Manager of “Tipa”, the first population based biobank in Israel, within the Maccabi Healthcare Services institute for research and innovation. Leading all biobank related activities since first devised early-2016. Responsible for planning the execution road-map, facilitating the successful biobank launch and continued scaling-up of biobank activities since then. Read her full bio.

Interview with Daniella Beller, Manager, Maccabi Research Institute Biobank

Q: What makes the Maccabi Research Institute biobank unique?

A: To explain the uniqueness of the Maccabi Biobank (named “Tipa” in Hebrew which means “drop” or “just a little”), first you must know a little about Maccabi.

Maccabi Healthcare Services, one of the largest health funds in the world, covers 2.5 million patients, which represents 25% of the Israeli market share with a nationwide representative distribution. In addition to community based healthcare services, Maccabi owns Assuta, the largest private hospital network in Israel with 13 facilities (private and public) across the country. Maccabi’s operating budget is $4 billion (USD) and employs approximately 5,000 physicians.

Maccabi has long been recognized, both in Israel and abroad, as a unique and innovative health care system which leads the way in cutting edge medical technology, comprehensive and integrated computerized information systems, cost effective management, and sophisticated monitoring and evaluation tools.

Since 1993, throughout Maccabi, electronic medical records (EMR’s) have documented complete medical information and data on each patient in a central database. This database provides comprehensive, systematic, quality data, of a stable population of patients across their lifetime (less than 1% of patients leave Maccabi). Maccabi has also formulated automated clinical registries for chronic diseases utilizing the comprehensive data in the EMR’s.

Our newly created biorepository is unique because of the data attached to it, which is collected continuously and for clinical purposes, regardless of the biobank. Because this is a stable population, we have medical history from cradle to grave which is standardized. In addition, our sample collection is continuous – we have samples from the same participant at different time points which can be connected to changes in their medical status.

The existing rich phenotype-linked genetic information as well as biological information through longitudinal sampling will enable quick execution of a wide range of research studies (genetics, biomarkers, etc.) on a multitude of medical conditions.

Samples will be collected from all adult consenting Maccabi members in order to create a wide population based cohort, which will provide a good representation of the Israeli population. In each research study specific populations can be “handpicked” from the repository by using the continuously updated EMR’s.

As we are a new biobank, we began by collecting whole blood, serum and urine using the existing Maccabi national phlebotomy infrastructure. We have a very ambitious plan to expand our collection to plasma, feces, teeth and more. The biobank’s informed consent is very broad so we can collect other types of samples as well, such as unused tissue samples from biopsy.

Q: What types of samples do you collect?

A: We are creating a biorepository as a research tool and do not plan to perform genetic testing ourselves. However, we do have certain genetic information (such as specific mutation tests which are performed as part of pregnancy screening) that are available. We will however require that our researcher collaborators return genetic information to the biobank, since there is no point in companies spending money sequencing the same samples multiple times. Additionally, we have committed to our participants that we will return their actionable incidental genetic findings. So this information will be collected so that those relevant participants can receive genetic counseling. This is another unique aspect of our biobank, as many similar initiatives around the world have chosen not to return participant results. Since we are both a health care provider and a research institute we feel that participants should have this significant information. This is an important first step to our beginning to practice personalized healthcare.

Q: What are some of the biggest challenges biobanks are facing and how can they be overcome?

A: I think the biggest challenges today are funding and regulation. In order to create and maintain a robust population-based biobank, significant funds are needed. Every step is costly– from the smallest tube to professional personnel. You can never know for sure how much of the resource that you are creating and spending money to maintain will be used for research. On the other hand, this is probably the most effective way to push personalized medicine research forward. Public initiatives for creating biobanks are usually the ones that receive public funding. However they tend to be very slow, creating committees and subcommittees and taking many years to actually start working. This may come at the expense of the private initiatives, which also contribute as a national research source. But since they move forward on their own and usually faster, they are not supported by the funds allocated for creating biobanks. Instead of being considered players in the overall effort of supporting science, they are many times perceived as competitors of the parallel public project and need to find funding on their own.

Additionally, researchers from around the world with whom we collaborate do not always understand that for every sample they take, many more remain in the freezer and in order to maintain the repository, their cost per sample must include much more than the cost of the plastic tube they take. This can pose a problem for companies that cannot afford to purchase these samples. So funding is a problem for both the biobank and its customers.

Q: How do you envision the funding problem being solved?

A: Philanthropy is very helpful but is not the solution for this industry. As biobanks become more and more recognized as national treasures, even those that are privately built, countries will find ways to support them through direct funding or promotion of research through grants, while understanding that this is an industry that needs to be publicly supported until it can become self-sustainable.

