William N. Hait (B.H.) is the global head of Johnson & Johnson External Innovation. He spoke to Scientific American Custom Media (SACM) about how humans might one day maintain their bodies as they do their cars today—and why we should look forward to that future.
SACM: You once said, “Imagine the human of the future will be more like our cars today.” What did you mean?
B.H.: When a car rolls off the assembly line, it comes equipped with numerous sensors that constantly monitor its health. If a component begins to drift out of spec, the check-engine light comes on and you take the car to the shop, where the data from the sensors are downloaded into a computer that recommends an adjustment before the car breaks down. Our cars enjoy a level of prevention and healthcare today that we should strive to achieve for humans in the future.
SACM: How does your car analogy relate to specific elements of healthcare?
B.H.: At Johnson & Johnson, we strive to eliminate disease through prevention, disease interception and cures. Today, we are beginning to understand each individual’s specs — that is, the diseases to which a person is susceptible. In the future, we too will be surrounded with sensors — wearables, implantables, et cetera — that continuously monitor our major components. And when we begin to go out of spec, our check engine light will come on and the data from our sensors will be downloaded into a computer that will recommend adjustments in diet, activities and medications before we break down with a disease.
SACM: Of these three concepts — prevention, interception and cure — where are we the closest and where do we have to the most work to do?
B.H.: With some areas, such as infectious diseases, we have seen major advances in prevention and cures. In fact, the cure of Hepatitis C will intercept many cases of liver cancer. But many major killers, like lung cancer or Alzheimer’s disease, represent huge unmet needs. These are complex illnesses where the causes are not always known. In addition, we must gain a clearer understanding of the individuals at greatest risk, so that prevention and interception will achieve the appropriate risk:benefit ratio.
SACM: When do you think that your car analogy could turn into healthcare reality?
B.H.: Monitors are not new. For example, implantable devices are available for patients with cardiac arrhythmias. These implantables not only monitor cardiac rate and rhythm, but can deliver a therapeutic shock to convert a serious arrhythmia back into a healthy state. Vaccines to prevent infectious diseases are in widespread use for an ever greater number of infectious agents. Statins intercept the disease-causing process of atherogenesis linked to hypercholesterolemia. The challenge is to apply this approach broadly. We need to increase our investment in prevention and interception, as we focus treatments on curing in addition to managing the morbidities of disease.