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Precision Health at MSU and Beyond: Shifting the Paradigm of Healthcare from Reactive to Proactive

Professor Anna Moore presented her latest research and vision for the Precision Health Program during a presentation to the MSU Board of Trustees on October 25, 2019.

Video transcript below:

Stephen Hsu: Our speaker today is Dr. Ana Moore. She was recruited under the Global Impact Initiative, joined Michigan State in 2018 as Professor of Radiology and Physiology in the Department of Radiology, in the College of Human Medicine. She’s the director of the Precision Health Program and the Assistant Dean in the College of Human Medicine.

Prior to joining MSU, she was Professor of Radiology at Mass General Hospital and Harvard Medical School and Director of the Molecular Imaging Program there. Dr. Moore is recipient of multiple grant awards from NIH and other funding agencies. She’s published her work in the most prestigious journals including Nature, Nature Medicine, Nature Biotechnology, Proceedings of the National Academy of Sciences and others.

She received multiple national and international awards, including a Distinguished Investigator Award from the Academy of Radiology Research and an Outstanding Teacher Award from the International Society for Magnetic Resonance in Medicine.

She served as a member of the board of trustees of the World Molecular Imaging Society and for her service to the society, Dr. Moore was elected as a fellow of the World Molecular Imaging Society. We’re very happy to have her at Michigan State and I’m sure you’ll find her presentation very interesting.

Anna Moore: Thank you. Good morning, members of the board. Good morning [inaudible 00:01:31] Stanley. Thank you so much for this opportunity to share my research with you and my vision for changing and shifting the paradigm of healthcare in the state of Michigan.

So I’m a new person here, so I thought the first slide, I just want to say a few words about myself and where I came from. So I graduated from MSU and there is a reason why you don’t recognize this picture because this is actually Moscow State University. Department of Chemistry, my home department, the arrow there.

So I received my undergraduate and graduate degree there and then I moved to across the globe to Massachusetts and started my postdoctoral fellowship at Mass General Hospital, Harvard Medical School, where I spent 27 years of my life. And finally all roads lead to MSU. So here I am, Michigan State University, trying to apply my knowledge, my experience, my life experience to developing a precision health program here at MSU and in the state of Michigan.

So one question is, what’s the difference between precision medicine and precision health? So precision medicine actually represent a reactive approach to medicine and to healthcare. It’s when the patient is sick and the doctor has to react, the doctor has to treat the patient. So what we really need to do is to re-shift our focus to proactive approach to medicine and focus more on prediction, prevention and early detection.

If we do that, we can improve outcomes and reduce the cost of health care. So in the next slide, which is probably the central slide of my presentation, I want to introduce to you components of precision health. So precision health starts at birth and we propose to do a genetic screening of each individual, like I said, preferably at birth or even earlier. And taking into account family history and socioeconomic factors, specifically because they’re different in different counties and different regions, to produce a risk assessment for each individual.

And based on this risk assessment, we propose to do customized monitoring of each individual. What it means is that if the person has a risk for breast cancer, the person should be monitored for early signs of breast cancer. If the person has risk for Alzheimer’s, early risks for early signs for Alzheimer’s.

So, but at the same time, if the person doesn’t have any risk and lives a healthy lifestyle, we’ll also need to do monitoring. And for that, we’re developing smart home solutions, smart kitchens with smart refrigerators, that would advise on your menu, smart bathrooms with smart toilets that’s going to measure your output, smart bedrooms with smart mattresses.

So this will all leads to early detection and better outcomes. But what’s even more important, we need to think how to bring those devices, how to bring those innovations to communities that are underserved at the present time, the community in the rural areas that are hard to reach.

So at the end, we want to make our healthcare really location agnostic and make sure we can reach each individual in the state of Michigan. So these devices and these wearables and other smart gadgets will necessarily produce a large amount of data. So the next component is actually big data analysis, where we use artificial intelligence methods, machine learning, predictive modeling, and the latest thing that’s called digital twin, when the computer basically creates a digital replica of your body.

And based on the information that received from devices, can tell what’s going to happen with the organs in your body over the period of time. Now precision medicine, like I said, is a part of precision health, and include precision Nanomedicine, precision imaging, in vitro diagnostic, biomarker discoveries. We do it in clinic, but mostly we do it at the bench.

And I just want to give you two quick examples of how we do that. We know that 90% of deaths from cancer happen from metastasis, not from primary cancer because metastatic cells are anatomically physiological morphologically different from primary cancer. At the same time, metastasis are treated in clinic pretty much like primary cancer, which is really not the right approach.