Q: How do you see the other challenge of regulation playing out?

A: In many places around the world, regulation is not keeping pace with research and technology. The way research is done today, especially through biobanks, is different than in the past – both in speed and volume. Regulation needs to catch up and find the right way to maintain patient privacy while enabling and promoting research, in general, and genetic research more specifically. There is a lot of fear about how to deal with genetic information and how to protect people from discrimination based on genetic information. At the same time, the technology is getting more and more advanced, and cheaper every day, making it more available.

Interview with Andrew Carroll of Google AI

Q: Artificial intelligence (AI) techniques have sent vast waves across healthcare, even fueling an active discussion of whether AI doctors will eventually replace human physicians in the future. Do you believe that human physicians will be replaced by machines in the foreseeable future? What are your thoughts?

A: I believe that applying AI technologies in healthcare will make physicians more valuable, and will make their careers more enjoyable and sustainable.

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Interview with L. Staton Noel III of Panaceutics

Q: What need is Panaceutics addressing?

A: One of the key barriers to making precision/personalized wellness and healthcare products is the contradictory goal of manufacturing individualized products on a large scale. Meeting demand for personalized products can be expensive and logistically challenging.

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Interview with Joe Zhang of Burning Rock Dx

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend?

A: The milestones in my mind include the first FDA clearance of Next Gen Sequencing instrument, MiSeqDx in 2013, this opened a new door for clinical utilization of parallel gene alteration detection in clinical setting.

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Why are Scientists So Upset About The First CRISPR Babies?

The use of new technologies can provide breakthrough benefits for both patients and providers. However, with increased sharing comes increased risks to the security and privacy of patient data. Currently data is being accumulated across many organizations and initiatives but is often either siloed or simply not accessible. Researchers suggest that patient education tactics can help quell security concerns during patient data sharing.

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Interview with Kara Davis of Stanford

Q: The Nobel Price in Medicine was awarded recently to James Allison and Tasuku for their work on unleashing the body’s immune system to attack cancer, a breakthrough that has led to an entirely new class of drugs and brought lasting remissions to many patients who had run out of options. The Nobel committee hailed their accomplishments as establishing “an entirely new principle for cancer therapy.” What is your first-hand experience the impact that those new drugs had on patients?

A: These immune checkpoint inhibitors have been an incredible demonstration of the ability of the immune system to control and in some cases.

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Interview with Shannon J. McCall of Duke University

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend?

A: After several years of the promise of precision medicine and abundant clinical trial work, the recent FDA approval of solid-tumor-agnostic therapies dependent on molecular biomarkers has catapulted genomic/precision medicine into the standard-of-care for late stage cancer.

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Interview with Tao Chen of Paragon Genomics, Inc.

Q: Once sequencing has been validated as a clinical solution via trusted workflows, and coinciding with the technological developments driving costs lower, we can expect accelerated human genome profiling for clinical Dx. How soon, do you think, will we see accelerated growth and what can we expect?

A: For whole genome sequencing to be a reliable clinical tool, it will largely depend on the cost of sequencing the genome and our ability to interpret the data.

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Call for Action: The Time is Now for Patient Data Interoperability

The use of new technologies can provide breakthrough benefits for both patients and providers. However, with increased sharing comes increased risks to the security and privacy of patient data. Currently data is being accumulated across many organizations and initiatives but is often either siloed or simply not accessible. Researchers suggest that patient education tactics can help quell security concerns during patient data sharing.

Read More

Interview with Andrew Magis of Arivale

Q: Once sequencing has been validated as a clinical solution via trusted workflows, and coinciding with the technological developments driving costs lower, we can expect accelerated human genome profiling. How soon, do you think, will we see what kind of accelerated growth?

A: I think the acceleration has already begun. Large sequencing projects such as NHLBI Trans-omics for Precision Medicine (TOPMed) and NIH All of Us are sequencing 150,000 and 1 million individuals, respectively.

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Interview with Emily Leproust of Twist Bioscience

Q: NGS is enhancing patient care through improved diagnostic sensitivity and more precise therapeutic targeting. Prominent examples include cystic fibrosis and cancer. What other clinical areas NGS will most likely to change the standard-of-care in the near future?

A: Preventative medicine – using genetic data to identify traits that have the potential to cause harm in the future.

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Interview with Michael Phelps of UCLA

Q: You invented the PET scanner that changed the lives of millions of patients with cancer, brain and heart diseases. What are the potential benefits to patients of combining PET with radio-ablation technologies?

