Defining the Future of Medicine

Prevention plans tailored to the individual and an interdisciplinary approach to patient care will be key, says new health chief

For more than three-quarters of a million people, the front door to the University of California, Irvine leads into a doctor’s office.

That’s how many patients visit a UCI hospital or clinic each year. The billion-dollar health enterprise includes UCI Medical Center, various clinics, the medical school, and programs in nursing science, pharmaceutical sciences and public health. It plays a primary role in ensuring the health of the Orange County community, but like so many other hospital systems, it faces challenges from a radically changing and competitive national healthcare system.

To meet those challenges and to infuse UC Irvine Health with a new vision and purpose, Dr. Howard Federoff joined UCI in July 2015 as the vice chancellor of health affairs and dean of medicine. In January, he also became CEO for UC Irvine Health (and stepped down as dean), making him – for all intents and purposes – the “top doc” in Orange County.

Federoff is also a prolific scientist and inventor. His work has led to 25 patented technologies, and in 2012, he was elected a fellow of the National Academy of Inventors.

Federoff talked with UCI Magazine about the future of UC Irvine Health, both as an academic medical center and as a national leader in integrated, high-quality and affordable care for everyone.

“I want us to continue to be recognized as the provider of choice for high-quality and affordable care. And we want to go even further.”

Q: Looking back, how did you choose to go into medicine? Did you grow up dreaming of being a doctor?

Federoff: I was particularly good at science and math and pursued those. When you have a family member who had a stroke, such as my maternal grandmother, and my dad, who died of colorectal cancer at a very young age in his 50s, I began to merge my interests and realized there might be an opportunity for a successful career in medicine. Those life experiences and my commitment to science made clear that I would want to be both a clinician and a scientist, and ultimately, I pursued both an M.D. and a Ph.D.

Q: As a researcher, you’ve made a number of advances in the areas of neurodegenerative diseases and gene therapies, and your discovery of blood biomarkers to predict Alzheimer’s disease received wide attention. How is that work going?

Federoff: When I was with the University of Rochester, we envisaged neurodegenerative diseases, such as Alzheimer’s and Parkinson’s diseases, as a group of entities that had peripheral manifestations – those outside the brain. We began our work to define these peripheral biomarkers and discovered that we could predict, with considerable accuracy, who among our seniors would progress to Alzheimer’s. We continue this work and now also study peripheral measures in Parkinson’s patients and those suffering from traumatic brain injury. The larger goal is to develop clinically useful tests that can guide the development of new treatments.

Q: As CEO, what are your objectives for UC Irvine Health to continue being the healthcare leader in Orange County?

Federoff: UC Irvine Health is the only academic medical center in Orange County, and I want us to continue to be recognized as the provider of choice for high-quality and affordable care. And we want to go even further. To do this, we are looking to develop new and better ways to deliver care. The principle distinction between us and other community healthcare entities within the county is that we actively conduct research, which means those individuals who are delivering the highest quality of care are often in the vanguard, where the research is being conducted. So one will have access to investigational modalities that will only be found at UCI – and not at community hospitals. We are defining the future of medicine.

Q: And what is this future of medicine?

Federoff: I see it as precision prevention, a model in which medical and lifestyle decisions like diet and exercise are tailored to the individual patient and diagnostic and genetic testing is used to identify and prevent possible future health issues. It’s really broadening the context of precision medicine, and our goal is to improve the health of the community.

Q: You’re also charged with starting nursing, pharmacy and population health schools. How will these three schools fit in with your overall vision of health affairs at UCI?

Federoff: Part of this future of healthcare involves team approaches that draw upon a wide array of expertise, such as those to be developed in our new schools. It’s exciting to be on the ground floor to create a platform de novo that integrates nursing, pharmacy and population health with medicine into a synergistic healthcare enterprise. We can help define and drive this comprehensive team approach to patient care and, when successful, share our best practices with other entities nationally and globally.