One Common Goal - Integrating Exposure Sciences through Total Exposure Health

摘要

Background: Total Exposure Health (TEH) is the Air Force Medical Service (AFMS) solution to capture workplace, environmental and lifestyle exposures to the individual using advances in science, technology and informatics to prevent disease, improve health and well-being, and develop precision health solutions through effective risk assessment, management and communication. Objectives: The Air Force Medical Service Strategic Vision seeks to ensure that its "supported population is the healthiest and highest performing segment of the U.S. by 2025." Achieving this vision will require a paradigm shift in military medicine from its usual primary focus on diagnosis of disease and injury and treatment. TEH is an approach to primary prevention and precision health that seeks to evaluate the totality of an individual's exposure history through risk assessment and integrate that with an individual's genetic makeup and clinical disposition, in order to understand the root causes of wellness as well as that of injury and disease through risk management but ultimately communicate that risk to the individual. Methods: We are at the intersection of healthcare and technology. Currently, we have the ability to collect more refined information on the individual based on their genetics, which allows us to focus on unique interventions that will lead to better well-being. We will discuss how TEH will partner across multiple program areas and integrate occupational, lifestyle, and environmental exposure data from traditional and new exposure assessment technologies (including sensors and "-omics" based molecular biology) with clinical and genomic data. As a developing healthcare infrastructure, we will also show how TEH will position "exposure scientists" to improve the patient/provider experience with a focus on individual exposures (unique and targeted) through proper risk communication, which is often forgotten. Results: These capabilities will inform strategies by reducing the health impacts of exposures, hence improving human performance, readiness, and the resiliency of all Airmen and their beneficiaries. Moreover, by educating individuals about their exposure profile, TEH will enable individuals and families to make healthy lifestyle choices and become proactive about their own health.