to some extent our national identity now includes health care innovation as a component.”
Mr. Shah introduced the panelists as “three experts on the topic of translating research and clinical insights into innovations,” beginning with Dr. Frank Douglas. Dr. Douglas had recently arrived in Ohio from Boston, where he was the founder and executive director of MIT’s Center for Biomedical Innovation.
Dr. Douglas acknowledged at the outset that “this is actually a very broad and difficult topic,” so that instead of trying to cover all its aspects, he would focus on one movement that has “everything to do with biomedical research and everything to do with how we manage our health.” That movement has been called “personalized health,” and includes a greater emphasis on prediction and prevention. He said he was one of a group of experts who participated in preparing a “Personalized Health Manifesto,” written by David Ewing Duncan, director of the Center for Life Science Policy at the University of California at Berkeley. This “manifesto,” and Dr. Douglas’ talk, both emphasized some of the “gaps” that exist in current health care, and the need to implement a new epoch of personalized health.
Toward a More Integrative Approach
Some of those gaps derive from our custom of looking at patients from an illness perspective, said Dr. Douglas, rather than a wellness perspective. He said that it was the historic strategy of the pharmaceutical industry to look for “one-pill-fits-all” solutions, a reductionist approach as opposed to an integrative approach.
A major gap, he said, is the mismatch between the “biological space and the chemical space.” Scientists have become very skillful in chemistry—making many kinds of small organic molecules that can be used to “fill any structure space you can think of.” On the biological side, however, especially concerning proteins and other large molecules, much less is known; definitive molecular structures are elusive because it is so difficult to discern the crystal structure of large molecules. “So although genomics has enabled us to identify potential targets for therapy,” he said, “without knowing the structure of these enzymes or proteins and often membranes, it’s very difficult to develop and market small organic molecules as agonists or antagonists to those targets.”
A second gap in biomedical research, Dr. Douglas said, is the activity of pathways. We now know much more about biochemical pathways and signaling pathways, he said, but we have barely begun to put together the maps