SERI launched the national ‘Swiss Personalised Health Network’ (SPHN) funding initiative in 2017. Looking back, we find that the creation of national data infrastructure and coordination among stakeholders were successful. The initiative is now entering its second funding period (2021-2024) in which the focus will be on consolidating the network and anchoring the established data infrastructure.
The healthcare system produces large amounts of data, particularly on the health status of patients. New technologies and methods have now made it possible to cross-reference and evaluate data and thus adapt therapeutic approaches to suit the specific needs of the individual. This is the basic idea behind the term ‘personalised medicine’. In order to tap into the potential of available data, many unresolved issues first need to be clarified. These include technical aspects such as data security and comparability of data collected in very different contexts, as well as ethical and legal aspects surrounding the sharing and reuse of data.
Infrastructure development during the first funding period
Thanks to its very good healthcare system and outstanding higher education institutions, Switzerland offers favourable conditions for research in personalised medicine. In order to exploit this potential, SERI launched the ‘Swiss Personalised Health Network’ (SPHN) in the 2017-2020 funding period, allocating a total of CHF 68 million. Coordinated by the Swiss Academy of Medical Sciences (SAMS) in collaboration with the Swiss Institute of Bioinformatics (SIB), the initiative aims to establish a national data infrastructure for clinical and related data. During the initial start-up phase, the ‘Data Coordination Centre’ was intended to help university hospitals cross-reference and compare their clinical health data to ensure interoperability. In addition, the SIB’s BioMedIT servers provide the platform for secure transfer and access to clinical data.
To achieve its objectives, SPHN has pursued a blend of top-down and bottom-up approaches over the past four years. On the top-down side, SPHN has signed performance agreements with all university hospitals for infrastructure implementation projects that enable data delivery for research projects as well as data interoperability. On the bottom-up side, SPHN has issued two types of open calls for project proposals, which give researchers the opportunity to apply for grant funding of their own projects. The first type of call seeks to draw proposals for ‘infrastructure development projects’, which serve to build or test specific infrastructures. The second type is intended to draw proposals for ‘driver projects’, which test the interoperability of data in a specific research area. In addition to these project funding activities, SPHN working groups have been set up to clarify important ethical, legal and social concerns. These working groups began early on to systematically identify infrastructure gaps in data-driven health research so as to enable the planning of future action steps.
Achievements and challenges
By the end of 2020, halfway through the funding initiative, the first projects had already been successfully implemented. University hospitals have also reached scheduled milestones in terms of the progress to be made under their performance agreements. Twenty-four research and development projects are currently under way - six of them under the ETH Domain’s ‘Personalised Health and Related Technologies’ initiative. In addition, SPHN has made major strides towards harmonising core clinical data and setting standards to ensure interoperability. In particular, legal and ethical aspects of using Big Data in medicine were taken into account in agreements signed on the sharing and use of data and biological samples.
The systematic analysis of gaps carried out in the first funding period of SPHN also revealed that further targeted efforts are needed in Switzerland to exploit the potential of research in personalised medicine. The evaluation conducted by SPHN's international advisory board highlighted the complexity of clinical health data and the complex regulatory landscape in Switzerland as challenges for research in data-driven medicine. For example, BioMedIT servers allow researchers to analyse clinical data from different sources in a secure environment. However, the consolidation and harmonisation of data poses a major challenge.
Objectives for the second funding period
For the second and final funding period 2021-2024, Parliament approved the Federal Council’s request for a budget allocation of CHF 67 million for the SPHN funding initiative. Over the next four years, the focus will be placed on consolidating the infrastructure now in place. At the end of 2024, the Data Coordination Centre will be given a permanent organisational structure, which will make it easier for researchers to access and use clinical health data. To further develop and consolidate the research infrastructure, SPHN will again launch open calls for projects, as it did in the first funding period.
In addition to setting up and operating the infrastructure and clarifying ethical and legal issues, SPHN will establish interfaces with cohorts and sources of other health data. The main gaps identified will be closed by setting up working groups, intensifying exchanges with stakeholders and issuing recommendations.
Project well on track
After SPHN’s first four-year funding period, favourable conditions have been created for the advancement of personalised medicine in Switzerland. This makes it possible to conduct innovative research in a new field of medicine that will benefit patients.
Benedikt Knüsel, SERI
Scientific Advisor, National Research Section
Nicole Schaad, SERI
Head, National Research Section
Deputy Head of Research and Innovation Division