It is beginning to feel to me like cancer has become as common as the common cold. Almost everyone I know—in every aspect of my life—is going through a cancer experience either directly themselves or via a friend or family member.

The grand challenge to end cancer has certainly brought significant improvements to treatment over the past few decades, but there is still much to learn about the underlying mechanisms that cause so many diverse kinds of cancer to emerge and how they might possibly be slowed or stopped. There is still too much painful experimentation and expensive guesswork involved in treating an individual patient based on what medicine can glean from randomized studies of large populations. Healthcare today really can't know the individual in his or her genetic and disease complexity, and thus, often fails to deliver a treatment protocol with precision or positive results.

From roulette to precision

As a cancer patient advocate for more than two decades, I have witnessed firsthand what the lack of precision brings us. It leads to a kind of "diagnosis and drug cocktail roulette," as one oncologist described it to me years ago, because physicians lack the tools to really understand an individual's case. Thus, the grand challenge for thousands of patients I have worked with has been to survive the experimentation, the trials, and the side effects from the treatment. We all laugh but also cringe at the all-too-common mantra: "It's not the disease you have to worry about, it's the cure!" We must give medicine the means to customize cancer care—and all care—for each and every one of us.

Given these challenges, I am excited about today’s announcement that Intel and Oregon Health & Science University (OHSU) have formed a multi-year strategic collaboration to explore this kind of individually targeted cancer therapy. We will deploy next-generation computing to help solve the data-intensive challenges that personalized medicine for cancer really requires. Very complex problems—like developing the ability to “turn off” the spread of cancer in a particular person—demand multidisciplinary teams of experts working side by side. Together, Intel’s engineers and OHSU’s biomedical experts are optimizing supercomputing clusters and software to isolate the genetic variations that contribute to the root causes of illness.

From weeks to hours

For more than a decade, Intel technologists and social scientists have worked with OHSU (my first clinical fieldwork for Intel was in several OHSU hospitals and clinics back in 1999!) to move toward a vision of what I call "Personal Health." Our prior work together has focused on two of the three pillars of Personal Health: care anywhere and care networking.  We have developed technologies and care models for helping to care for people—especially seniors—in their own homes through telehealth, remote patient monitoring, online coaching, intelligent prompting, and care coordination of virtual, networked teams.

Today's announcement continues our innovation partnership with OHSU and focuses on the third pillar of Personal Health: care customization. Scientists can now gather billions of data points on how a specific patient’s cells are malfunctioning. Genetic abnormalities that cause these tumors manifest differently in each of us. What’s more, even a healthy human body creates millions of these mutations.  So it’s an enormous scientific challenge to determine, for each individual, which mutations are relevant in creating "my" disease. But that's where medicine must go.

We're bringing together Intel’s strengths in developing energy-efficient, extreme-scale computing solutions with OHSU’s pioneering work in imaging an individual's complex biological information in four dimensions (three-dimensional space and time). The calculations required to advance in this field are mind-boggling. Today, it takes weeks to analyze this information for an individual, but through this collaboration, we hope to shorten the data-crunching from weeks to hours and bring the costs down to something that can be clinically viable for every patient.

Digging into the ‘circuitry’ of cancer

If we succeed, this would mean more tests can be performed in a given time, with hopefully quicker discoveries. Eventually, this all leads to the promise of highly precise diagnostic tests to customize care for someone going through cancer because we can now understand that person’s particular mutations in enormous detail. But our joint team plans to do research not only into the mutations but also the "circuitry" that enables malignant cells to spread. The ultimate hope here is to learn how, for a specific individual, this circuitry can be “turned off” to stop the spread of cancer cells!

I know well what these kinds of breakthroughs could mean for patients. I have experienced my own "roulette game" of trials and experimentation for kidney disease for almost 25 years. In fact, I write this blog about our new OHSU-Intel collaboration from a hospital bed, as I recover from a routine biopsy of my new kidney transplant to make sure that it continues to do well. One of the things that helped get me to this amazing state of normal kidney function and good health again was having my whole genome sequenced.  It, too, took weeks of computing and then months upon months of analysis to make sense of my own unique case. Today, these tools are too slow, too expensive, and too rare—I want to make sure everyone has access to the kind of customized care that I lucked into.