A: PET provides imaging assays of the biology of disease in many diseases today.

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Interview with Daniela Ushizima of Lawrence Berkeley National Lab

Q: Artificial intelligence (AI) techniques have sent vast waves across healthcare, even fueling an active discussion of whether AI doctors will eventually replace human physicians in the future. Do you believe that human physicians will be replaced by machines in the foreseeable future? What are your thoughts?

A: I really hope that human physicians will not be replaced by machines in the foreseeable future.

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Interview with Amy Compton-Phillips of Providence St. Joseph Health

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend? What technological advancements are driving this change?

A: Genomic medicine is poised to move quickly from the research realm into integration with healthcare delivery, but there is always a time lapse between technology advances and what we do with those advances.

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Interview with James Taylor of Precision NanoSystems

Q: There are various new, emerging technologies that bring us closer towards a cure for life-threatening disorders such as cancer, HIV, or Huntington’s disease. Prominent examples include the popular gene editing tool CRISPR or new and improved cell and gene therapies. By when can we expect these new technologies being part of routine clinical care?

A: Patients are already receiving treatment using novel gene and cell therapies.

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Interview with Julie Eggington of Center for Genomic Interpretation

Q: Together with Robert Burton you founded the Center for Genomic Interpretation (CGI), a non-profit organization. Can you tell us more about CGI and the mission behind it?

A: CGI’s mission is to drive quality in clinical genetics and genomics. CGI works primarily with laboratories, health insurance payers, clinicians, and patients/consumers.

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Johns Hopkins
University Of Michigan

The Precision Medicine World Conference (PMWC), in its 16th installment, will take place in the Santa Clara Convention Center (Silicon Valley) on January 20-23, 2019. The program will traverse innovative technologies, thriving initiatives, and clinical case studies that enable the translation of precision medicine into direct improvements in health care. Conference attendees will have an opportunity to learn first-hand about the latest developments and advancements in precision medicine and cutting-edge new strategies and solutions that are changing how patients are treated.

Agenda highlights:

  • Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
    • AI & Data Science Showcase
    • Clinical & Research Tools Showcase
    • Clinical Dx Showcase
    • Creating Clinical Value with Liquid Biopsy ctDNA, etc.
    • Digital Health/Health and Wellness
    • Digital Phenotyping
    • Diversity in Precision Medicine
    • Drug Development (PPPs)
    • Early Days of Life Sequencing
    • Emerging Technologies in PM
    • Emerging Therapeutic Showcase
    • FDA Efforts to Accelerate PM
    • Gene Editing
    • Genomic Profiling Showcase
    • Immunotherapy Sessions & Showcase
    • Implementation into Health Care Delivery
    • Large Scale Bio-data Resources to Support Drug Development (PPPs)
    • Microbial Profiling Showcase
    • Microbiome
    • Neoantigens
    • Next-Gen. Workforce of PM
    • Non-Clinical Services Showcase
    • Pharmacogenomics
    • Point-of Care Dx Platform
    • Precision Public Health
    • Rare Disease Diagnosis
    • Resilience
    • Robust Clinical Decision Support Tools
    • Wellness and Aging Showcase

Agenda highlights:

    • Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
      • AI & Data Science Showcase
      • Clinical & Research Tools Showcase
      • Clinical Dx Showcase
      • Creating Clinical Value with Liquid Biopsy ctDNA, etc.
      • Digital Health/Health and Wellness
      • Digital Phenotyping
      • Diversity in Precision Medicine
      • Drug Development (PPPs)
      • Early Days of Life Sequencing
      • Emerging Technologies in PM
      • Emerging Therapeutic Showcase
      • FDA Efforts to Accelerate PM
      • Gene Editing / CRISPR
      • Genomic Profiling Showcase
      • Immunotherapy Sessions & Showcase
      • Implementation into Health Care Delivery
      • Large Scale Bio-data Resources to Support Drug Development (PPPs)
      • Microbial Profiling Showcase
      • Microbiome
      • Neoantigens
      • Next-Gen. Workforce of PM
      • Non-Clinical Services Showcase
      • Pharmacogenomics
      • Point-of Care Dx Platform
      • Precision Public Health
      • Rare Disease Diagnosis
      • Resilience
      • Robust Clinical Decision Support Tools
      • Wellness and Aging Showcase
  • Luminary and Pioneer Awards, honoring individuals who contributed, and continue to contribute, to the field of Precision Medicine
  • 2000+ multidisciplinary attendees, from across the entire spectrum of healthcare, representing different types of companies, technologies, and medical centers with leadership roles in precision medicine
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