So when I was at Mass General, we discovered the component in metastatic cells that’s responsible for their survival and can be targeted and inhibited to kill those metastatic cells specifically and precisely. You can look at the image on the bottom of the screen. Those are two mice over the period of time. Mice on the left were treated, they had metastasis, they were treated and as you see, metastasis disappeared.

The mice on the right hand side, were not treated and you can see the spread of metastasis to the contralateral side, into the lungs. So now I am really blessed to be here at MSU, where we have a College of Veterinary Medicine, where we can bring those studies a step up and test them in companion animals with spontaneous disease with spontaneous mammary carcinoma.

And you can see our first study is in companion cats, we were treating an animal with metastatic disease. Another example is coming from a Dr. Morteza Mahmoudi that I just recruited from, also from Harvard, from Brigham and Women’s Hospital, who is working on nanotechnologies, where in the drop of blood you can not only detect the disease but also predict the response to therapies.

So all these things we do at the bench, not just to satisfy our scientific curiosity, there is the element of that as well, but to really translate it into clinic and to elevate suffering of the patients. So as I told you before, the later the disease is detected, the worse is the outcome. This is an example for different types of cancer. You can see the survival goes down. And that actually lead, not just for cancer but for other disease, to really lower life expectancies for the population.

And when I saw this map, and maybe some of you saw this, for the state of Michigan, I was really disturbed by that. There is really an uneven distribution of the life expectancy in the adjacent county. You can see in the Detroit area, there’s adjacent counties where life expectancy is almost 10 years different. This is really bad, I think. We need to work to improve that. And I declare here that MSU is uniquely poised to lead the transformation of healthcare in Michigan.

We have multiple examples of outstanding [inaudible 00:00:08:04] have been recruited and actually been working at MSU, spending the research from preclinical to translational and finally, clinical. We have dedicated facilities, we’re really happy to have a new Institute for quantitative health scientists, a new building that was also built right across from it where my program moved just a few weeks ago.

And I want to thank the board and the administration of the university for giving us the opportunity to work in those beautiful new facilities. The state wide footprint of Michigan State University Healthcare is very important, where we can reach rural communities and underserved populations and our colleagues are working there relentlessly and they have our full support.

We also have experience in managing critical healthcare issues and those of you who work in Flint know how hard it is and we really support our colleagues in Flint and other areas that require really hard work to improve lives and health of our population. So we believe that all this effort will lead to highest impact, not only at Michigan State University, bringing our research up, but also in the state of Michigan.

Early diagnosis would lead to improved outcomes and this is again, example for cancer. Hopefully we can lift up survival rates if you have early detection and also that would lead to increased life expectancy across the state. How do we do this? We’re building collaborations and partnerships in research areas with multiple departments, multiple colleges in Grand Rapids area and also outside of MSU, with our colleagues in other universities, in other states and even in other countries.

We build our collaborations, partnership with our clinical colleagues in the hospitals. We’re really happy to know that we’re going to see soon a brand new hospital, McLaren Hospital, hopefully become our partner as a university medical center. The Karmonos Center that will bring its branch to East Lansing, where we can do our clinical trials and receive samples right from the operating rooms. This is really, really exciting.

We’ll build our collaborations with industry who understand that we’re here to serve our patients. And this is just a very quick example that collaborations with Siemens already resulted in a donation of a PET/MR system. It’s a clinical system, which we’ll use here for imaging large animals and hopefully for clinical trials and small animal systems that were donated by PerkinElmer, for the amount of $5.7 million, at no cost to the university.

So and finally, this beautiful area that now we call Biomedical Research Complex. So BRX at MSU has brand new buildings and IQ Institute and a new building again, where my program just moved and this is an unprecedented opportunity for us to establish precision health headquarters and make sure that we implement this program. And I believe that precision health is the future of healthcare and that would lead to a healthy Michigan and beyond. So thank you so much for listening to me. I’ll be happy to take questions if you have any.

Speaker 3:  Questions for Dr. Moore, so maybe I’ll just make a comment. It’s been amazing, I think we’ve been talking about precision medicine for some time and we’ve had these extraordinary technical breakthroughs and as you know better than I, in terms of sequencing, in terms of imaging that have allowed us to visualize and analyze data in ways we haven’t before.

But it’s wonderful for me to see it being actually practically applied and particularly in the issue around healthcare disparities, which I think is one of the major challenges we face. And we talk about one of the roles of colleges like and universities like Michigan State, is really to make a difference, to really tackle the big problems and make a difference and bring multiple disciplines together to do that.

So your slide, where you showed everybody who’s participating in this, I think is particularly inspirational. So I’m very excited about the work you’re doing. So glad you came from a place I’ve visited briefly, MGH, and came here. And again, we’re excited about the work you’re doing and look forward to working with you. Thank you for being here today.

Anna Moore: Thank you.

Speaker 3: Thank you.

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