Wednesday, July 27, 2016

Everything You Need to Know about Health and Disease
You can always count on Americans to do the right thing – after we have tried everything else.
Winston Churchill

Winston had it right when it pertains to health care. 
We have tried market care,  government care,  Medicare,  Medicaid,  and a blending of the four- ObamaCare.  
We have tried blaming the doctors, the pharmaceutical companies,  the big insurers, the progressives, the insurers.
None of it has worked too well.    So now we have decided to step back and examine the real culprits – our genetic background – our age, race, education, sexual orientation, and gender - and  our lifestyles – what we eat, how much we exercise, some, drink, and sleep.
Doctors have known this for a long time – you cannot prevent or treat a chronic disease, or transform a life style or stop a bad habit– in a 15 minute office visit.   The truth is: what goes on outside the office or the hospital, not what goes on inside, that determines health  or stops a disease in its tracks.
Precision Medicine Initiative
The  Obama administration  finally recognizes this reality.  In concert with thousands of researchers, scientists,  physicians, clinics, data experts – the administration  has asked for million volunteer patients  , to join in a “precision medicine initiative” to collect information from questions, physical exams,  electronic health records,  DNA   and genomic analyses  and other sources to from a “precision medicine cohort.” 
The idea behind this $130 million federal initiative  to solve the mysteries of disease and why it occurs,  says Rhonda K.Trousdale, MD, an endocrinologist at Harlem Hospital  is 
“To use data to find correlations between peoples’ life style, family history, environment,  and genomic data – to figure out what factors contribute to disease and how they effect different populations in different ways.  That’s what precision medicine is all about.”
Bringing Together Various Players in Health System

I like this project.  It brings together all the players - patients, physicians,  investigators,  information technology geeks, politicians -  in our culture,  our health system, and our government in a conjoint effort.
And it takes advantage of the latest technologies- rapid reductions in the cost of high-throughput genomic sequencing, targeting  potential molecular targets for therapy,  particularly for killer diseases like cancer, diabetes, and cardiovascular disease.  
It uses widespread access to iphones and other devices to  makes it possible to collect data form patient volunteers.   The initiative empowers clinicians, patients, and investigators to work together  towards more personal care  to improve outcomes.
This initiative may take 10 years to bear fruit.   But it is bipartisan,  recognizes the realities of genomics,  life style factors, and genomics in the evolution of disease, and emphasizes factors beyond what occurs in hospitals and doctors offices, which treat diseases after the horse  has left the barn  and have little control on what happens outside the barn.

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