Over the last decade, a shift has been taking place in health care. This shift has been fueled by changes in our understanding of human biology as a result of the genomic revolution and the recognition that genes are not the dominant cause of disease.
At the same time, technological advances have also impacted medicine: personal health information can be captured on smart devices, advanced computing power has made analysis of large amounts of information about individuals possible, and the Internet — especially social media — now makes it easy to communicate health information quickly to large networks of people.
Many clinicians and scientists have an eye on the future of health care, which will be here before we know it. Here are five concepts to watch that will transform and revolutionize medical care. Soon we will have a treatment model and an economy focused on wellness, rather than disease treatment.
1. Functional Medicine
Functional medicine — an approach to patient care that targets the underlying causes of illness rather than treatment of symptoms — has been gaining national attention over the last decade. In 1991, I founded the Institute for Functional Medicine (IFM) to train health care practitioners in what was then a novel concept: focusing on the patient — his or her unique biochemistry and environment — rather than the symptoms and complaints that can be addressed in the space of a six-minute office visit.
Today, more than 100,000 clinicians have participated in IFM programs, and the effect is becoming widespread. In September 2014, the renowned Cleveland Clinic became the first large facility to offer the functional medicine model to patients when CEO Toby Cosgrove opened the doors to the Center for Functional Medicine. Will the future be functional? Cosgrove and many others believe it will.
2. P4 Medicine
Simply put, Dr. Leroy Hood — an MD and a Ph.D. — is a living legend in science and medical circles. For more than four decades, Dr. Hood has stood at the leading edge of genomic research and he played a key role in the success of the Human Genome Project. So it should come as no surprise that a scientific pioneer would have a vision about the future of health care, and for Dr. Hood that vision is P4 Medicine: predictive, preventive, personalized and participatory. In the P4 model, systems biology thinking and social networks will be key and the implications will be striking (including turning around the escalating costs of health care).
3. Systems Biology
In the practice of medicine, there's specialization: if you have a digestive issue, you'll probably see a gastroenterologist; for headaches and other types of pain, an appointment with a neurologist may be appropriate; and hormonal complaints might lead you to the waiting room of an endocrinologist.
Specialists, who are experts in their respective fields, are definitely needed in health care and that will not change. However, the human body is made up of interconnected networks, not individual organs that exist independently of one another. The concept of systems biology — viewing the body and its systems in a holistic and integrative way — is now acknowledged to be an important aspect of medical care.
4. Quantified Self
Do you wear any devices to check your activity and sleep patterns? Maybe you have a simple pedometer app on your phone (10,000 steps a day, anyone?). Or perhaps you keep a food diary to monitor your calorie intake. If you do any of these things, then you're already participating in what has come to be known as the quantified self movement, meaning you're tracking your personal data and using this information to make lifestyle decisions that could affect your health.
But there's an extreme edge of the quantified self movement that you may not be aware of, and you'll find it in the laboratory of Dr. Michael Snyder of Stanford University. In this age of detailed DNA analysis and blood biomarker analytes, what information could be gleaned from a detailed and ongoing examination of an individual's personal biochemistry?
This is an experiment Dr. Snyder and his team undertook in 2010 — with Dr. Snyder himself the subject of the study — and called iPOP (Integrative Personal Omics Profiling). The revelations from this effort were dramatic, including a real-time diagnosis of type 2 diabetes that was managed through real-time lifestyle changes.
Now, more studies are in the works and even more data points — such as gut microbiome analysis — are possible. Among the research to watch is the 100K Wellness Project, an ambitious longitudinal study from the Institute for Systems Biology (headed by Dr. Lee Hood, above) that seeks to follow 100,000 well people for decades in order to learn more about patterns of wellness and disease.
5. Personalized Lifestyle Medicine
Medicine has always had many labels: traditional, alternative, integrative. But no matter what adjective — if any — is used, the patient should be at the core of health care. And, as is increasingly being recognized, every patient is completely unique; each one of us is an n-of-1 experiment. If our genes do not necessarily determine our lifetime health (and they don't), how do we plan for lifetime wellness? We do so by controlling the messages sent to our genes — messages encoded in choices we make about diet, activity level, stress, and toxins.
I choose to view the future of health care as personalized lifestyle medicine because it encompasses all of the concepts that have been described here: genomics, systems thinking, patient-activated networks, self-monitoring, lifestyle choices, and, above all, personalization. You have the opportunity and power to shape your own pattern of health and longevity. It's what personalized health management is all about.
Leading scientists and researchers recently gathered in Seattle to discuss and debate personalization and the future of health care. Videos of these presentations — many of which focus on the five concepts described above — can be viewed for free at the website of the nonprofit PLM Institute.
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