The convergence of personalized medicine with digital health and artificial intelligence, systems biology, social networks, big data analytics and precision medicine is on the cusp of enabling an emerging field: scientific wellness.
“Over the next 10-15 years there will be a scientific wellness industry in contrast to the disease industry and the market cap will far exceed that of the disease industry,” said Leroy Hood, Chief Science Officer at Providence St. Joseph. “The contrast between 20th and 21st Century medicine is striking, 21st is proactive, focused on the individual, disease and it employs personalized data clouds to explore the complexities of human beings.”
The idea of scientific wellness is a quantitative approach.
that includes improving the health of individuals, create personalized treatments, reverse disease transitions and reduce costs — distinct from the current wellness trend focusing primarily on behaviors such as diet and lifestyle.
Precision medicine even more important
Precision medicine, much like the future in cyberpunk author William Gibson’s oft-cited quote, is already here — it’s just not evenly distributed yet.
“Today, we are already changing people’s lives through the use of genomic medicine,” said Nephi Walton, MD, Assistant Professor of Genomic Medicine at Geisinger Health Systems.
That said, with some 6000 known genetic diseases in existence, hospitals have to undertake some heavy tech lifting to manage so much information, Walton added.
That is already happening. “We’ve made terrific strides in terms of understanding biology, how it affects human health, defines wellness, relates to disease,” said Murray Aitken, Executive Director of the IQVIA Institute for Human Data Science.
The next phase is not about drugs, it’s about engaging patients, said Peter Bergethon, MD, Vice President of Quantitative Medicine and Clinical Trials at Biogen.
“Whether AI or wearables, technologies exist and the availability is widescale,” said Derek Cothran, Senior Vice President of Client Strategy and Development at EnvoyHealth. “It’s about taking that more precisely to a patient. We want to take information to patients so they consume it in ways they already consume data.”
Technologies exist and precision medicine practices are expanding beyond the poster child of oncology. Indeed, hospitals including Ascension Wisconsin, Thomas Jefferson University, and Gibbs Cancer Center are broadening the use of precision medicine.
“We all realize the promise of precision medicine will far outstrip the field of oncology,” said Douglas Reding, MD, CMO of Ascension Wisconsin. “Look at precision medicine as a discipline, not disease-specific.”
Gabriel Bien-Willner, the Molecular Director of Precision Medicine at Gibbs Cancer Center in Spartanburg, South Carolina, said the community hospital is working on cardiology, prenatal and pharmacogenomics, for instance.
“We’re starting to look at precision medicine in terms of sleep and fatigue,” Adam Dicker, MD, Chair of the Department of Radiology Oncology at Thomas Jefferson University. “We can’t do this at the population level. For the patients who are interested, we’re starting with them and we’ll slowly win over the rest.”
Dicker’s point that such practices cannot be applied to all patients today is an interesting one — and the telling thought is that the whole trend may sprout beyond treating the patient immediately in front of a clinician.
“One of the strongest applications of precision medicine might not be in treatment but in the prevention domain,” said Michael Dulin, MD, Director of the Academy for Population Health Innovation at the University of North Carolina Charlotte.
Indeed and that’s exactly where the emerging scientific wellness field will figure into the future of healthcare.
Scientific wellness is only a matter of time
Provident St. Joseph’s Hood said that 21 Century healthcare will focus on improving wellness for the individual, creating medicine that is preventive, personalized and participatory, and reverses rising cost trends.
“We think we can deal with Alzheimer’s really effectively in the next 3-5 years,” Hood added.
Using Alzheimer’s as one example, Hood explained that data clouds about patients and computer-aided diagnostics will enable researchers and clinicians to pinpoint the earliest sign of cognitive decline, which can happen anywhere from 4 to ten years prior to today’s diagnoses. From there, scientists can divide Alzheimer’s into sub-types and use individuals with high genetic risk to track cognitive transitions.
“The vision is in a period of 10 years to have a world virtually free of Alzheimer’s, it costs us half a trillion dollars a year and that gives you an idea of the savings that will come,” Hood said. “I’ll guarantee you that within a 10-year period genomes will be less than $100 a piece and you’ll be able to do a genome in less that 15 minutes.”
Alzheimer’s is only one example. The scientific wellness approach could also work for other neurodegenerative diseases with minor modifications.
Ultimately, scientific wellness will equip people with the data and tools to modify habits, be those diet, exercise, sleep or their genes to optimize personal health.
“The way forward is there,” Biogen’s Bergethon said. “It’s time to act at least on the initial pieces.”
The next HIMSS Precision Medicine Summit will take place at HIMSS19 in Orlando on Feb. 11, 2019.
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