Redesigning Medicine from the Inside Out

Dr. Julie Chen on Systems-Based, Science-Led Care

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Sarah Pesce, Radence Chief Operating Officer

by Sarah Pesce

Chief Operating Officer, Radence

In today’s rapidly evolving medical landscape, physicians are increasingly called upon to balance innovation with evidence, patient expectations with system constraints, and emerging tools with deeply rooted traditions. For Dr. Julie Chen, a board-certified internal medicine specialist physician with fellowship training in integrative medicine with years of experience as a leader in genomic precision medicine — a specialty that focuses on the future of healthcare, reclaiming what medicine was always meant to be: comprehensive, compassionate, and grounded in science.

“We all went into medicine to help people heal,” said Dr. Chen. “But many of us find ourselves navigating systems that are optimized for disease management, not for prevention. That isn’t a personal failing. It’s a systems problem.”

Dr. Chen currently serves as Chief Medical Officer at Radence, a company pioneering a multimodal precision-based model of care. At its core, Radence seeks to identify and intervene on disease risk earlier than traditional models allow — not in response to pathology, but in anticipation of it.

“Most of what we see in chronic disease is not sudden,” Dr. Chen said. “It’s a long, progressive breakdown of physiologic resilience. Our job is to understand that trajectory and to act on it early, when the patient still feels ‘fine,’ but the biology is already shifting.”

Addressing the Limits of Traditional Care

Dr. Chen has tremendous respect for the goals of current conventional medicine. However, she sees it as incomplete.

“Our traditional system is remarkable at acute intervention,” she said. “But it’s less equipped to manage early disease interception of the slow-developing dysfunctions that characterize so many of our biggest health challenges — cancer, cardiovascular disease, neurodegeneration, metabolic dysfunction.”

She points to constraints many physicians know well: 15-minute visits, fragmented specialty care, limited tools for subclinical disease, and a reactive rather than predictive infrastructure.

“It’s not that doctors don’t care about prevention or early detection,” Dr. Chen said. “It’s that the system doesn’t always give them the time or tools to do it well.”

A Multimodal, Systems-Oriented Approach

What Radence offers is a framework to augment what clinicians are already doing. Its platform brings together genomics, imaging, metabolomics, advanced blood work, and wearable data to generate a comprehensive picture of an individual’s health trajectory.

“We use high-resolution tools to pick up signals that traditional workups might miss. But more importantly, we translate those findings into real-world decisions. We help people understand their risk and take steps to modify it,” Dr. Chen said.

That process is deeply collaborative. Radence doesn’t seek to replace a patient’s care team. It works in partnership with referring clinicians, offering extended assessments and evidence-based recommendations that complement existing care plans.

“This is not about displacing primary care or specialists. It’s about supporting them with another layer of data and insight,” Dr. Chen said. “We know that no one understands the patient better than their own doctor. Our role is to enhance that relationship, not compete with it.”

Precision without Elitism

One concern often raised about precision or concierge medicine is equity—that these models only serve the affluent. Dr. Chen sees this differently.

“Early adopters always pave the way for broader access,” Dr. Chen said. “Every major medical advance — from medications to whole-genome sequencing — started in specialized settings before becoming standard. What we’re building now will eventually become more scalable. But someone has to lead, and that’s where Radence comes in.”

To that end, the company is investing in outcomes research, clinical validation, and real-world evidence to support its protocols. “We’re not just innovating,” she said. “We’re validating. We’re contributing to the science so this model can expand.”

Data Alone is Not Enough

Despite Radence’s technological sophistication, Dr. Chen emphasizes that data is only as powerful as the context it’s given.

“We’re not just handing people dashboards,” she said. “We’re walking them through it. We pair high-resolution diagnostics with meaningful conversation. That’s where trust is built. That’s how change happens.”

The result is more than early detection testing. It’s engagement.

“When patients understand their physiology, when they see the why behind a recommendation, they are more likely to act,” Dr. Chen said. “We’re not just changing lab values. We’re changing behavior.”

