Eric Elster, MD, FACS, FRCSEng (Hon.) CAPT, MC, USN (Ret.)
Dean, School of Medicine Uniformed Services University / WRNMMC
Col Churchill was a leader in military medicine. He was a surgeon, military officer, and innovator. He strived to bridge the gap in academic medicine. At the Uniformed Services University we are continuing his legacy by building military/civilian partnerships and bringing precision medicine into the future of surgical care.
The Uniformed Services University’s (USU) Surgical Critical Care Initiative (SC2i) was formed in 2013. We are advancing precision medicine for surgical critical care and implementing insights into improvements for clinical practice in both military and civilian healthcare. SC2i is a consortium of 7 federal and non-federal institutions, including Walter Reed National Medical Military Center, USU, Naval Medical Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Duke University, Emory University, and Decision Q Corporation.
Precision medicine (PM) combines patient specific medical information with advanced computer analytics to assist with complex, time-sensitive decisions for improving individualized care. PM improves diagnoses, mitigates adverse events, and reduces the length of hospital stays and rehabilitation times; patient outcomes and quality of life are improved, while healthcare costs are decreased.
The challenge is identifying the specific clinical and biomarker data to drive artificial intelligence (machine learning) algorithms and deliver the right care to the right patient at the right time. SC2i is enrolling patients, collecting medical data, collecting specimens, performing a wide variety of molecular assays, and leveraging complex data sets to develop clinical decision support systems (CDSS) that transform patient care. By identifying differentially expressed genes, examining inflammatory protein expression profiles, and building models to identify the most relevant predictors, SC2i has developed and deployed two tools into hospitals, with nine others in development.
Our current CDSS, WounDx™, allows a surgeon to use an individual patient’s biological response to injury to improve the fidelity of decisions, rather than solely rely on visually guided judgments and clinical experience. This will decrease rates of wound failure, infections, and other complications of recovery.
