Welcome back to The Future in Five Questions, where this week we spoke with Dr. Leroy Hood — a pioneering biologist who developed scientific devices used in the Human Genome Project, and which helped with the fight against HIV and AIDS, among numerous others. Hood, co-founder of the Institute for Systems Biology, has co-written a new book on the future of medicine titled “The Age of Scientific Wellness” that describes how, with advancements in genetics and artificial intelligence, hospitals are vastly increasing the number of healthy years in patients’ lives. Here he talks about his vision for “big data-driven health” and how it could revolutionize the health care industry, the psychological impact of longer lifespans for humans, and the earthquake AI has caused in health. The following conversation has been edited and condensed for clarity: What’s one underrated big idea? Few in the contemporary health care system realize that "big data-driven health" will transform health care from its current focus on disease care to wellness and prevention. Today, one can follow the health trajectory of each individual, assess it with a data-driven approach, and then optimize individual wellness and prevention. This has been partially validated by the data generated (and analyzed) from a four-year genome and longitudinal phenome analysis of 5,000 individuals that led to hundreds of “actionable possibilities”, each of which could improve individual wellness or prevent disease and has led to more than 25 scientific papers. The genome is the “source code” of human development, and the phenomes are the interplay of individual life behaviors and one's environment that lead to specific characteristics as measured by blood analyses, the microbiome and digital health devices. The nonprofit Phenome Health is proposing a million-person, government-funded, 10-year genome/phenome project — a second Human Genome-like project — to demonstrate that all individuals will have an enormous increase in health and this approach will lead to the avoidance of chronic diseases and hence trillions of dollars of cost savings for health care. What’s the technology that you think is overhyped? The technologies I’m interested in aren’t overhyped, rather they are under-resourced. The million-person project will fund phenomic technologies and thus have the ability to bring their cost down 1,000 to 10,000-fold, just as the Human Genome Project catalyzed a 10 million-fold decrease in the cost of DNA sequencing. These changes will require imaginative new approaches whose roots are embedded in nanotechnology, powerful new imaging techniques, dramatic advances in digital health devices, and the ability to more effectively read the enormous amount of information available in the blood — making blood a window into health and disease. What book most shaped your conception of the future? “The 100-Year Life” by Lynda Gratten and Andrew Scott, which explores the psychological and sociological issues one needs to consider if one lives for 100 years. In taking a systems view of health care, I argued in the early 2000s that it should be predictive, preventive, personalized and participatory — “4P” health care. The first three Ps have to do with science, and the fourth has to do with education, psychology, sociology and economics. It’s about persuading patients, physicians, health care leaders, health care technology leaders, regulators, politicians and the like to accept data-driven health care that leads to optimizing wellness and preventing disease, thus enabling the 100-year life. What could government be doing regarding technology that it isn’t? In health care one of the most important advances would be to support the development of phenomic studies assays that are global, multi-dimensional, miniaturized, parallelized, automated and cost-effective. The million-person project discussed above, if initiated, will provide an opportunity for the government to support phenomics to create new and more effective measurements, as was done for the Human Genome Project on DNA sequencing. What surprised you most this year? The evolution of the emerging power of AI and its potential ability to transform our capacity to analyze and utilize the enormous complexity of phenome measurements on individuals. For example, there’s the revolutionary potential of knowledge graphs, mapping to graphs the inter-relationships of most of the information in the medical literature. There are digital twins, creating in silico representations of human homeostasis with regard to chronic diseases like Alzheimer’s disease and diabetes and even human wellness, with the ability to make millions of virtual humans to test hypotheses derived from big data. And there are large language models like GPT-4, that with proper education will have the ability to take the complexity of an individual phenome and analyze its deficiencies and ascertain what actionable possibilities are necessary to move the individual back to normal homeostasis and then to send these on as prioritized actions to the individual’s physician for follow up. Collectively, these will transform our ability to deliver wellness and prevention to individual patients.
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