Four Disease Domains, One Coordinated Strategy

Radence begins by focusing on the survival layer — the four disease categories responsible for the majority of premature mortality and morbidity: cancer, cardiovascular disease, metabolic dysfunction, and neurodegeneration. These are not isolated silos, Dr. Chen noted. They are deeply interconnected through shared pathways of inflammation, oxidative stress, metabolic regulation, and genetic risk.

“If you have insulin resistance, you’re not just at risk for diabetes. You’re at increased risk for dementia and cardiovascular disease,” she said. “We take a systems-level view of risk. That means we can intervene in ways that impact multiple domains simultaneously.”

From there, the platform expands to assess autoimmune risks, hormone regulation, immune function, and more.

“We meet the patient where they are, and then we grow with them,” Dr. Chen said. “It’s dynamic. It’s continuous. And it’s deeply personal.”

An Invitation to the Medical Community

For Dr. Chen, one of the most innovative aspects of Radence is the partnership.

“We want to work with clinicians who are curious, collaborative, and committed to pushing the standard of care forward,” Dr. Chen said. “Whether you’re a cardiologist, internist, neurologist, or family physician, there’s a place for you in this model. We need your insight. Your experience. Your trust.”

She knows that change is never easy, especially in a field as high-stakes and evidence-driven as medicine. But she also knows that physicians are problem-solvers.

“We’re not asking people to abandon conventional care,” Dr. Chen said. “We’re inviting them to build on it. To extend it. To make it better.”

In an era where both patients and clinicians are demanding more — more answers, more support, more continuity, Dr. Chen sees Radence as a blueprint for what’s possible.

“This is the future of care: science-led, system-aware, patient-centered, and clinician-empowering,” Dr. Chen said. “We’re not starting over. We’re starting ahead.”

Sarah Pesce

Chief Operating Officer, Radence

Sarah Pesce is the Chief Operating Officer at Radence. She previously served as COO of Thorne Lab, a division of Thorne HealthTech, where she led the development of a clinical platform offering a comprehensive, 360-degree view of individual health. Prior to Thorne, Sarah was COO of Lab100 at Mount Sinai Medical Center, where she shaped clinical operational strategies for advanced digital screening assessments. She also served as Senior Director of Business Development and Clinical Operations for Mount Sinai’s Executive Health Program and worked as Nurse Practitioner for Dr. Valentine Fuster, managing complex cardiology patients and launching impactful ambulatory programs.

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Understanding Atherosclerosis, Cardiovascular Disease, and Stroke Risk

Atherosclerosis is a condition that affects millions of people worldwide, often without warning. It plays a central role in the development of both heart disease and stroke, two of the leading causes of death and disability. Understanding what atherosclerosis is, who is most at risk, and the importance of early screening can significantly affect long-term health outcomes.

What is Atherosclerosis?

Atherosclerosis refers to the buildup of plaque, composed of cholesterol, fatty substances, calcium, and other materials, inside the walls of arteries. Over time, this buildup can narrow arteries and restrict blood flow to vital organs such as the heart and brain. If a plaque ruptures, it can trigger the formation of a blood clot, leading to a heart attack or stroke.

Often called a silent disease, atherosclerosis can develop slowly over many years without causing symptoms until a major cardiovascular event occurs.

Why is Atherosclerosis Important?

Atherosclerosis is the underlying cause of most cardiovascular (heart) and cerebrovascular (brain) events. Consider the following:

Heart disease remains the leading cause of death globally. This is the main reason why Radence is focused on it as a key area from the beginning. Stroke is the second leading cause of death worldwide and a major cause of long-term disability. The risk of confounding health issues after a stroke is multiplied. Many individuals with advanced atherosclerosis experience no symptoms until a heart attack or stroke happens. In fact, statistics from the Barnes-Jewish Hospital show that about 70% of people who have a stroke were asymptomatic before.

The ability to detect and manage atherosclerosis early can prevent these life-altering events and significantly improve both quality of life and longevity.

Who is Most at Risk?

