When Jamie Coffin (>Fig. 1); Worldwide General Manager and VP Healthcare and Life Sciences Division, joined Dell five years ago, the company was primarily a hardware company. Through a set of acquisitions, it has turned into a provider of end-to-end solutions and services for enterprises, being amongst others the world’s largest healthcare IT services company with approx. 13,000 staff, described Coffin. Among the companies acquired was Perot Systems, a provider of IT services of which roughly 70 percent involved the healthcare sector. Today for Dell, approximately half of the business is in services, and Coffin sees his division as the biggest integrator in the healthcare industry. Among today’s major challenges for care providers is the adoption of electronic medical records, said the manager. Patient information is required, e.g., at the point of care to make precise clinical decisions possible. Physicians typically have eight to ten minutes to spend seeing a patient; and there is a vast volume of data which is, or might be, made available to them, including data from genomics and proteomics.

IT: enabling convenient access to critically required information
IT can help provide access to this valuable information; mobility is a key issue in that respect. Physicians are continuously on the move, and information has to be made accessible to them wherever they are, securely and safely, and no matter what device is being used at the endpoint. Convenient solutions such as “Mobile Clinical Computing” from this vendor “save an enormous amount of time”, through fast authentication and access to applications, outlined Coffin. The “Unified Clinical Archive” for medical imaging helps care providers in Europe and the U.S., such as UCLA, to store imaging data in a vendor-neutral format and make it retrievable anywhere, anytime … via the “cloud”. This off-site, Internet-based data storage and communication service is designed to provide flexibility and cost-effectiveness. Data privacy and security are a key issue in this respect.

Cloud technology to help research move forward
“Dell gives one percent of its pre-tax earnings to charitable organizations”, added Coffin. To the list of activities funded by the company, a large pediatric oncology program has recently been added. Its context is the convergence of molecular biology and IT which is currently taking place, said the manager. The combination of next-generation sequencing technology and high-performance computing has helped to vastly reduce efforts and costs which go into the analysis of a person’s genome – nowadays, this takes less than two weeks and costs about 10,000 US dollars versus the Human Genome Project which took ten years and cost 3 billion. This approach therefore has now become clinically relevant, in particular for oncology patients.
Pediatric neuroblastoma is an aggressive type of cancer which attacks the sympathetic nervous system and affects the heart rate, blood pressure, and digestion. Currently, approximately 98 percent of children with the disease die within one year. Tumors are unique to each child; researchers therefore require data that can provide information on how to attack tumors individually. Dell recently announced it will donate cloud-computing architecture to speed up the search for successful treatments to help significantly reduce the mortality rate.  The Translational Genomics Research Institute (TGen) will use the vendor’s cloud infrastructure to store data for the world's first personalized medicine trial for pediatric neuroblastoma. TGen is a non-profit organization that performs genomics research to develop quicker diagnoses and treatment of diseases. The trials will target the tumor by tackling drug pathways, using a cloud-based genomic sequencing analysis platform. The TGen Cloud architecture runs at up to 8.2 teraflops and is based on Dell Precision Workstations, which researchers will use for analysis and review.
The vendor’s high-performance computing will provide a dedicated clinical cluster to perform 8 trillion operations per second. In the first stages of the trial, 12 U.S. medical centers will enroll patients, including the National Cancer Institute in Bethesda, MD.; Children's Mercy Hospital and Clinics in Kansas City, MO.; and Connecticut Children's Medical Center in Hartford, Conn. – Later stages could expand the number of hospitals participating to around 20. More than 200 billion measurements per patient will be analyzed, shared, and stored in the cloud. The technology will enable scientists to move genomic data more effectively, reducing the trial-and-error needed to find suitable treatment, added Coffin.

Facts vs. memories 
Delivering lower-cost care at higher-quality outcomes – this is the key challenge for the sector. Until now, physicians thought back of what they had learned at medical school when doing a diagnosis and therapy plan for patients presenting with symptoms. In future, a deluge of valuable data – from genomics, imaging, etc. – will be made available to them which they will need to analyze within the patient consultations which last for eight to ten minutes. Bringing this information into a viewable format, helping healthcare workers to share that information, and providing decision support tools to enable precise clinical decisions: information technology, involving extensive medical informatics know-how, will play the critical role in this, underlined Coffin. In order to help the sector move towards this future, Dell is bringing expertise in integration, and investments in vast data center capacity to the sector.