Posted on 09/06/2013 at 10:36:15 AM by Student BloggerBy Kathryn Coakley, MS RD
When was the last time you scheduled an appointment with your healthcare provider without a concern? A “healthy physical” seems like an unrealistic concept to most American adults who are pressed for time and motivation—after all, what can medicine provide in the absence of disease? Enter predictive health, the process of assessing a patient's genetics, environment, and lifestyle, calculating the probability of developing disease based on a risk profile, and tailoring recommendations to each individual. The process of monitoring risk factors before disease onset will require resources, but a preventative approach to healthcare may save serious spending—$218 billion per year—compared to treating after the fact. Predictive health has the potential to save health and money, but is our infrastructure capable of implementing personalized medicine?
The answer is yes. Emory's Predictive Health Institute has applied and evaluated a model of predictive health through its Center for Health Discovery and Well Being by enrolling a cohort of healthy individuals and following them prospectively. The Center's model of “wellcare” is built around the concept of a Health Partner, an individual rigorously trained in nutrition, physical activity, motivational interviewing, interpretation of test information, and objective goal-setting in building a personal health plan. Each Health Partner meets with participants on a regular basis to provide motivation, information, and resources to keep health in check. During meetings, body composition, dietary intake, and a multitude of blood tests are performed. Results are synthesized by Health Partners and presented to participants with suggestions of how to apply results to manage and improve health. This personalized approach to healthcare is geared towards identifying signs of “unhealth” prior to the onset of disease.
Predictive health cannot be delivered without the Health Partner interface. The interpretation of risk factors and probability of disease development to individuals is critical in the predictive health framework. The U.S.'s current training system largely funnels healthcare professionals into specific fields—medicine, dentistry, nutrition, nursing, therapy—instead of fostering an interdisciplinary approach. A change in training and professional education may accompany the paradigm shift to predictive health, but in our overburdened health system, who assumes the Health Partner role?
Nutritionists and dietitians receive cross-disciplinary training by nature of the profession and are well-versed in disease development, prevention, and management. Those interested in community and public health, research, teaching, or consulting dietetics as defined by the U.S. Office of Personnel Management may be particularly well suited to unique, integrative roles in predictive health. As predictive health transitions from idea to reality, responsibilities of Health Partners and those serving as liaisons to the public will become more refined. Nutrition professionals from clinical dietitians to research scientists may wish to jump at the opportunity to assume these roles and greatly impact an exciting new field and the future of medicine.