UNIVERSITY HEALTH SCIENCES COUNCIL STRATEGIC PLAN Thematic Foci: Health Vision: Promotion of quality of life through personalized health. Rationale/Background In the next five years, Penn State will harness its formidable set of health- related resources to position itself to be a leader in personalized health. We define personalized health holistically, referring to physical, psychological and behavioral health. At the centerpiece of this vision, is understanding individuals in all their complexity, and the social contexts and physical environments in which they live and work, and leveraging that new knowledge to create innovative programs, policies, products, and practice for research, education, outreach and patient care that will improve health and well- being (see attached figure). Several trends point to the importance of personalized health in the decade ahead. Under the Affordable Care Act, Americans will be given increasing responsibility for managing their health; the complexity of health insurance offerings and health care options today requires an educated consumer to make thoughtful decisions and prioritize their own wellness. Likewise, pressures will intensify for health care providers to focus on disease prevention and reduce costly patient readmissions. Another relevant trend is the aging of the baby boom generation, a dramatic demographic development that has been likened to a silver tsunami that will put unprecedented pressure on a fragmented health care system. At the same time, scientific progress in the areas of omics (e.g., genomics, metabolomics, the microbiome), smart technology (e.g., sensors, accelerometers), and the analysis of big data (e.g., electronic medical records, intensive streams of data from devices, imaging data, social media, etc.) will enable health care providers and prevention scientists to pinpoint disease outbreaks geographically, tailor clinical treatment and health interventions to communities and individuals, potentially leading to more effective and efficient use of resources. The theme of personalized health is broadly applicable but it may be especially relevant for three groups: children, for whom preventing disease offers great potential; older adults, whose health problems collectively put the most pressure on health care resources; and vulnerable groups that may be disadvantaged in terms of access to care, the quality of care available to them, and the health and well- being they ultimately enjoy. Importantly, a focus on personalized health capitalizes on our highly collaborative, interdisciplinary research environment and builds on recent university investments in key areas such as genomics; infectious disease; real time collection of data on daily experiences, health symptoms, and environmental exposures; health disparities; demography and population health; and big data. Page 1 REV. 6/10/2015
Goal 1: Become a leader in interdisciplinary research on personalized health. We envision a continuum of research activity, ranging from basic to applied science, but where there is considerable overlap, a robust interdisciplinary conversation, and a consistent focus on better understanding the individual and the social contexts in which he or she lives (e.g., family, workplace, neighborhood) in order to improve health. Providing direction and momentum are three lead institutes: the Huck Institutes for the Life Sciences, the Social Science Research Institute (SSRI), and the Clinical and Translational Science Institute (CTSI). Building on recent investments in such areas as genomics and infectious disease, research initiatives from the Eberly College of Science (a proposed new Center for Evolutionary Risk Assessment and Management) and the Huck Institutes (PReAdapt, an initiative on Promoting Resilience and Adaptation in biological systems) will focus on understanding and combating rapidly evolving disease phenomena (e.g., infectious disease, cancers, drug resistance), areas also of interest to the Penn State Milton S. Hershey Medical Center s Cancer Institute and Center for Personalized Medicine. Complementing these initiatives, the College of Agricultural Sciences will focus on the continuum of processes linking healthy, disease- resistant crops and the development of functional foods to improving human and animal health. The College of Health and Human Development (HHD) will invest in research to better understand the role of the microbiome and its role in nutrition, as well as the biological mechanisms linking health- related behavior (diet, exercise, sleep, smoking, alcohol and other substance use) and stress to health outcomes. The SSRI brings expertise and infrastructure supports for real time, individualized collection and analysis of multi- modal data on daily experiences, health symptoms and environmental exposures, and, through its Population Research Institute, a population health focus that highlights health disparities and situates health in context. The Institute for CyberScience and other academic units share an interest in strengthening innovative methods that will advance these areas of scientific inquiry through the analysis of big data. Penn State s Institutes for Energy and the Environment (PSIEE), partnering with the Huck Institutes and relevant colleges, will focus attention on how the processes outlined above interact with environmental conditions that are rapidly changing due to climate change, urbanization, and the like. The University will also invest in activities that translate basic knowledge into programs, policy, products and practice, building on the knowledge generated from basic research of the kind outlined above. In this regard, we can leverage our multi- campus system and the presence of Cooperative Extension offices throughout the state to disseminate information and programs tailored to community contexts in which individuals live and work. The CTSI will play a key role linking the relevant activities, disseminating information to communities, and in turn relaying information about health- related needs in communities back to the various groups studying personalized health. The Penn State Hershey Institute for Personalized Medicine, in concert with the Hershey Cancer Institute, will take a multifaceted approach to developing clinical treatments tailored to each person s unique biological make- up, environmental and contextual conditions, disease predispositions, and history, an approach complemented by the College of Nursing s emergent focus on person- centered care. The College of HHD will create a new center focused on designing and evaluating personalized interventions to enhance health. The focus here is on combining data from smart technology such as sensors, accelerometers, and mobile health monitoring devices with other data about the individual (e.g., genomics, family support, Page 2 REV. 6/10/2015
