Legendary scientist Leroy Hood sees big changes ahead for 21st Century healthcare
The scope of Leroy Hood's accomplishments in science and medicine is daunting to describe. Since his days at Caltech in the 1950s (where he studied under towering 20th Century figures such as Richard Feynman and Linus Pauling) he has been a trailblazer in biology, genomics and precision medicine, bringing big advances to a healthcare industry that's all too often known for its conservatism.
For the past half-century, Hood, who now serves as chief science officer at Providence St. Joseph Health, has pioneered new approaches to detecting and treating disease.
Beginning his career in the '60s, Hood helped develop an array of transformative technologies that have helped pave the way toward where we are today with precision medicine: automated DNA sequencers, DNA synthesizers, protein sequencers, peptide synthesizers, the ink jet printer for constructing DNA arrays (and large-scale synthesis of DNA), as well as the nanostring instrument for single-molecule analysis of RNA and DNA.
He was a key player in the Human Genome Project. He launched the first cross-disciplinary biology department, at the University of Washington. He co-founded the Institute for Systems Biology and has been a champion of systems-based medicine as a critical tool in the fight against cancer and neurodegenerative diseases.
Hood has published 750 papers, received 36 patents and founded or co-founded 15 different biotech companies. And he is one of an elite 15 individuals elected to the National Academy of Science, the National Academy of Engineering and the National Academy of Medicine.
At the HIMSS Precision Medicine Summit in Washington on May 18, Hood, who did so much to advance medicine in the 20th Century, will explain the big evolution in store for 21st, describing how four converging phenomena – systems medicine, big data and analytics, digitalization of personal measurements and patient-led social networks – are leading to what he calls P4 healthcare: predictive, personalized, preventive and participatory.
"In the past 100 or so years, there have been two fundamental paradigm changes in medicine. One occurred in 1910, with the Flexner Report, which argued that medicine and healthcare should be science-driven, as should medical education," said Hood.
"The second occurred with the entree of systems thinking into medicine, and that's led to the concepts of systems medicine, which is a global holistic approach to disease," he explained.
"There are two central thrusts in healthcare," said Hood. "One is wellness and the other is disease." While the 20th Century healthcare focused almost exclusively on the latter, recent years have – slowly – seen a shift imperative to prioritize health and wellness.
"Almost everyone practices 20th Century medicine right now," he said. "And it's going to be a fundamental paradigm change to practice 21st Century medicine."
Specifically, Hood is interested in what he calls "scientific wellness." Which centers around high-throughput biological data and rigorous analytics.
It's exemplified by an ongoing collaboration between Institute for Systems Biology and Providence St. Joseph – along with Arivale, an ISB spin-off company that uses personalized data and health coaching to help spur individual wellness.
The Providence-Arivale Feasibility Study of Scientific Wellness is gathering biological data from some 1,000 patient, and studying their genome, blood, saliva, microbiome and lifestyle factors. Personalized health coaches can then help them, based on their genetic profile and other biological factors, can help them tailor a wellness plan based on those analytics.
All the patient's data is stored in what Hood calls a "personal, dense, dynamic data cloud."
The aim, rather than managing or curing disease, is to spot developing health challenges as early as possible and develop plans of action to help prevent them. That's the gist of what Hood means when he speaks of P4 healthcare – the program is designed to be predictive, preventive, personalized and participatory.
Those personalized data clouds offer the "ability to mark that earliest transition point for the chronic disease – say, Alzheimer's," he said. "Once we have those markers, then we can use these other techniques of systems medicine to actually create a therapy at its earliest stage, even before it manifests itself as a detectable phenotype."
With that approach, Hood is bullish on the chances for making some big headway in the fight against chronic disease in the near future.
"We think within five years we'll be able to do that for 80 percent or more of individuals with the earliest stages of Alzheimer's," he said.
There are 5.3 million people in the U.S. with Alzheimer's today. Their treatment costs around $2.6 billion, he points out – their caregivers another $2.4 billion.
Beyond the obvious benefit to patients and their families, "we're talking about tens of billions of dollars" in savings, said Hood – who says he's hoping more and move payers will be convinced to subsidize those expensive data clouds, given the savings they could help enable.
The ISB partnership with Providence St. Joe's "has opened up the opportunity to bring P4 and scientific wellness to a major healthcare system and spread this throughout the rest of the United States," he said.
He's enthusiastic that others will want in on the action, but realizes it's also a challenge to help spread new approaches such as this nationwide.
"The healthcare system is enormously conservative," he said. "It fights all new ideas vigorously. But new ideas gain footholds, often through younger physicians, younger professionals who are more flexible and creative."
They also gain traction when major health systems "can show it's going to save you a bundle of money and improve the health of the individual," he said. "The way you force people to adhere to a paradigm change is to show them they can do things they never did before."
He's similarly optimistic about the role patients will play in the years ahead. Lots has happened to enable this P4 moment, from connected mobile devices to the power of big data. Hood is no stranger to the latter (his leading-edge DNA sequencer work, after all, helped create some of the "first big data ever").
But there's one development over the past decade that he sees as potentially transformative: "The power of social networks both to educate and to recruit patients as advocates for change."
Patients, he said, "are going to be a very strong part of the thrust. They'll go to their physician and say, 'You're not practicing 21s Century medicine, I want to go to someone who is.' We've already seen that start to happen."
HIMSS Precision Medicine Summit
Accelerating precision medicine to the point of care is focus of summit in Washington, D.C. May 17-18, 2018.