Numerous dietary, lifestyle, and demographic factors can increase the likelihood of developing atherosclerosis, and here are some of the biggest influencers:

Diabetes High blood sugar can damage the inner layers of the arteries, leading to plaque buildup increasing risk for diabetes. Diabetes itself is a risk factor for numerous additional chronic diseases, including cardiovascular disease and stroke. Family History Genetics can raise your risk — especially if you have an inherited cholesterol disorder like familial hypercholesterolemia, which affects about 1 in 300 people. There are other important genetic predispositions Radence takes into account when assessing risk with a complete genetic profile. High Blood Pressure High blood pressure, or hypertension, quietly harms your body over time by damaging your arteries and helping plaque buildup, which can lead to heart attacks or strokes. It’s known as a silent risk factor because it usually has no symptoms, but it’s incredibly common. In fact, about 1 in 2 adults in the US has high blood pressure, often without realizing it. It’s the No. 1 controllable cause of death related to heart disease, which makes early detection and management especially important. Inflammation and Inflammatory Diseases Conditions like rheumatoid arthritis or psoriasis cause chronic inflammation that can injure blood vessels and promote plaque formation. People can still have uncontrolled inflammation from environmental, lifestyle, and biological factors too, from air pollution, chemical exposures, poor gut health, lack of quality sleep, processed sugars or low fiber intake — all contributing to persistent low-grade inflammation and increasing risk for heart disease. Lack of Physical Activity Sedentary lifestyles, like prolonged sitting, lack of purposeful movement, and loss of skeletal muscle mass are associated with unfavorable cholesterol profiles that contribute to atherosclerosis and cardiometabolic risk. Older Age Plaque buildup often begins in childhood and worsens with age. Risk increases in men after age 45 and in women around age 55 as estrogen levels decrease through menopause. Risk is also higher in younger women with endometriosis, polycystic ovary syndrome, gestational diabetes, or preeclampsia during pregnancy. Overweight or Obesity Obesity or carrying excessive weight in the abdomen is a metabolic and vascular disease accelerator and increases risk for heart disease and related conditions like type 2 diabetes and certain cancers. Statistics show nearly 3 in 4 adults (age 20+) in the US are overweight or obese. Obesity is starting at an earlier age too. Nearly 1 in 5 children and teens (ages 2–19) are considered obese, emphasizing the importance of early screening to avoid long-term consequences. Race and Ethnicity Race and ethnicity play a significant role in the risk for atherosclerotic cardiovascular disease (ASCVD), with certain populations experiencing a disproportionately higher prevalence of disease. Black or African American individuals in the US are at a 30% higher risk for hypertension, stroke, heart failure, and premature ASCVD compared to white individuals, often due to a combination of genetic susceptibility, socioeconomic factors, and reduced access to preventive care. Hispanic and South Asian populations also face elevated ASCVD risk, with South Asians demonstrating higher rates of insulin resistance, central obesity, and cholesterol abnormalities, often at lower BMI levels, contributing to earlier onset and more aggressive cardiovascular disease. Additionally, Native American and Alaska Native populations experience some of the highest rates of obesity, diabetes, and metabolic syndrome, all of which are potent drivers of ASCVD. These disparities underscore the need for personalized, culturally aware, and early prevention strategies tailored to high-risk racial and ethnic groups. Smoking and Secondhand Smoke About 1 in 3 coronary heart disease deaths are linked to smoking or secondhand smoke. Even exposure to secondhand smoke can contribute to atherosclerosis and stroke. Risk also increases with pack years, even if you haven’t smoked recently. Unhealthy Diet While certain foods may be helpful to minimize risk, other foods can play a role in increasing risk. High intake of saturated fats (from meat and full-fat dairy), when not part of a well-formulated diet, healthy weight, and exercise plan, raises cholesterol. Similarly, excessive alcohol or binge drinking can also elevate total cholesterol and impact inflammation markers.

Radence screens for atherosclerosis and cardiometabolic risk earlier and even in individuals considered low risk by these conventional standards because a significant proportion of disease develops silently and is often missed by traditional screening tools.

