Through discovery, treatment and implementation — along with the use of analytics and big data — University of Michigan researchers will soon advance specialized medicine and personalized health care.

The recently revealed Precision Health initiative — which University President Mark Schlissel announced at his Leadership Breakfast earlier this month — will combine several research areas across the University outside of medical disciplines to create a broad approach to optimizing the use of research data.

Aside from incorporating these different disciplines, however, Precision Health is partnered with the University’s Office of the Provost, School of Public Health, College of Engineering and Michigan Medicine.

Tina Creguer, Precision Health senior project manager, said the goal is ultimately to improve patient care in a way that addresses several misconceptions about precision medicine, an approach for protecting health and treating disease that considers other factors aside from an individual's own health, according to the Centers for Disease Control and Prevention.

“The idea is really to bring together multiple disciplines and expertise from across campus to address the issue of precision health,” Creguer said. “We specifically chose the name Precision Health because we are trying to incorporate many other factors than just medicine.”

Some of these factors include lifestyle, environmental, family history, social environment, genetics, which will all contribute to large amounts of data about individual health. The available and collected data will then allow disciplines like social work to take advantage of this work and come up with strategies for better patient care.

While the initiative is still in its initial stages, one project is already underway. With the opioid project, Creguer said, researchers hope to take an approach geared toward addiction prevention first — especially by more personally and precisely applying prescriptions to patient needs — before having to address addiction treatment.

"The project will examine ways we can predict how much pain medication someone will need, based on their individual genetic profile, physiological condition and social, environmental and lifestyle factors,” Schlissel said at the Leadership Breakfast. “This will allow physicians to tailor how they help individual patients manage their pain. … There is no better university in our nation to tackle a problem like this."

Precision Health Co-Director Sachin Kheterpal agreed, and said this particular project within the initiative allows researchers to utilize the resources that are available through the University’s 19 schools and colleges for maximum care.

“We wanted to make sure that we created an initiative that not only leverages those strengths but demanded them, and that’s one of the reasons why — in addition to the overall infrastructure and the overall science that we’re going to be funding using this effort — that we did pick one specific public health concern: the opioid misuse challenge that is currently going on,” Kheterpal said. “It’s one that demands the most out of Michigan.”

The Michigan Genomics Initiative — which just reached a milestone 50,000 participants, and is a big part of the research already being conducted for Precision Health — will continue to be expanded to diversify the population of the project’s sampling. Aside from the opioid project, mental health, cancer and metabolic disease remain of interest to researchers within the initiative for future consideration.

And while students are not yet involved, there are several plans to engage with student researchers on campus, Kheterpal said. For example, the initiative will be offering funding for additional research programs, developing curriculum through a certificate program and potentially some degree programs, and continuing education for practitioners.

Lastly, developing data and analytics tools that will allow researchers to easily access, use the information that is collected and eventually integrate this information into the field; all of which are priorities as well, Creguer said.

“There has been a great advancement of precision medicine, particularly in the area of cancer, so what we’re attempting to do is so much broader,” Creguer said. “There are lots of avenues we can go down, but we anticipate choices somewhere we can have large impact drawing on the resources we have here at the University.”

This initiative will not come without challenges, however; a need for infrastructure, computing power and capabilities, along with the desire to implement these findings into the field in a practical and applicable way will always have to be considered, Creguer said.

In addition, Kheterpal said there is a necessity to create appropriate levels of focus to ensure research doesn’t fail for the sake of working on too many projects at once, along with adjusting cultural expectations of medicine.

“There are cultural issues to be managed here related to the culture of health care, medicine and how we define the interaction between a health care system and the community that it serves,” Kheterpal said. “A lot of what Precision Health is about is improving the transparency of the information that we offer, improving the transparency of the data that we have when we make a recommendation to a patient. … That’s going to require some culture changes both on the part of providers who are giving that information and on the part of the patient or the health participant who’s receiving that information.”

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