A new kind of health careThe Emory/Georgia Tech Predictive Health Initiative is

being built through support from Emory University and

the Georgia Institute of Technology; the Robert W. Woodruff

Health Sciences Center Fund and other corporate, foundation,

and private philanthropy; industry partnerships;

commercialization of proprietary discoveries; and federal

and nonfederal research grants and contracts.

For information on how you can become involved with or help

support the Emory/Georgia Tech Predictive Health Initiative,

call 404-727-6543.

Emory/GEorGia TEch PrEdicT ivE hEalTh in iT iaT ivE

The end of diseAse, the beginning of a new kind of heAlTh cAre

Emory University and the Georgia Institute of Tech-nology have joined forces to create a new kind of health care—one in which planning for optimal health and longevity begins at birth and for which disease is no longer the primary focus. The Emory/Georgia Tech Predictive Health Initiative brings together clinicians, scientists, and engineers along with experts in public health, business, law, and bioethics, with a commitment to developing the bioscience that will enable this new definition of human health.

Predictive health is no longer a futuristic dream. At Emory and Georgia Tech, iT’s A work in ProGrEss.

The problem with today’s health care. Modern medicine de-

fines health as the lack of illness, and modern health care focuses

almost exclusively on treating disease. This focus has resulted in

numerous medical miracles but also in an unsustainable depen-

dence on increasingly expensive interventions that often negatively

impact quality of life. One third of the Medicare budget is spent

during the last year of life, and a third of that is spent in the last

month of life, often in expensive and ultimately futile intensive

care. Medical expenses and lost productivity because of illness are

the leading causes of personal bankruptcy. It is time to make health

care live up to its name: care for health.

The science to change it. In the

past, a focus on curing disease was

appropriate, given the limits of

biomedical knowledge and technol-

ogy. But today those limits are being

erased. Science, technology, and

sophisticated social inquiry are pro-

viding new knowledge and insights

on which to base a new kind of health care. Advances in genom-

ics have revolutionized our understanding of individual variation

in risk of disease and response to therapy. Existing technologies

can take pictures of the insides of our cells, with no pain and with

minimal inconvenience. Clinicians can launch molecular-sized

particles to parts of the body to scout for information or to alter

cell machinery. Bioinformatics can make sense of unfathomable

amounts of apparently disparate pieces of information. Growing

more powerful every day, such resources can be harnessed and

coordinated to make humankind healthier and to free societies

from the growing burdens brought about by our current approach

to health care.

The power of predictive health—and what is different at

Emory/Georgia Tech. Clinical biomarkers have long been used

to measure biologic processes in disease diagnosis and to track

the progress of an illness or a treatment. Biomarkers may include

levels of specific proteins in the spinal fluid, abnormalities in

brain chemistry noted during a PET scan, or blood counts that

track a patient’s white cells or platelets. Increasingly, clinicians use

biomarkers to try to detect disease before symptoms appear. For

example, high levels of PSA in the blood may indicate the pres-

ence of prostate cancer.

The Emory/Georgia Tech Predictive Health Initiative is build-

ing a new approach to defining and maximizing health by focusing

on a limited number of broad biologic processes and “generic”

biomarkers that underlie and characterize health itself. Detectable

alterations in these broad-based processes can signal the begin-

nings of disease. Rapidly growing technologies, from genomics to

proteomics and nanotechnology, eventually will allow clinicians to

detect these alterations and predict virtually all disease before it oc-

curs. Applying new interventions will restore equilibrium to these

biologic processes and prevent

progression to disease.

Some of these broad-based bio-

markers for health and longevity

are already beginning to be under-

stood. Members of the Emory/

Georgia Tech Predictive Health

Initiative are recognized interna-

tionally for their work in inflamma-

tion—which serves as a biomarker

for diseases ranging from athero-

sclerosis and cardiovascular disease

to cancer and Alzheimer’s.

What the initiative will do to make “health care” live up to

its name: DEVELOP the science and technology that will focus

biomedicine on quantitative definitions of health risk assessment

before alterations in biologic processes lead to disease. INVENT ef-

fective interventions that will decrease risk and interrupt processes

that will lead to disease, thus preserving health throughout life.

TRANSLATE this knowledge into a new system of health care that

is accessible and cost-effective and that provides individuals and

societies with the tools needed for optimal longevity, quality of

life, and productivity. INTEGRATE research, education, and clinical

care into a defined, dynamic program that sustains continual dis-

covery and translation of new knowledge. BALANCE these advances

with dialogue and consideration of the ethical, social, behavioral,

economic, and political issues they evoke.

Strength to make it happen: an Epicenter of Discovery

in predictive health. The Emory/Georgia Tech Predictive Health

Initiative, an integral component of Emory’s overall strategic plan,

builds on the long-standing partnership between Emory and Geor-

gia Tech, including its nationally ranked joint biomedical engineer-

ing department with expertise in areas such as nanotechnology,

imaging, and genomics. Other resources within this partnership

include a large and diverse patient population served by Emory

Healthcare; a systems biology program at Georgia Tech that uses

computer modeling to characterize metabolism at the cellular level;

and expertise in health care systems at Emory’s Rollins School of

Public Health, which together will enable the initiative to build

bridges between individual and population health. The initiative

also draws on faculty expertise in ethics, humanities, law, business,

health policy, and economics.

rather than focusing

almost exclusively on

treating disease, health

care must live up to its

name: care for health.

A story of predictive health It’s 2015, and Heidi Smith has just entered the world at Emory Crawford Long Hospital. She weighs 7 pounds, 6 ounces, has damp curls and a gusty cry, and seems in every way a perfectly healthy baby.

Within 24 hours, a blood sample is taken and analyzed for hundreds of proteins. This analysis gives doctors a picture of her health status and risk for future disease. From this, they identify the basic biomarkers that characterize good health as well as deviations from these biomarkers that could signal problems to come.

Heidi’s biomarkers indicate some risk of arthritis. The Smiths are told that their baby is indeed healthy,

but the predictive health physicians would like to follow her over the next few years to watch for further indica-tions of eventual juvenile, rheumatoid, or adult-onset arthritis. By age 5, it is clear that without intervention, she will develop crippling rheumatoid arthritis by the time she is a young woman. She is put on a regimen of exercise and drugs—and the disease never happens.

This means that Heidi avoids hundreds of thousands of dollars in medical bills over her lifetime, using her money instead to put two children through college and graduate school. She does not have to retire early from her job as a high school biology teacher because of crip-

pling pain and swelling in her joints. At 68, she is able (sometimes) to

beat her granddaughter in tennis. And she anticipates a long and healthy old age, just as her clinicians predicted.

researchers are study-

ing “generic” biomarkers

that characterize good

health. They seek to

detect early alterations in

these biomarkers so they

can intervene to restore

equilibrium and prevent

progression to disease.