Symptoms: Often Absent Until Advanced Disease

Undetectable atherosclerosis, early signs of insulin resistance, and visceral adiposity can be present years before symptoms or abnormal labs emerge. Evidence shows that early vascular and metabolic changes can lead to irreversible damage if left unaddressed, and that intervening (with non-invasive modifications to diet and lifestyle) in these early stages and younger years dramatically reduces future cardiovascular events, stroke, and diabetes risk.

One of the challenges with atherosclerosis is that it frequently progresses unnoticed by simple point in time, single tests. When symptoms do arise, they can include:

Chest pain or discomfort (angina) including back, shoulder and neck and arm pain Shortness of breath Numbness, weakness, or paralysis (often on one side of the body, indicating stroke) Sudden difficulty speaking, seeing, or walking Feeling lightheaded or dizzy Heart palpitations Fatigue

By the time symptoms like chest pain or stroke occur, the disease is often advanced, more difficult to manage, and requires more invasive testing and interventions. Unfortunately, for many, the first sign of atherosclerosis could be a major cardiovascular or cerebrovascular event which can have profound consequences. Even individuals who feel healthy and have no symptoms may still be at elevated risk due to the environmental, demographic, and lifestyle factors.

The Role of Early Detection Screening

Early screening plays a critical role in identifying future risk for atherosclerosis and cardiometabolic dysfunction — often years before symptoms develop or a formal diagnosis is made. Atherosclerosis begins with inflammation, endothelial damage, lipid abnormalities, and insulin resistance progressively impairing vascular health.

Early detection enables early intervention, which can prevent irreversible vascular damage and reduce the lifetime risk of cardiovascular events, diabetes, and related diseases. Radence takes a proactive, precision-based approach that combines advanced imaging, metabolic biomarkers, and longitudinal monitoring to identify risk before it becomes clinically apparent. This enables timely lifestyle and therapeutic interventions that are more effective, less invasive, and ultimately help members maintain health span — not just lifespan.

Key findings support early screening using the comprehensive testing protocol that Radence recommends:

In research studies, 61% of individuals with “low risk” have atherosclerotic plaque identified via carotid ultrasound1. Ultrasound is a valuable, non-invasive test Radence uses as part of a multimodal approach to stratify a member’s health risk. Testing has been associated with significantly improved adherence to preventive treatments, including lifestyle changes and medication initiation.2 The ultimate goal is to prevent disease. Radence takes steps to help members change the trajectory of their health risk with proactive measures. Detecting plaque early can allow for more aggressive management of cholesterol, blood pressure, and other risk factors to prevent heart attacks and strokes before requiring invasive treatment. A member’s care plan is tailored to them. How to Reduce Your Risk

Atherosclerosis is a serious and progressive condition that is often undetectable without medical imaging. By recognizing personal risk factors, undergoing appropriate testing, and initiating preventive strategies early, Radence members can greatly reduce their risk of heart attack, stroke, and other complications.

At Radence, we are committed to proactive health management. Carotid ultrasound, blood work, genetics, body composition, and other gold-standard testing modalities are valuable components of a comprehensive approach to preserving cardiovascular and neurological health, providing invaluable data about your future.

No matter if you are asymptomatic, have risk factors, or wish to better understand your vascular health, Radence will help put you on a personalized data-driven path to proactive health.

Investing in prevention today can help safeguard your health for years to come.

Chen CH, Hung CL, Po HL, et al. Early detection of subclinical atherosclerosis in asymptomatic patients assessed by carotid duplex and coronary computed tomography. Int J Gerontol. 2013;7(1):27-34. Johnson HM, Turke TL, Grossklaus M, et al. Effects of an office-based carotid ultrasound screening intervention. J Am Soc Echocardiogr. 2011;24(7):738-747.

Defining the Radence Standard of Care

While the healthcare industry is often crowded with buzzwords, Radence is building something deeper, more rigorous, and far more human. At the heart of Radence’s model is early detection for disease interception and enduring support. The Radence journey is about creating a lifelong process of understanding, protecting, and optimizing the health of our members.

Led by Chief Medical Officer Dr. Julie Chen, Radence is defining a higher standard of care than anything else available today. She is a rising star in the field of health span extension through precision medicine in her approach to caring for members.

