Biology Reference
In-Depth Information
TWO BIG CHALLENGES: EDUCATION
AND INFORMATION TECHNOLOGY
FOR HEALTHCARE
One big challenge for P4 medicine is the education of
consumers, patients, physicians, and the members of the
broader medical community, including the principal
stakeholders in the healthcare industry. This education will
present an enormous challenge and will ultimately require
the effective exploitation of social networks for education
integrated with new effective information technology
teaching strategies. Many individuals will initially want to
remain 'old-fashioned patients' letting the doctor tell them
what is best. However, once individuals see the power of
consumer-driven medicine to improve individual health,
that will change (just as skepticism has disappeared with
the widespread acceptance of cell phones).
The Institute for Systems Biology has successfully
developed modules for teaching systems biology to insert
leading-edge biology into high-school biology courses, and
is currently developing similar modules for P4 medicine.
Early education of consumers/patients is key. Another
interesting idea is the suggestion that there be a commercial
TV program, hopefully with very broad coverage, along the
lines of the forensic CSI TV program to explore solving the
problems of P4 medicine in a well-written and compelling
manner that brings a knowledge of P4 medicine to the
average viewer, just as CSI has brought insights in crime
forensics to a broad audience. Another possibility is that
one could use computer-game-like strategies to bring the
principles of P4 medicine to patients, physicians and
members of the healthcare community
cloud at the heart of P4 medicine. Yet that is what is
required, and an effectively orchestrated open-source
approach could transform IT for healthcare. We must be
able to capture the deep insights that will come from
various patient social networks.
IMPACT OF P4 MEDICINE ON SOCIETY
P4 medicine will have an enormous impact on society and
healthcare.
1.
P4 medicine will transform the practice of healthcare in
virtually every way. Table 23.2 provides a summary of
some of the powerful new strategies and technologies
P4 medicine will create and employ.
2.
P4 medicine will require that all healthcare companies
rewrite their business plans in the next 10 years or so.
Many will not be able to do so and will become
'industrial dinosaurs'. There will be enormous
economic opportunities for the emergence of new
companies tailored to the needs and opportunities of P4
medicine.
3.
P4 medicine will at some time in the future turn around
the ever-escalating costs of healthcare and will in fact
reduce these costs to the point where P4 medicine can
be exported to the developing world, enabling
a 'democratization of healthcare' unimaginable even 5
years ago. These savings will arise from many of the
features described in Table 23.2: the early diagnosis and
hence more effective treatment of disease; the stratifi-
cation of each major disease into its major subtypes to
achieve a proper impedance match for each individual
against a drug effective for a particular subtype of
disease; the ability to identify genetic variants that
cause drugs to be metabolized in a manner dangerous to
the patient (this is termed pharmacogenomics, and more
than 50 such variants have been identified to date); the
ability to 're-engineer' disease-perturbed networks with
drugs to generate a powerful and less-expensive ratio-
nale for drug-target selection; an increasing focus on
wellness for each individual; and the emergence of
striking near-term advances in modern medicine. These
include an increasing ability to deal effectively with
cancer, and to use stem cells for replacement therapy.
Additionally, these advances will lead to new
approaches to diagnostics and understanding disease
mechanisms, an understanding of aging that will allow
individuals to optimize and extend their effective
mental and physical health routinely into their 80s and
90s, an understanding of the metagenome (e.g., pop-
ulation of microbes) of the gut and other body surfaces
that will provide deep insights into one incredibly
important manner in which the microbes of our envi-
ronment influence our health, and finally the emergence
at least for those
who are comfortable with the digital revolution.
Another challenge is how to produce an information
technology (IT) for healthcare that can handle the enor-
mous multi-scale data dimensionality that will arise from
P4 medicine
e
for in the end P4 medicine is defined by the
interconnected 'network of networks'
e
genetic networks
connected to molecular networks, to cellular networks, to
organ networks, to the networks of individuals in society,
for each provide unique insights into the complexities of
disease (
Figure 23.4
). We must understand the individual in
the context of all of these integrated networks, as this is the
only way to capture both the digital information of the
genome and all of the diverse environmental signals
impinging on the individual from many different sources.
This requirement places enormous demands on the need to
develop an effective IT for healthcare. Healthcare IT must
be comprehensive, interoperable, data-driven (e.g., bottom-
up), biology-driven and, we believe, fundamentally open
source. It is probably beyond the capacity of any single
organization to fashion a comprehensive IT for healthcare
that goes beyond medical records to encompass the
collection and distribution of the entire heterogeneous data
e
