Marshfield Clinic: Redefining medicine, one person at a time
By Kris Leonhardt
MARSHFIELD – The Marshfield Clinic Research Institute is among a group of medical and scientific organizations collaborating in a nationwide research project called “All of Us.”
All of Us is building research toward precision medicine, a new method to address disease treatment and prevention that takes into account a person’s lifestyle, environment, and genetic makeup.
“It’s a national effort to recruit a million people to develop precision medicine research,” said Dr. Murray Brilliant, who serves as the principal investigator for All of Us Wisconsin. “This research in precision medicine will then be used to power where we are going and how we are going to transform health care into personalized precision-type medicine.
“In order to do that, we have to have large amounts of data, so we can account for individual differences between people and how that contributes to their health and well being. In a million people, things that are present even in only one in a thousand; in a million, there are a thousand cases of that. So, we can learn even something as rare as one in a thousand, what is the best treatment, what contributes to people having this particular disorder, how can we prevent it, and how can we best take care of it.”
Brilliant said that Research Institute’s personalized medicine project was a precursor the center’s involvement in the project.
“This has actually served as a model for this precision medicine initiative,” he said. “We have 20,000 people in the personalized medicine research project, and we’ve come up with, really, hundreds of study results and publications, and even novel treatments – potential novel treatments have come out of that research using only 20,000 people. So, we think that expanding this type of research to a million people across the country will be quite the transformative event for the future of medical care.”
Marshfield Clinic will partner with other organizations to secure the needed demographic for the study throughout the state of Wisconsin.
“Here at in the Marshfield Clinic Health System network, we are looking to recruit about 33,000 people, but across the entire state of Wisconsin, we are aiming to recruit 100,000 people,” Brilliant said. “In order to do that we’ve partnered with colleagues at the University of Wisconsin at Madison and Medical College of Wisconsin in Milwaukee and BloodCenter of Wisconsin that has hundreds of locations throughout the state. So, our network covers the entire state of Wisconsin.”
The All of Us research program is open to individuals 18 and older that live in the United States that are willing to come forward on a volunteer basis, and Brilliant added that diversity is very important.
“If a person joins, we will actually have information about people just like them,” he added. “The program is called All of Us. We want people to have the opportunity to join as they like. We want it to be representative of the population of the United States. Here, in central Wisconsin, we have a large rural population that has traditionally been underserved in biomedical research and the benefits of that research (are great.) If we don’t have participants like people here, then we won’t have data on how to help the people like we have here. If a person doesn’t join, then we don’t have information about people just like them, and we can’t help people just like them.”
Brilliant added that the central Wisconsin population is unique as there is not a large mobile population and the Marshfield Clinic Health System was one of the first health care systems to employ electronic health records.
“Marshfield Clinic has been in business for more than 100 years now, so our records go back more than 100 years – electronically 30-35 years,” he said. “This is a really rich source of data. When you have longitudinal health records like that, we can actually look at, and try to identify the earliest signs of disease, the earliest signs that a person is on path to have a disorder, and if we can recognize those things at a very early stage, we can actually employ methods to prevent disease.”
Project Manager Lisa Kunst said the program started recruitment in February 2018.
“We are going to be recruiting for at least the next five years. We are going to expand to other centers,” she said, stating that the program had been focusing on the Marshfield area.
“It’s definitely a long-term effort, and we are still ramping up.”
To become a participant in the project, the enrollment process requires online registration which includes three surveys, followed by an initial visit where the participant will have measurements taken, a blood draw, and a urine specimen.
“We are not asking people to come in more than that initial visit currently,” Kunst said.
“What we do ask people to do is stay engaged with us on an ongoing basis. This project is longitudinal, so we are looking at a 10 year or more period of time that we will want to stay in touch with people.”
She added that future survey information may be required, which can be completed online.
Through the All of Us project, facilitators hope to redefine the future of medicine, by looking at the individual more closely.
“We will have so much more information on how to treat people as an individual, rather than just throwing medicine that worked for someone else that was nothing like them and crossing your fingers hoping it works,” Kunst said.
For more information on the project or to register, visit JoinAllofUs.org.