Dr Tõnu Esko, PhD, is Deputy Director of Research, Estonian Biobank, Estonian Genome Center, at the University of Tartu. He is also Visiting Researcher, Boston Children’s Hospital; Harvard Medical School; Broad Institute of Harvard and MIT. His work in big data and real world evidence makes the EMIF programme of great interest to him. He will participate in the upcoming event “EMIF: E-managing the Future of Health Data” in Budapest, from 16th-17th March.

“If you can gather all this data together – from historical data i.e. disease history, to the ‘omics’ data and genetic data – we could, for instance, develop a web-based service where patients could see how their past and current lifestyle decisions affect their disease risks. For example, if a patient knows he has a higher risk for smoking-induced cancer, that might motivate him to stop smoking – or if he has a genetic tendency to become obese in later life, then maybe that will motivate him to follow a healthier lifestyle.”

As Deputy Director of Research at the Estonian Biobank of the University of Tartu’s Estonian Genome Center, Dr Tõnu Esko, PhD, is well versed in the hurdles of harnessing big data and real world evidence. “The main challenge for us – and I think this is a challenge that many similar initiatives, such as EMIF, face – is that we have this bulk of data available, coming from different sources – but we need to find ways to put this data together effectively,” says Esko.

Data from the Estonian biobank comes from many different databases – registries, national biobank, local hospital electronic health records, and more. What’s more, new data comes in annually and sometimes even twice per year, “so you have to handle this mass of data and also find clever algorithms and technical means to help merge and organise this data,” Esko explains.

Data sharing for the betterment of public health

There are many challenges in moving this process forward, but Esko remains motivated by the promise that the successful implementation of big data and real world evidence systems holds for public health. “If you can gather all this data together – from historical data i.e. disease history, to the ‘omics’ data and genetic data – we could, for instance, develop a web-based service where patients could see how their past and current lifestyle decisions affect their disease risks. For example, if a patient knows he has a higher risk for smoking-induced cancer, that might motivate him to stop smoking – or if he has a genetic tendency to become obese in later life, then maybe that will motivate him to follow a healthier lifestyle.”

Such integrated data systems would be of use not only to patients and doctors, Esko points out, but also to academia and researchers, as well as industry involved in medicines development. “This data can be useful for so many different people. The aim is to see how we can then make this information available via electronic health systems to patients, doctors and others, to improve public health as a whole,” he says.

Similar challenges at national and European level

In his role as Deputy Director of Research at the Estonian Biobank, Esko places a significant emphasis on the value of collaboration and best-practice exchange. “I’m looking at how to use the data from a scientific standpoint, while also looking at how to create collaborations with different partners that will allow us to make data available in a form that will be useful for others, including industry partners, for their development.”

The upcoming EMIF conference will offer the opportunity to exchange ideas and learn how others are handling the challenges posed by big data. There are already success stories in Europe: Esko highlights Denmark as standing out in its work in electronic health records. While there are positive examples of how people have come together in gathering and analysing data, many current initiatives face similar challenges in technical and practical implementation, Esko believes.

“I’m very interested in the upcoming discussions in Budapest to learn how EMIF is approaching some of the challenges we see, which are undoubtedly a problem at a European scale, as well as at national scale,” says Esko.

About Tõnu Esko
Dr Tõnu Esko, PhD, is Deputy Director of Research, Estonian Biobank, Estonian Genome Center, at the University of Tartu. He is also a visiting Researcher, Boston Children’s Hospital; Harvard Medical School; Broad Institute of Harvard and MIT

More about the Estonian Biobank: http://www.geenivaramu.ee/en

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