Of course, there are no guarantees in this type of grand endeavor. We cannot know now how successful such investigations will be, or how soon average patients will benefit. But we do know that it is high time time to end the dangerous roulette game of diagnoses and drug cocktails that cancer patients must endure. It is time to stop the guesswork by giving physicians the tools to deliver true care customization for an individual. It is time to end the war on cancer by ending cancer once and for all. I hope and believe that this pioneering collaboration between Intel and OHSU will make significant contributions to these ends. And that one day these kinds of efforts will help make "cancer" one of those historical diseases that future generations will have heard about but not really understand because they have never seen anyone go through it.

Intel spent a day recently with nurse practitioner Ginger Harris as she went on home visits with a new Intel-inspired Ultrabook. As our population grows older, technology plays a significant role in providing home-based care for people who have trouble getting to the doctor's office. Critical for "on-the-go" clinicians is a reliable computer that is lighter, faster, and "instant-on."

Watch the video to see what Intel-inspired Ultrabooks can bring to mobile health workers. What questions do you have?

A year ago, I blogged a new year's resolution that I would blog more in 2011 about what was happening in healthcare reform, innovation, and information technology efforts that Intel is involved in around the world. I knew then that I should have stuck to my prior decade-long resolution not to make new year's resolutions (or annual predictions, for that matter!) because I didn't get to blog as often as I had hoped.  You would think I would know better by now: best intentions are nice, but you shouldn't make promises that you can't keep. So I won't promise to blog more in 2012--only to do the best that I can.

I used to make these same impossible promises to myself each January about "getting in shape." Given the number of neon gym membership ads shoved under my windshield wiper while parked at the grocery store, I suspect it is the same for many people. January is about the “I-ate-so-much-over-the-holidays-but-am-now-going-to-eat-right-and-exercise” resolution—to promise ourselves to do better in the nutrition and fitness departments. Thus, we buy not only gym memberships but all kinds of diet “solutions” and home exercise equipment each new year. We buy into these grand promises to ourselves that we will lose 40 pounds or run a marathon. We sell everyone around us on the concept that this is the “new me.” And for most of us, the intent to do the right thing lasts through the first quarter, the energy to do so through mid February, and the commitment just until the stores have sold the last leftover holiday wrapping paper and candy that no one bought at full price.

About three years ago, I finally got off this endless cycle of unfulfilled, self-made promises and set a different course that has produced far better results in terms of my health. I achieved this (and other positive side effects like losing 35 pounds and preparing for a 10k run) first and foremost by firing my doctor. I also fired myself as a "passive patient"--and rehired myself as a key "owner" of my own health and wellness. Many people are shocked when I tell them this, as if they could never imagine switching to a new physician. But it is preposterous that the idea of firing your personal doctor is so preposterous! Many of us demand the best possible service, expertise, and attention when we get our cars repaired, our vacations planned, or the health of our children or parents dealt with, but we somehow will just keep going to the same doctor year after year for ourselves, even when we feel like the relationship is lackluster at best.

In my case, I had gone to the same primary care doc--the one I had sort of stumbled into because he was "accepting new patients" in the brochure I was given when enrolling in benefits at my "new" Intel job--for TEN years! It was not that he was a bad doctor. He routinely saw me once a year. He was friendly enough (though he could never remember that I go by my middle name "Eric," not my first name "James"). And he dolled out the obligatory drugs for my multiple chronic conditions, small injuries, and the occasional flu as required. The problem was that he was, well, just another passive primary care physician...and I was, well, just another passive patient...caught up in the typical treadmill of reactive medicine as we each waited for the next "problem" to warrant a clinic visit. Over the last five years that I saw him (and I know this because I tracked it in my journal), he literally did not physically touch me during any of my visits. It got so bad that I even joked with friends that "my doctor seems to be afraid of touching his patients" because he simply interviewed me and placed check-marks on a form. But, still, I tolerated and maintained this mediocrity for years: I got my prescriptions; he got his reimbursement from my insurer; our interaction was simply a transaction that neither of us paid much attention to.

