure

FitBit Daily Steps &
Calories Burned
MyFitnessPalCalories Ingested

Azumio-Heart Rate
Withings WiFi Scale Daily Weight

Zeo-Sleep
From One to a Billion Data Points Defining Me:
Big Data Coming to the Electronic Medical Record (EMR)
Billion:Microbial Genome
My Full DNA,
MRI/CT Images

Tomorrow’s EMR

Today’s

SNPs
Million: My DNA SNPs,
EMR
Zeo, FitBit
Blood
Variables

One:
My
Weight Weight

Hundred: My Blood Variables
The Cost of Sequencing a Human Genome
Has Fallen Over 10,000x in the Last Ten Years!

This Has Enabled Sequencing of
Both Human and Microbial Genomes
Healthcare Must Include a Vast Amount
of Microbial Information That is Not in Today’s Medicine
Your Body Has 10 Times
As Many Microbe Cells As Human Cells

99% of Your
DNA Genes
Are in Microbe Cells
Not Human Cells

Inclusion of the Microbiome
Will Radically Change Medicine
2012 Was
the Year of Human Microbiome
Quantifying Our Human Superorganism:
Distribution of Microorganism Ecology on Our Bodies

Nature Reviews
Microbiology
v.9, p. 279 (2011)
Inflammatory Bowel Disease Has a Radically Different
Gut Microbiome Ecology Than Healthy State
Expansion of
Actinobacteria

Collapse of
Bacteroidetes

Explosion of
Proteobacteria

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Adding Consumer-Generated and Microbiome Data to the Electronic Medical Record

  • 1. “Adding Consumer-Generated and Microbiome Data to the Electronic Medical Record” Using Big Data to Advance Healthcare Panel National Health Policy Conference Washington, DC February 4, 2014 Dr. Larry Smarr Director, California Institute for Telecommunications and Information Technology Harry E. Gruber Professor, Dept. of Computer Science and Engineering Jacobs School of Engineering, UCSD http://lsmarr.calit2.net
  • 2. Consumer Self Measurement is Exploding Totally Outside of the Medical Complex From the First San Francisco QS Meetup in 2008 To 116 Cities in 37 Countries in Four Years
  • 3. I Arrived in La Jolla in 2000of My Body andin the Midwest By Measuring the State After 20 Years “Tuning” It Using Nutrition and Exercise, Ithe Obesity Trend and Decided to Move Against Became Healthier Age 41 Age 51 Age 61 1999 2000 1999 1989 I Reversed My Body’s Decline By Quantifying and Altering Nutrition and Exercise http://lsmarr.calit2.net/repository/LS_reading_recommendations_FiRe_2011.pdf 2010
  • 4. I Used a Variety of Emerging Personal Sensors To Quantify My Body & Drive Behavioral Change Withings/iPhoneBlood Pressure FitBit Daily Steps & Calories Burned MyFitnessPalCalories Ingested Azumio-Heart Rate Withings WiFi Scale Daily Weight Zeo-Sleep
  • 5. From One to a Billion Data Points Defining Me: Big Data Coming to the Electronic Medical Record (EMR) Billion:Microbial Genome My Full DNA, MRI/CT Images Tomorrow’s EMR Today’s SNPs Million: My DNA SNPs, EMR Zeo, FitBit Blood Variables One: My Weight Weight Hundred: My Blood Variables
  • 6. The Cost of Sequencing a Human Genome Has Fallen Over 10,000x in the Last Ten Years! This Has Enabled Sequencing of Both Human and Microbial Genomes
  • 7. Healthcare Must Include a Vast Amount of Microbial Information That is Not in Today’s Medicine Your Body Has 10 Times As Many Microbe Cells As Human Cells 99% of Your DNA Genes Are in Microbe Cells Not Human Cells Inclusion of the Microbiome Will Radically Change Medicine
  • 8. 2012 Was the Year of Human Microbiome
  • 9. Quantifying Our Human Superorganism: Distribution of Microorganism Ecology on Our Bodies Nature Reviews Microbiology v.9, p. 279 (2011)
  • 10. Inflammatory Bowel Disease Has a Radically Different Gut Microbiome Ecology Than Healthy State Expansion of Actinobacteria Collapse of Bacteroidetes Explosion of Proteobacteria