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KPBS Midday Edition

Scripps Wants To Personalize Health Care With $120M Grant

Dr. Eric Topol demonstrates a mobile health app on a smartphone.
Canada 2020
Dr. Eric Topol demonstrates a mobile health app on a smartphone.

Scripps Wants To Personalize Health Care With $120M Grant
Scripps Wants To Personalize Health Care With $120M Grant GUEST: Steve Steinhubl, director of digital medicine, Scripps Translational Science Institute

The Scripps Translational Science Institute has been a national leader in using high-tech innovations to personalize medical care. The Institute has been awarded a $120 million grant from the national institutes of health to further that concept. The Institute will recruit citizen scientist volunteers who use mobile apps to track their personal medical data and send that information to researchers. Joining me is Dr. Steve Steinhubl, director of digital medicine at Scripps Translational Science Institute. Welcome. Thank you. We have heard about smart phones and other digital devices being used to monitor various physical conditions. What is different about this study? The scope and breadth is the biggest and most exciting aspect. There's really never been a medical study of this size ever. It has the potential, using the possibilities made available by our you bet he was connectivity with smart phones and other wireless devices as well as the cup at -- computational power, to completely change the way we think about health, wellness, what we know about it and how it's different in all of us. And best how to optimize that. And doing it in 1 million people across the country. 1 million volunteers nationwide I read by 2020. How many people is a Scripps going to monitor? Scripps is in charge of enrolling 350,000 direct volunteers. People can get in and the part and a participant in the precision medicine initiative either through joining through select healthcare provider organizations that were also part of the NIH grants or through federally qualified health centers this was part of President Obama's vision for this that anybody in the United States who is interested could enroll and that's what we are responsible for. For those individuals who do not happen to be cared for at other specific sites. Anywhere from San Diego to Alaska to the northernmost reaches of the main. How will the transfer of medical information work from these volunteers to researchers? It's going to be a combination of several things. Initially when people volunteer they will fill out a short questionnaire that will include their past medical history. They will be directed to get a baseline physical exam, some of blood pressure and vital signs. And have a tube of blood drawn that will be kept in a bio bank being run by the Mayo Clinic. We anticipate that genomic studies and biomarker studies will be carried out with that in the future. That is just the beginning. Everybody will eventually have the ability to link their electronic health record also to this so that initially from all the healthcare provider organizations. We also think that in five years, everyone will have their own health record and will have the ability to link their electronic health record to the database. Almost that is being handled through the data support core which is at Vanderbilt University with the key aspect of it being very secure and private for everybody. Is this going to be inconvenient or time-consuming for the volunteers? Not if we do our job well. That is the important question and one of the key aspects of the design. We want to volunteers to feel that they get much more out of being part of the study then they are getting to be part of the city. We want people to stay engaged in the study for years and decades. If we make it inconvenient are hard for people to do our we don't provide the information back to the volunteers, they will lose interest. I would not blame them for doing that. Our challenge is to make sure that the information we provide to volunteers is something that they find very useful to them and helpful to them. And something they would miss if they weren't part of the study. You have referred to this as more than a study. And really the development of a medical model. Why is that? It's really designed to say -- can we provide healthcare this way? Can we get away from this episodic snapshots of seeing somebody in a clinic visit once a year or once every couple months? And instead, manage people where they live and manage them in a way that is personalized to them. By manage I mean help them make better decisions for their own personal wellness, to maintain their health, to Patricia LeDoux a lot of acute diagnostics within your own home. And having the results sent to a group of healthcare providers that can focus and say, okay, you are okay or no, you have something going on and we should check more. This is all very possible. It's been very difficult to model that for the nation. This will provide the opportunity to do that. As the study continues, to expect new technologies and new apps to be developed that can monitor more physical functions? Absolutely. That is one of the most exciting things about this. They will be technologies available in 5 or 10 years we cannot dream of. Even today we have the ability to monitor individuals blood pressure and EKG and respiratory rate and temperature very easily with wireless devices that can send that information. In the future we will have breath analytics that are being developed that can monitor people for the earliest signs of cancer or the earliest signs of infections. And when those technologies are available and appropriate for the precision Michigan -- Mehta did -- medical cohort. One of our jobs is to bring that out. How can people volunteer through Scripps ? The good news is, I don't think our website can handle all the volunteers -- right now the volunteer process will not be available. Maybe November 1. If you look at the NIH website under PMI or precision medicine initiative, there is a box there that people can click to provide their email address so they stay informed. As soon as we're up and running and ready to start accepting volunteers, they will get a notification and be able to volunteer. I have been speaking with Dr. Steve Steinhubl, director of digital medicine at Scripps translational science Institute. Thank you very much. My pleasure. Thank you.

Scripps Translational Science Institute received a $120 million, five-year grant from the federal government last week to help recruit hundreds of thousands of participants in a study researchers hope will fundamentally change the way patients receive health care.

The grant will allow Scripps and others to enroll one million subjects across the nation. Scientists will use smartphone sensors and a mobile app to gather real-time health information, such as heart rate, along with more traditional data such as patients' medical histories or genetic information.

The study, which is expected to go on for decades, could provide a model for doctors to personalize their patients' care, according to Scripps director of digital medicine Dr. Steve Steinhubl. He said doctors currently practice "population medicine," recommending treatments based on what has worked on a population of people. For example, giving aspirin to 1,000 patients may reduce their risk of heart attack overall, but some may have bad reactions to aspirin. Steinhubl said he hopes the sensors and other devices will allow doctors to understand patients better on an individual level.

"More than a study, it will be a model for how health care can be provided in the future," Steinhubl said.

He likened the project to a modern-day version of the Framingham heart study, which followed several thousand residents of Framingham, Massachusetts beginning in 1948. Researchers discovered high-blood pressure increased patients' risk of stroke and exercise decreased that risk — basic tenets of heart disease now, but novel at the time. The study was based on annual medical exams with the Framingham residents, according to Steinhubl.

"But Framingham isn’t representative of the entire U.S. and annual exams aren't representative of their daily lives," he said. "Even still, we’ve learned a lot from that one study."

Steinhubl joins KPBS Midday Edition on Thursday with more on the way Scripps' research could change health care.

Corrected:
Those interested can sign up here for updates from the Precision Medicine Initiative program.