Introducing the Swiss Personalised Health Network

Switzerland is known for having one of the highest concentrations of healthcare specialists in the world. The Swiss Health Valley in Western Switzerland is host to a large number of research organisations and leading companies in life sciences, biotechnology, medical technology and medicine. It is therefore not surprising that the country is embarking on a nationwide project to harmonise and link the resulting large volumes of data.

Personalised Health as a regional and national Priority

This ambitious idea, which originated from the Lemanic Centre for Personalized Health (a cluster of universities and hospitals around Lake Geneva) in 2014, and was later picked up by a Zurich-Basel cluster, rapidly gained support. The proposal was approved by the State Secretariat for Education, Research and Innovation (SERI) in January 2016 as a priority for the country and subsequently an initial federal financial contribution of CHF 70 m for 2017-2020* was allocated to the establishment the Swiss Personalized Health Network (SPHN).

The aim of the SPHN is clear: “to valorise the potential of medical, clinical and -omics data and achieve data interoperability among all relevant stakeholders”. Once established and extended to “all partners, including non-medical institutions and industry”¹, the project should transform medical research and open the way for a new kind of medicine, altogether predictive, preventive, personalised and participative.

The potential of Personalised Medicine

Personalised Medicine (PM) is often described as “customised”, “stratified”, or “precision” medicine which in my mind implies it’s about “the right medicine, just for me”. But for the moment, PM is still in the exploratory phase. We increasingly are able to observe the biological organisms and mechanisms and the (patho)physiological processes involved at the origins and through the course of diseases. As our understanding improves, this opens up new avenues for potential treatments.

In drug development, pharmaceutical companies have turned their attention to identifying biomarkers (indicators) to develop new products and anticipate therapeutic effects, classifying individual patients into specific categories to then focus on the individual and deliver “tailored” medical solutions in the future.

Biomedical research is able to look at individual biological structures or processes thanks to rapid progress in Information Technology offering ever more precise and affordable tools like high-performance computing, medical imaging and diagnostics technologies. As a result, an enormous amount of data is being produced every day: hospital databases, cohorts, registers, digital health records etc. To unlock the real potential of Health data and derive a personalised and cost-effective approach to treatment or prevention of diseases, it has become imperative to be able to standardise the handling and facilitate the linking of data contained in all these various and regularly updated sources.

Unblocking big data:  A new infrastructure for data collection and use

For BIG DATA to be big and interesting for health research there has to be a critical mass. In a small country like Switzerland, this can only be achieved by bringing together local and regional players into a national network where data can be exchanged and compared in a safe environment.

The SPHN Initiative will help research and innovation harvest the power of BIG DATA in Health by guaranteeing its quality, compatibility and inter-operability. For the initial implementation phase (2017-18), this will take place between the two PM clusters in Lausanne-Geneva and Zurich-Basel area. The clusters regroup university hospitals, higher education institutions and research institutes. Also included are the Swiss National Science Foundation (the SNSF is the main funding institution for sciences and research) and the Federal Office for Public Health, both based in Berne.

Molecular data will come from the research performing organisations, clinical data from hospital databases, as well as from SNSF supported existing cohorts such as the Swiss HIV, Swiss transplants and Swiss Hepatitis C cohorts and rare disease registries. Data will be extracted, treated and stored in Clinical Data Repositories accessible by all biomedical research domains, including fundamental, translational and clinical research, health services research and PM research.

As it evolves, the national program will stay accessible to every research institution in Switzerland willing to participate and able to contribute to the infrastructural costs. Current ongoing projects like the Swiss Biobanking Platform (regrouping all Swiss biobanks) or the future Human Biomonitoring Project will also be integrated into the network.

Having put the governance and structure in place, the second part of the SPHN implementation (2019-20) will focus on funding new research projects. A federal contribution of CHF 20m (£15m) is planned for SNSF funded bottom-up projects, encouraging such initiatives as the discovery of new biomarkers for personalised diagnostics and measuring the effectiveness of preventive and therapeutic treatments.

A special advisory group will treat and anticipate all ethical, legal and social implications. Most importantly, it will keep the general public informed and encourage Swiss citizens to become partners in this large social project.

Where next? Leading the way in personalised health research

The Swiss initiative will assemble a network of biomedical knowledge that is comprehensive, current, computable and traceable. Once the technicalities of data inter-operability have been overcome, success will be measured by efficiencies gained at the research system level, where the SNSF should play a role in the active coordination and evaluation of PM research activities, keeping a real-time centralised overview of results in biomarker research, accessible to all. A central oversight of research proposals and results would help avoid waste and duplications as well as direct research where gaps in the underlying theory have been identified. Well explored biomarkers will speed up clinical trials, adoption in clinical practice and reimbursement by insurers, for improved patient care.

By combining local and regional efforts, the SPHN initiative could turn Switzerland into a leading nation in best practice for personalised health research, at least on a par with other European countries. The UK already counts a number of initiatives led by the National Institute for Health Research to exploit strengths in health research, technologies and data. The SPHN should become an attractive partner for further multidisciplinary collaborations between the two countries.

^{*SERI message subject to parliamentary approval in Autumn 2016.}

^{1 Prof. Peter Meier-Abt, president of the Swiss Academy of Medicine}