 And joining us now to talk about your health or Dr. Alan Schuldiner, the Associate Dean for Personalized and Genomic Medicine at the University of Maryland School of Medicine, and Dihwan Nwaba, Clinical Research Coordinator for the Maryland Precision Medicine Research Study. Thanks to both of you for joining us, Dr. You're the co-lead on this study, so tell us about it. That's correct. This is called the My Healthy Maryland Precision Medicine Research Program, and it's one of the largest, if not the largest study ever done in the state of Maryland, and maybe one of the largest in the U.S. The overall goal of the My Healthy Maryland Project is to improve the health of Marylanders all over the state, and to do that through research and ultimately the implementation of precision medicine into routine health care practice in our state. Precision medicine sounds a little bit painful. There's no pain involved in this, right? No pain. In fact, it's one of the easiest studies that one can enroll in. We hope to enroll up to 250,000 Marylanders over the course of the next several years. So of course, it has to be relatively painless if we're going to enroll that number of individuals. And as you'll hear, this can all be done online or with a mobile phone. And ultimately, we hope that these 250,000 individuals will be engaged and available for research for years to come. Ms. Enwaba, who can participate and how can someone participate? So anyone who is a Maryland resident over the age of 18 can participate in the study, and so the study consists of going online and creating an account and doing the consent itself paced. And there are a few surveys to complete as well. And then we also ask for a sample, which is a cheek swab sample. And you can't do that through your phone, so how is that transported? So our research team will see who has completed consent and completed their surveys. And then we will mail out a sample collection kit to the participant. You know, minority group members are often underrepresented in a variety of medical studies. What are you doing to avoid that in this case? Well, we do know that historically there has been a lack of trust of medical research in minority populations. And so we try to make an effort to rebuild relationships in minority communities by just being visible places like health fairs, farmers markets, church-sponsored events in order to build rapport and trust. Furthermore, we have a community advisory committee that gives us great advice on ways to engage the community. Doctor, what are the potential benefits for people who choose to participate? Well, as I mentioned, the My Healthy Maryland study is one of the largest ever conducted. In some ways it's sort of thousands of studies all in one, rather than researching one particular disease and having another study that researches another disease. My Healthy Maryland project is what we call disease agnostic. Anyone can join. Healthy people who don't have any issues or health problems. And the idea here is that these individuals will engage in research and there's a certain altruistic nature to knowing that you're a part of something big and helping mankind. In addition, though, as we gather more and more information and more and more data as the My Healthy Maryland project proceeds, we expect to be able to provide back to participants information about general health as well as at the end of the day information about their individual health, including, for example, genetic information or other information that might help them prevent or better treat disease. What specifically are you looking for? Are there certain genes when the swab comes in that you're most focused on? Well, My Healthy Maryland project is much more than just genes and genetics. In fact, precision medicine is a field where you take all sorts of information and combine that information in various ways, analyze it in various ways to become smarter about how a particular patient might be susceptible to a disease so that it can be prevented or diagnosed earlier and, of course, treated more effectively. So we will utilize survey information, such as the online surveys about health that Devan mentioned. We're also going to utilize electronic health record data from the participant, hundreds of thousands of participants, and also from the cheek swab, we will be able to obtain genetic information and combine all of that information together to better understand human health and disease, and also, in a particular individual, their susceptibility to disorders to maintain their health. Also information that potentially can allow us to predict which medications would be best for a given individual. Do you expect to be able to reach out to people to say, we noticed something? We looked at the information about your lifestyle, we looked at your medical record, we looked at genetic exam, and there's something here that needs attention. Is that going to happen? Yes, it will. That's the goal of the My Healthy Maryland project is to engage participants over years and even decades to come. Participants will have the option to participate in different parts of the study. So it's totally in the hands of participants as to whether they want to participate in, say, a diabetes study or a cancer study or other studies, and whether they really want that information returned to them or not. So it's always the choice of the participant as to what information they would have returned. I wonder if the genetic component to it might give some people