Beyond Access to Precision Care

Precision programs often involve many modalities and a great deal of data. At Radence, the bar is much higher. Our interpretation of precision medicine involves a multimodal approach, innovative tools, and high-quality data to provide actionable insight that can impact our members’ day-to-day quality of life.

“The beauty and artisanship of our approach lies in selecting the right tools to get an accurate picture of each individual from their health data and creating a highly personalized action plan tailored to each member,” said Dr. Julie Chen. “Providing precision data gives our members some control over their health span. It’s a partnership. Radence gives members clear data-driven guidance and recommendations for an optimized pathway to optimal outcomes. What matters most is the quality of what Radence members receive. From the clinical on-science precision of early detection testing to the accuracy of who our members truly are — that is what leads to reproducibility in our interpretations. Our care model is designed for scientific integrity at every level.”

Radence’s multimodal, multi-layered approach to early detection triangulates insights across tools, organ systems, and time, she explained. “It’s about doing the right tests, not over testing. Quality vs. Quantity,” Dr. Chen said. “It’s about building a more complete picture of your health and reducing the chance of false positives or false negatives that could lead to either unnecessary panic or missed opportunity.”

“While there is significant value in having data, there is an intentional approach to why we gather that data and what we do with it,” she said. “It’s aligned with desired outcomes and personal goals. This is not about gathering random data. The how and the what are based on the why, based on each person’s intentions, goals, and risk factors. That makes it personalized.”

We Walk with You

At Radence, we walk with you. We use what we learn to create a mutual understanding of your health at a cellular level.

“Health is a moving target,” Dr. Chen said. “Diseases evolve. Physiology changes. We grow with our members, so we can see how their bodies are evolving, whether they’re moving toward disease or away from it.”

This continuous relationship enables Radence to detect small shifts that might otherwise be missed. “Our longitudinal approach isn’t just about diagnostics. It’s about building a true health partnership,” she said. “One that is alert, adaptive, and deeply informed.”

The Human Lens

While Radence focuses on science and personalized precision care, what truly guides this innovative model is something deeply human: care as if you’re family.

“When I meet one-on-one with our members, I always ask myself: ‘If this was my parent, my child, my best friend — how would I approach this?’ That’s the lens we bring to every decision,” said Dr. Chen. “Every clinician at Radence is trained not only in the protocols and tools, but in this philosophy. It’s not enough to be highly skilled. Our providers must be deeply invested. If they’re not doing that, they’re not part of Radence.”

The Discipline of Iteration

Medicine moves fast — and Radence does more than keep pace. We lead.

The Radence model is built to never stand still. Whether it’s adding new genes to a genomic panel after just one insight or reevaluating a testing protocol after a single ambiguous case, our clinical team is in constant conversation about continuous improvement.

“There is no static,” Dr. Chen said. “If I don’t like what I’m seeing in a meeting, we iterate. Immediately.”

This commitment to refinement is part of what makes Radence unique.

“We aren’t simply offering what’s available, we are building what should exist,” she said. “Every encounter, every report, every protocol is held to a higher standard, constantly evaluated and pressure tested, focused on the drive to be the best and deliver the best. Always.”

A Curated Experience Rooted in Science

Consistency is not a luxury. It’s a clinical imperative for Dr. Chen and her team at Radence. From the quality of imaging machines to the communication style of our clinicians, Radence is working to ensure that every touchpoint delivers the same level of excellence.

“Whether you’re speaking to a radiologist, internist, or nurse practitioner, you are engaging with one unified standard of care. That level of consistency is rare. And it’s intentional,” Dr. Chen said.

Innovative Care, Rooted in Love

“Radence is not just a system. It’s a mindset. A culture of care rooted in curiosity, rigor, and love. Our members are not patients, they are part of the Radence family,” Dr. Chen said.

To care for someone as if they are family is a high bar.

“It means we don’t accept good enough. It means we question everything. And it means that we are always watching, learning, evolving — so that we can see the stumble before it happens,” Dr. Chen said. “That’s the Radence Standard of Care.”