Modern medical technology is revealing the secrets of the human genome at an accelerating rate, and also making it possible to give patients anywhere intensive monitoring once available only in the hospital.
But translating medical technology into medical practice has fallen far behind, says Samir Damani, a Scripps Clinic cardiologist. Damani has co-founded a company called MD Revolution to close that gap.
Damani said the company personalizes medicine to the individual, something that advances in genomics is supposed to provide, but hasn't materialized. Genomics refers to the complete set of DNA in an individual.
"Medicine lacks plasticity, and the average technology takes 15 to 20 years to (enter) clinical practice, and we can't afford to do that anymore," Damani said.
MD Revolution, which opened this month, offers customers intensive workups and tests to guide them in staying healthy, Damani said. These are developed with Damani's clinical experience with patients, augmented with a team of specialists and including everything from nutritional consulting to health apps for the iPhone.
Colleagues at the company include board member Nicholas Schork, director of bioinformatics and biostatistics at the Scripps Translational Science Institute, which combines personalized medical with digital technology..
Customers can select from three programs, called DNA-Fit, DNA-Select and, at the high end, DNA-3-Day. The cost ranges from roughly $2,000 to $10,000, depending on the choice of programs. Some of the cost goes to devices that customers are given to assess their progress and gather data that's emailed back to the office. For DNA Fit, for example, the devices include a heart monitor and iPod Touch.
MD Revolution also gives customers a report in electronic form on a USB drive. The genomic information is not linked to the medical records, Damani said, so it's kept confidential. Customers have the option to share this information with their regular doctors, if they choose.
Equipped
Once they've been examined initially, customers have the option of a virtual office visit via teleconferencing.
"You can meet with me through Skype on ITV or on Facetime on your iPhone," he said. "These are the kinds of technologies that are built into the practice."
While the programs aren't now covered by insurance, Damani said he expects they will eventually be, because they are scientifically valid approaches to preventing and managing health problems.
The programs include a scan of customers' DNA to find disease predispositions and how they metabolize drugs. The higher-end programs include a more complete genomic report, medical imaging, metabolic testing and more extensive monitoring of vital signs and activities.
Damani said the programs aren't meant to steal customers away from their regular doctors, but to help the patients stay healthy, and to help the doctors help their patients stay healthy.
For example, customers can get a personalized exercise regimen that's crafted to their own physiology. And the intensive examination can detect a wrong diagnosis.
Bringing in science
"My first patient was a 75-year-old gentleman who thought his heart was going to explode," Damani said. "He was diagnosed with Parkinson's disease but did not really have Parkinson's disease. He had a bad tremor and he had something called orthostatic hypotension, where he gets really light-headed because his blood pressure drops. We took him off the medication, but he had never really exercised at the level he should have."
Testing found that the man had a low metabolic rate, so he was given instructions on how to perform interval training. He also received a wrist monitor that tracked his heart rate. The patient emailed the information from the device to MD Revolution, so doctors could check on how he was responding to the exercise.
"There is a science to exercise, there is a science to nutrition, there is a science to genomics" Damani said. "There's a lot out there that's being under-utilized because our system doesn't allow us, as physicians, to use these because of time constraints. You cannot see 20 patients a day and be able to provide some of these tools."
Source:NCT
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