social networks) to design, evaluate and refine personalized interventions. The College of Engineering will work with all of the relevant partners to develop new devices and technologies to facilitate disease prevention and health promotion through real time environmental and health monitoring, feedback, and intervention/therapy delivery. Goal 2: Create innovative, interdisciplinary and inter- professional graduate and post- graduate programs that focus on personalized health. Research and graduate education go hand in hand. Having a vibrant cadre of graduate students and post- doctoral scholars will help pull faculty together from different academic units and different campuses around the theme of personalized health. The University Health Sciences Council (UHSC) will work with the colleges to create a dual- degree doctoral program and/or an academic minor focused on personalized health that will be of wide interest to graduate students. The UHSC will also work in tandem with the lead institutes to encourage faculty to submit innovative training grants to support graduate students and post- doctoral trainees and to bring faculty together across areas described under Goal 1. We also see great potential for an integrated interdisciplinary undergraduate minor in personalized health, building on the theme of health and wellness that is emerging in the revision of General Education. The development of new curricula will present opportunities to engage undergraduate students in mentored research and internship experiences. Building on Goals 1 and 2, we propose moving in two quite different directions to make an impact on health and well- being: Outward, to the Commonwealth (and beyond) and inward to our own faculty, staff, and students. Goal 3: Increase Penn State s engagement as a partner across the Commonwealth in improving the health of Pennsylvanians. Penn State will reach out to the Pennsylvania Department of Health to establish an ongoing, collaborative relationship. Pennsylvania faces many health challenges. For example, it has high rates of childhood obesity in some communities, ranks fourth nationally in the percentage of the population over age 65, and confronts significant health disparities in some urban centers as well as rural communities. The focus will be on developing relationships with communities to translate findings from research into programs, policies, practices and products that make a difference on the ground. In this regard we can take advantage of our geographically dispersed campuses especially in those settings where the Colleges of Nursing and Medicine are already seen as significant health resources. There may be opportunities to analyze state health data in innovative ways to address new questions and to help the state make funding decisions based on rigorous research evidence, as HHD s EpisCenter (http://www.episcenter.psu.edu/) does in the area of prevention science and the SSRI s Clearinghouse for Military Family Readiness ( http://www.militaryfamilies.psu.edu) does for military families. First steps are to catalog health- related groups at Penn State that have ongoing relationships in specific communities or geographic regions and to work with the Pennsylvania Department of Health on the nascent CIC Health Disparities Initiative. As the personalized health initiative gains traction, we envision a possible WPSU documentary on personalized health to bring attention to this important area, as well as outreach through conferences, Cooperative Extension programming, and social media. As we gain Page 3 REV. 6/10/2015
more understanding of the risks and needs of the Pennsylvanians, we can utilize this knowledge to help our state direct resources to where they are most needed. Many additional opportunities to work with communities exist in other parts of the United States and around the world, and the hope is as the evidence base accumulates, Penn State researchers will be in an excellent position to adapt programs, policies, products and practice to the needs of other communities and, in so doing, deepen the evidence base. Goals 4: To develop an innovative, multi- pronged, University- wide public health campaign to encourage faculty, staff, and students to focus proactively on their own health and wellness. We will treat the next five years as a public health campaign across all the Penn State campuses to increase faculty, staff and students engagement in healthy behavior (e.g., physical activity, healthy eating, less smoking) to promote health and prevent disease. Encouraging a healthier workforce will help Penn State curtail rapidly rising health care costs and improve faculty and staff quality of life. Creating an environment in which students receive consistent messages about the importance of making good decisions around health will prepare them for the world they are entering. The health campaign could also be a focus of research and projects for capstone courses, with each incoming cohort of students providing an opportunity to try new things and make the campaign more effective. Components of such a campaign might include: Offering technology solutions to monitor personalized health status. Expanding programs focused on positive health choices across the Penn State Commonwealth campus system that already exist - - for example, Kinesiology s Exercise is Medicine initiative, nutritional information, ban on smoking and reduction of alcohol use. Creation of a Wellness Clinic for faculty and staff. Working with Strategic Communications on branding and socializing the initiative. Supporting Strategies To become a leader in personalized health will require that the University make the most of its resources and make some strategic investments. Specific actions include: Tasking the three lead institutes (Huck, SSRI, and CTSI) with coordinating the research component of the personalized health initiative by asking them to envision personalized health as the shared space in their collective Venn diagram. Specific activities include proposing mechanisms to link investigators across the research continuum (and across campuses), proposing strategic investments to support the initiative (e.g., faculty cluster hires; conferences; internal sabbaticals; seed funds for pilot research and curriculum development). Charging the Office of the Vice President for Research (UP) and the Vice Dean for Research and Graduate Studies, College of Medicine to find better ways to link researchers at Penn State Milton S. Hershey Medical Center with colleagues at University Park and other campuses (e.g., housing options so that investigators can spend short or long stays at one another s campuses; mechanisms to share staff time; efficient ways to provide access to tissue samples and to patient populations). Page 4 REV. 6/10/2015
Charging subcommittees of the Academic Leadership Council, together with Student Affairs, Human Resources and other relevant units, to develop specific plans for the educational and public health campaign portions of this plan. Reinvigorating the University Health Sciences Council by charging that group to serve as the advisory council for this component of the University s strategic initiatives. Page 5 REV. 6/10/2015
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