Health Care Is Getting Personal
A study of “digital twins” marks a new Miller School center’s first step toward becoming an engine of change
By Samantha Richter
Illustration by Jacey
W
hat if we were able not only to predict which treatments or therapies might produce the best outcome for a patient, but also to test those predictions before administering treatment? Could we make the promise of precision medicine a reality? Could we harness clinical insights from thousands of individuals to improve overall population health?
Azizi Seixas, Ph.D., research associate professor of psychiatry and behavioral sciences at the Miller School, is aiming to answer these big questions. He is disrupting the digital health and technology worlds with an ambitious research project to create a “digital twin” — an individual’s digital health proxy — to test treatment protocols and therapies before they are used with the patient.
The project, named the MILBox, is the first from the Miller School’s newly established Media and Innovation Lab (The MIL). It is comprised of a digital box, which serves as a launchpad for apps, solutions, content, wellness resources and data, and a physical box that gets sent to study participants’ homes. The physical MILBox contains the most cutting-edge patient-worn and in-home devices on the market, such as an ambulatory blood pressure monitor, an actigraph to measure sleep and wake cycles, a smart scale and an air quality device, as well as a mobile phone to securely transmit data to the cloud. The components of the boxes are selected based on the participant’s initial health screening, providing an even more personalized profile.
Unique, Like a Fingerprint
The wearable technology and smart home devices will obtain the participant’s biological, clinical, behavioral and environmental data that will be used to create the digital twin. The longitudinal data, collected over seven consecutive days, will be combined in a biological health algorithm that is unique to the individual, like a fingerprint. This algorithm essentially serves as a digital twin of the individual, allowing health care practitioners to employ artificial intelligence to virtually test and evaluate various treatment options and potential outcomes before applying them in the physical world.
“The digital twin pro-gram is an opportunity to revolutionize how data is captured and utilized to better inform treatment teams about the health and well-being of their patients.”
“The digital twin program is an opportunity to revolutionize how data is captured and utilized to better inform treatment teams about the health and well-being of their patients,” Dr. Seixas said. “Our approach to obtaining holistic, longitudinal patient data is designed to overcome the gaps and data drop-offs that have limited these kinds of efforts until now.”
Based on his earlier research funded by the National Institutes of Health, Dr. Seixas will initially examine the connection between poor sleep and serious health conditions including heart disease and dementia. He hopes to recruit a diverse group of 1,500 participants — especially those from traditionally underserved communities or communities of color. The first participants were enrolled late last year.
Easing Burdens in Underserved Communities
At a time when access to the latest innovations in health care is often limited to the few, Dr. Seixas’s vision is to provide affordable, quality and accessible health care and wellness to all. The health disparities in underserved communities are undeniable: While average life expectancy is increasing, it is decreasing among racial and ethnic minorities, the under- or uninsured, and low-income families. As health care costs continue to skyrocket, these communities are suffering consequences such as limited or no access to care, high disease burden and premature death.
“Digital twins will help make health care more personal,” Dr. Seixas said. “We can demonstrate to an individual how changes in behaviors, treatment compliance and other common interventions will impact them using a model of themselves that takes into account who they are, the environment in which they live and the lifestyle choices they make. We evolve from providing generic advice to demonstrating how various factors are intricately interconnected. At its core, precision medicine is personal medicine.”
From Silicon Valley to Silicon Beach, health-tech organizations are eager to partner with Dr. Seixas. The data collected from the MILBox will be analyzed using machine learning, powered by Amazon Web Services. Open Health Network, a company in Mountain View, California, will manage, process and protect the data using its proprietary technology platform PatientSphere 2.0. The platform is a personalized, fully HIPAA-compliant care coordination management system that will support the MILBox app on the user’s smartphone, maintain the cloud-based data acquisition system, manage the data analysis and construct the digital twin algorithm.
“The ultimate goal is to be regional, national and global leaders in digital health technology and innovation, with a special emphasis on making these solutions accessible to all,” Dr. Seixas said.
A Training Ground for Providers and Researchers
The MIL extends the Miller School’s mission to provide world-class clinical care, innovate medical education, conduct groundbreaking research and provide impactful community outreach. As an integral part of the Miller School, it will serve as a training ground for the next generation of compassionate health care providers and visionary researchers, and serve the University’s mission to promote health equity throughout South Florida and beyond.
The MIL will focus on five key components of academic medicine, including medical education, clinical care, research, community service and outreach, and venture opportunities. With these pillars in mind, The MIL will serve as a locus for learning, collaboration and investment in the emerging technologies, systems and solutions to shape the future of health care. Additional projects include building state-of-the-art digital therapeutics and innovative solutions to improve prevention, awareness, assessment and adherence to chronic disease management; improve clinical trial literacy and participation among underserved communities; and create smart cities and homes through interconnected digital solutions.
“The MIL is an engine for change, driving new ways of learning, collaborating and investing in the emerging technologies, systems and solutions that will shape the future of health care for the benefit of all,” Dr. Seixas said. “The relationship between health care and technology is extraordinary, and we know relationships require work. I am grateful for the opportunity to work with experts at the Miller School and reimagine what a more accessible and equitable health care system looks like and what it can do for all.” 
