The 21st century presents numerous health challenges, such as population aging, increased prevalence of chronic diseases, as well as increasingly unhealthy lifestyles.
Most of the diagnostics and therapies in medicine today are one size fits all, which are ineffective for many of the patients and for the system. The personalised medicine (PM) approach for the prevention and treatment of diseases considers the biological, behavioural and environmental differences between individuals. By means of an elaborate analysis of big data, including clinical, genetic and imaging data, this approach may help understand the routes of many diseases, enable their early detection, facilitate administering the most effective therapy to each patient, thus by improving the chances for successful remedies and for saving lives, while decreasing the administration of superfluous treatments.
In Israel, with its excellent longitudinal retrospective electronic health records and well organised and centrally managed healthcare system, the conditions are ideal for implementing a PM approach.
The Israeli Ministry of Health, together with five other governmental organisations: the Israel Innovation Authority, the High Council of Education, Digital Israel Bureau, Ministry of Treasury and the Medical Corps, all agreed to establish and finance a new entity called “Mosaic”; an entity meant to serve the purposes of research and public health. The initiative, a world leader in this new era of biomedical science, was launched in March 2023 at the president`s house in Israel.
Mosaic, Psifas in Hebrew, is Israel's National Genomic Medicine Initiative developing a unique infrastructure for facilitating large scale prospective studies based on advanced integration of community and hospitals longitudinal retrospective clinical data, fully sequenced genomes and a platform for patient recall and follow up studies.
It is designed to collect health data and biological samples (for Whole Genome Sequencing) from hundreds of thousands of volunteers establishing a community of participants. The information obtained will accelerate the development of medical care specifically tailored to the diverse ethnicities that comprise the Israeli population.
Launching patient recruitment in Q1 2023, Psifas is planning recruitment of 60-80K patients annually with specific maladies such as liver disease, acute and chronic kidney disease, stroke, Psoriasis and Multiple Sclerosis and many additional medical conditions, such as Obesity with and without complications, Alzheimer's disease, and Sepsis in healthy people.
The plan is to use the Psifas platform to support several strategic prospective studies using the new infrastructure, to demonstrate the power of modern genomics and post-genomics technology on specific maladies with potential high impact.
The goals of the initiative are:
- Improve the health of all Israelis;
- Generate an innovative national infrastructure for promoting basic and translational genomic-clinic research in Israel's research institutes, health organisations and life science industry;
- Develop an enabling ecosystem for personalised medicine in Israel by creating synergy between the biomed industry, health organisations and the academia;
- Utilise the Psifas platform for recall and/or prospective studies focused on Psifas' consented patient populations.
Schematic Presentation of the Psifas Project
The vision of this sequencing-based initiative is not just another genome project, but rather the formation of a research and innovation platform that will enable scaling of new sequencing-based technologies in the real world.
Psifas is aiming at this vision, based upon the following foundations:
- Funding support by the government (80M USD), but recently (2021) outsourced to a non-profit-company.
- Strategic alliance of the major Israeli hospitals, Health Maintenance Organisations (HMO), academia and industry to build an efficient framework for innovation to enable the development of a personalised medicine ecosystem towards better treatments and prevention. Championing advanced molecular analysis of biosamples.
- Recruitment of hundreds of thousands of fully consented individuals. With informed consent, volunteers will provide access to their clinical data in the HMO and medical centres involved and give blood for Whole Genome Sequencing (WGS).
- Deploying massive clinical data layers based on modern existing Electronic Health Record (EHR) systems.
- Studying population diversity: Israel Reference Genome Study (IRGS) is already on its way, developing comprehensive germline genomic maps for 63 unique Israeli sub-populations.
- With the generous donation of the Adelis foundation, Psifas will employ advanced tools that were developed over the past 5 years by researchers in the Weizmann Institute of Science (WIS) through extensive work on complete data of 4.5M Israeli individuals, members of the Clalit HMO. Many classical gaps and confounders affecting more than 20 years retrospective EHR analysis and patient stratification were already effectively solved by the WIS scientists.
The Psifas initiative represents a formal Israeli agenda and is a part of a bigger program - the government's resolution no. 3709 to promote digital health as a growth engine and a means to improve health.