I finally got tired of this treadmill going nowhere and decided to look for a physician I loved, not just one I tolerated. I started asking around for recommendations from friends and colleagues, and while most everyone thought their doctor was "fine," almost no one seemed to love their physician as much as they did their easy-to-recommend babysitter or mechanic or financial planner. Which was strange to me, because people seemed incredibly loyal to their primary care physician and loathe to change to a new one, but unwilling to recommend one. Finally, a colleague at work gave me a passionate recommendation--she said I had to join GreenField Health because she loved all of their doctors and staff whom she had interacted with. I got on its website where it described itself as "a completely different doctor's office." Three years into this relationship, I readily admit that GreenField lives up to the hype: it was a game-changing move for me, and I am someone who loves my doctor, the staff, and the entire setup.

Now, I happily write a $500 check to GreenField each January as an annual resolution and investment in myself and a contract with them that I am very happy to make. This money enables them to provide me with a service--a doctor patient relationship--that I really need. There is no waiting room. I can get an appointment any time. We interact online through secure email when appropriate. I have a physician champion who oversees the complexities of my care across all the specialists I see. They take the time to help me--whether it is a 5 minute call or two hour exam. But most importantly, my doctor there starts with a very different question when we meet. He starts each "visit" by asking, "What should we work on together this year?" instead of the ubiquitous "What's wrong?" or "What seems to be the problem [for me to fix] today?" This is such an important, radical act to begin with a different question. He immediately enlists me as a partner with him on whatever health and wellness project I want to embark on. In my case, it was getting off the New Year's diet fad and onto a more ongoing, proactive, preventive, healthy lifestyle. The GreenField philosophy--embodied in that opening question--moves beyond the fix-what-is-broken mentality that governs so much of reactive medicine today to a proactive partnership for better health (and better "cost, quality, and access" as today's health reform mantra goes). Each year--and I am looking forward to my upcoming January meeting with him--we work on a plan together for my health for the year, and because he can afford through such a financial arrangement to spend time to help me deliver upon that plan, we actually make it happen.

I realize full well that not everyone is in a position to be able to fire their doctor or to pay $500 a year for this kind of personalized service. But each of us can demand more from our doctor and can step up as a partner to own more responsibility for our health. We can begin to get off the reactive medicine treadmill that is premised upon (and financed around) pharmacological fix-its rather than tackling more fundamental health issues. What my GreenField experience has helped me to realize is that we, as patients, have to be active members of a coordinated team and that we need a physician champion to help oversee all the other meds we take, specialists we see, and complex health needs that we have. I’ve been fortunate enough through GreenField to have a taste of the future of healthcare now: a true partnership, a prevention orientation, and a care team who takes the appropriate time to teach and enlist me in my own care and behavior change.

All around the world these days, we hear healthcare experts abuzz with catch phrases like "medical homes" or "patient centered medical homes" or "next generation primary care" or "coordinated, collaborative care teams."  And against the backdrop of these many discussions of electronic health records, meaningful use criteria, quality measurement, telehealth, clinician workflow, change management, age friendly cities, payment reform, cloud computing for clinics, data security, predictive analytics, and personalized medicine--many of which are topics I will end up blogging about in 2012 to some degree--it is important to remember that, at the end of the day, real reform--real innovation in healthcare--has to be about building better relationships between patients and doctors. (Or perhaps there will be better words for these staid, traditional roles, such as "providers" and "partners.") If all our efforts in reform and healthcare IT come to fruition successfully, then this kind of care I fallen in love with at GreenField shouldn’t be the "boutique" or "concierge" exception for only a few….it should become the norm and standard in care for everyone.

What do you think?