pause. I mean, there's fear about what would happen to information. If somebody has the breast cancer genes or well known, and I don't know what the legal status is of the ability of, say, a health insurance company, a life insurance company, disability to look at that data and re-rate somebody to charge them more or deny coverage based on the gene, how would you answer that concern? Well for one thing, this is a research study and the data that we produce, including the genetic data, is kept in very secure environment, computer environments that are password protected, dual authorization, and the like. So there is always that very small risk that a database, any database, can be hacked and that the data can fall into the hands of others. But a very low risk since we have very tight data security measures in place. And in terms of knowing or learning about a gene that may predispose the disease, it's a risk benefit proposition, isn't it? If we can learn something about our genes that will help us prevent or delay disease, of course that's a big positive. And there are laws, actually, federal laws that protect genetic information from being used incorrectly. Those laws cannot be, state that genetic information cannot be used, for example, to deny a person from getting health insurance. It falls short of some other issues, such as life insurance, as you mentioned. But there are federal laws that protect individuals from, as it's called, genetic discrimination. Devon, when you're talking to people about this, what sort of concerns have you heard and how do you respond to those? So I have heard people talk about concerns about their genetic information and we do let them know. It's spelled out in the consent, the ways that we try to protect participants' confidentiality. We have a certificate of confidentiality that we've obtained from the NIH. And as Dr. Scholdinger says, we have all of our information in very secure databases. So we try to reduce any concern in that way. What are you asking in terms of lifestyle information, exercise, diet, that sort of thing? Yes, that sort of thing, smoking, history, just basic lifestyle behaviors that may or may not have influence on health outcomes. Dr. the cool thing here is that this is a window into what medicine might look like a generation from now, isn't it? I think you're right. And when I was driving up here for this interview today, I was thinking about Dr. Spock in Star Trek. And as you know, when a person was ill, he thought about that when you were in traffic on the subway, thinking I wish I could beam myself into the studio. It's not the beaming piece. Go ahead. I had that little transducer, right, that he would hold over a person and within a few seconds know an awful lot about that particular individual. I would guess that that transducer was a supercomputer that had and was obtaining all sorts of information about that individual, but not just that individual, all of the electronic health record data of thousands, even hundreds of thousands of individuals. And it's that information that that transducer was able to make the right diagnosis and precision treatment. Where will that happen first? What field of medicine do you think that vision will first be realized? Yes. In some ways, precision medicine is advancing at different rates in different fields. And I would say that probably the field of cancer is now the most advanced in application of precision medicine. As you know, people can be screened for genes that might predispose them to things like breast cancer or colon cancer. And also from biopsy tissue from the cancers, physicians can actually predict which medications might be better for a given cancer in a given individual. We hope that we can do that for all diseases in the future so that we can keep people healthy. And even with where we stand in medicine today, you would argue that knowing is better than not knowing. If you get some genetic information that maybe there's a colon cancer risk, you can affirmatively do something about it. Well, that's correct. But it's always the choice of each individual as to whether they want that information or not. I personally would opt to have that information because I think that information can be very useful. It's very actionable. And it's more important, in my view, to prevent disease or at least delay disease so that the morbidity and mortality, particularly of chronic diseases that occur later in age, can be curtailed. Devon, if people want to learn more about this, if they want to consider enrolling, I have a web address of myhealthymaryland.org. How can people learn more? So the website is MarylandPrecisionHealth.org, and we have flyers that we post all around. We have advertisements that we are getting ready to put on Facebook. We have a website, of course, the website that you can learn more about it. And if you have questions, we have a link to the full consent so you can be able to see the consent, see if it's something that you want to do. We also have our coordinators as a resource who can answer questions. So any of these ways are work out. And we're always trying to be in the community. So if you see us, then we're happy to answer any questions. And we also have an app. Of course, my Healthy Maryland, you can download the app from the Apple Store or any other store that you download apps from. Perfect. Dr. Shaldinar Misha and Wabba, thank you both for your time. You're most welcome, thank you. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.